Professional Documents
Culture Documents
Learning Objectives
Be able to state the requirements for clean, aseptic or sterile technique recommended for common procedures Demonstrate use of the SCRIPT method to prepare for and carry out procedures
Be able to demonstrate aseptic and sterile technique for 4 procedures
Slide 2
The goal is to reduce health care-associated infections that occur when staff spread microbes to patients Germs move to patients from hands, and from objects used for patient care
Use of clean, aseptic or sterile technique reduces the number of germs transferred and thus, reduces the risk of infection
Slide 3
Clean technique refers to the use of routine hand washing, hand drying and use of non-sterile gloves
Slide 4
Clean Technique
Use clean technique if staff or objects will touch intact skin, intact mucous membranes or dirty (contaminated) items
Slide 5
Slide 6
Acts done to patients that come in contact with the wounds, blood stream, the inside of the body, or normally sterile parts of the body Remember invasive procedures invade the inside of the body
Slide 7
Antiseptic hand hygiene (alcohol, betadine or chlorhexidine) Usually sterile gloves Antiseptic (e.g alcohol) on patients skin Use of clean, dedicated area
Slide 8
Aseptic Technique
Use aseptic technique for brief invasive procedures that may break skin or mucous membranes, or normally sterile parts of the body
Example: placing a urinary catheter, suctioning, placing an IV, emptying a ICD drain
Slide 9
Surgical hand rub with long acting antiseptic Hands dried with sterile towels Sterile field Sterile gown, mask Sterile gloves Sterile supplies Skin prep A dedicated room
Slide 10
Sterile Technique
Use during surgery and for invasive procedures with high rates of infection
Examples:
Any long invasive procedure Placement of central lines and thoracic lines
Slide 11
Slide 12
Clean
Procedure space On ward or at beside
Aseptic
Dedicated area
Sterile
Dedicated room
Gloves
Hand hygiene before the procedures
Clean or none
Routine
Sterile
Aseptic, e.g. alcohol
Sterile surgical
Surgical scrub Iodophors, chlorheximide Long acting agent Yes
No No
Alcohol No*
No
No
Yes
Increase the level of technique from clean to aseptic, or aseptic to sterile if nosocomial infections persist
Slide 14
Matching procedures to the kind of technique required Objective: to discuss measures currently done, and to discuss current recommendations
Slide 15
To Prevent Contamination
Keep clean, dirty, and sterile items separate:
Only put sterile items in a sterile field Change gloves and wash hands if going from a contaminated act to a aseptic or sterile act Time skin antisepsis and surgical hand hand hygiene with a clock The sterile field is considered sterile except for the 2.5 cm border Wet items are considered contaminated
Slide 16
Use the S.C.R.I.P.T. reminder to plan Visualise every step in advance, to make sure supplies are available
Slide 17
S.C.R.I.P.T Procedures
Should the procedure be done in a dedicated room or space? Who will ensure that all visible dirt is removed form the space ahead of time, and surfaces disinfected if necessary?
Slide 19
Work flow: can staff move from hand washing to hand drying to separate clean and sterile areas without passing or touching contaminated areas? Where will used instruments and specimens be placed?
Slide 20
All team members should be clear on who should be using clean, aseptic or sterile technique and what elements are intended Example: a physician places a thoracic drain with sterile technique,the nurse assisting uses clean technique, and the person who empties the drain in subsequent days uses aseptic technique
Slide 21
Slide 22
Slide 23
Prepare in advance for the type of hand hygiene that is necessary Arrange the supplies including hand drying towels, as appropriate
Slide 24
These may include aprons, shoe covers for bloody procedures, masks, hair coverings, face shields or goggles
Slide 25
Trash
Plan appropriate leak proof, puncture proof containers for the transfer and disposal of sharps, infectious waste, and specimens Sharps containers should be moved to the point of use so sharps can be discarded by the original team and not left for later staff to find and discard
Slide 26
Summary
Slide 27
Team
Script
Assign roles and demonstrate procedure Assign observers who note contamination
Slide 28
Break