This document provides guidelines for maintaining sterility and proper sterile technique. It discusses how scrubbed personnel should maintain sterility within the sterile field by performing proper hand washing and donning sterile gloves. It also outlines how to ensure sterility of packages and items by handling them with clean dry hands and surfaces. Specific rules are defined for establishing and maintaining boundaries of the sterile field, and how scrubbed and unscrubbed team members should interact within the sterile field. Proper procedures are described for passing items, working with tables and drapes, and addressing any breaks in sterile technique.

1. ORPs Educational Programme
Remember: It’s either sterile or it is not!
SCRUBBED PERSONNEL
 Scrubbed persons should function within a sterile field.
 Before putting on gloves (and gown, if needed) surgical hand sepsis should be
performed.
 Surgical hand antisepsis decreases microbial counts on the skin and decreases
transfer of microorganisms
ENSURING STERILITY
 Sterile goods are stored in clean, dry areas.
 Sterile items are handled with clean, dry hands.
 Sterile packages are laid on dry surfaces.
 If a sterile package becomes damp or wet, it is considered nonsterile and therefore,
cannot be used.
STERILE PACKAGING
 The integrity of a sterile package or sterile drape is destroyed by perforation,
puncture, or strike through.
 Strike-through is the soaking of moisture through nonsterile layers to sterile
layers or vice versa.
 Package expiration date for sterility must be checked just prior to opening it.
DEFINING THE STERILE FIELD
 It is not easy to define the boundaries between sterile and nonsterile areas;
therefore, the following precautions should be taken:
 In opening sterile packages, a margin of safety is always maintained.
 The LAST flap is pulled TOWARD the person opening the package, away
from the non-sterile hand.
 Flaps on peel-open packages should be pulled back, not torn, to expose
sterile contents: Contents should be flipped or lifted upwards, and not
permitted to slide over the edges.
 Only the interior and surface levels of the cover are considered sterile.
SCRUBBED VS. UNSCRUBBED
TEAM MEMBERS
Presentation : STERILE TECHNIQUE
Fascinator : SAMUEL DENIAL
Date of Presentation : February 09, 2013
Day & Time : Saturday @ 08:30 am

2.  Supplies for scrubbed personnel: obtain sterile items by opening them onto the
sterile field before donning sterile gloves or with assistance from a uncurbed team
member.
 Team members who are not scrubbed should face the sterile field on approach, not
walk between two sterile fields, and maintain a safety margin of at least six
inches.
(PAGE # 02)
TEAM MEMBERS
 Uncurbed people NEVER reach over a sterile field to transfer sterile items.
 When pouring solutions into a sterile basin, the assistant holds only the lip of the
bottle over the basin, to avoid reaching over a sterile area.
 The scrubbed person sets cups or basins, to be filled, at the edge of the sterile
table. The assistant stands near this edge of the table to fill them.
RULES FOR PASSING
 Uncurbed personnel face and observe a sterile area when passing it to ensure they
do not touch it.
TABLES
 Only the top of a sterile, draped table is considered sterile.
 The edges and sides of the drape extending below the table level are considerer
unsterile.
 Anything that drops below the level of the table surface is considered unsterile
and must be discarded.
BREAK IN STERILE TECHNIQUE
 Corrective action should occur immediately unless patient safety is compromised.
 If patient is at risk, correct the break in technique as soon as possible.
 Each institution should determine how break in technique should be reported and
recorded, and the wound classification should be adjusted accordingly and
documented in the record.
AORN (ASSOCIATION OF OPERATING ROOM NURSES)
RECOMMENDED PRACTICES FOR MAINTAINING A STERILE FIELD
I. Scrubbed persons should function within a sterile field.
II. Sterile drapes should be used to establish a sterile field.
III. Items should be used within the sterile field should be sterile.
IV. All items introduced to a sterile field should be opened, dispensed, and
transferred by methods that maintain sterility & integrity
V. A sterile field should be maintained & monitored constantly
VI. A sterile field should be maintained & monitored constantly

3. VII. All personnel moving within or around a sterile field should do so in a manner
that maintains the sterile field.
VIII. P&P’s for maintaining a sterile field should be developed, reviewed periodically,
revised as necessary, and readily available in the practice setting.
Association of Operating Room Nurses (2006). AORN, 83(2),402-416
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