ASSISTED GOWNING & GLOVING PROCEDURE

Presented by: CARMINA FELISILDA- GURREA, RN

ASEPTIC TECHNIQUE: PRINCIPLES AND PRACTICES

Surgical site infections (SSIs) are the second to third most common site of health care associated infections (HAIs).

These complications of surgical procedures cause considerable morbidity and, when these occur deep at the site of the procedure, can carry mortality as high as 77%.

There are several key steps or “chains” that have to be connected to result in infection.

However, for SSIs, the initial introduction of microbial pathogens occurs most often during the surgical procedure performed in the Operating Theatre (OT).

The basis for all infection-free surgery is founded on the principles of basic aseptic technique.

Aseptic technique is a group of procedures that prevent contamination of microorganisms through the knowledge and principles contain and control.

Principles of Aseptic Technique

All items used within a sterile field must be sterile. A sterile barrier that has been permeated must be

considered contaminated. The edges of a sterile wrapper or container are considered

unsterile once the package is opened. Gowns are considered sterile in front, from shoulder to table

level, and the sleeves to 2 inches above the elbow. Tables are sterile at table level only Sterile persons and items touch only sterile areas; unsterile

persons and items touch only unsterile areas. Movement within or around a sterile field must not

contaminate the field. All items and areas of doubtful sterility are considered

contaminated.

RECOMMENDED PRACTICES FOR BASIC ASEPTIC

TECHNIQUE RECOMMENDED PRACTICE I Scrubbed persons should wear sterile gowns and gloves

RECOMMENDED PRACTICE II Sterile drapes should be used to establish a sterile field

RECOMMENDED PRACTICE III All items used within a sterile field should be sterile.

RECOMMENDED PRACTICE IV All items introduced into a sterile field should be dispensed by

methods that maintain sterility of the item and integrity of the sterile field.

RECOMMENDED PRACTICE V A sterile field should be constantly monitored and maintained

USE OF BACTERIAL BARRIERS

Minimizes a patient’s exposure to microorganisms that might be shed from the skin, mucous membranes, or hair of surgical team members

Protects surgical team members from exposure to blood and to blood-borne pathogens.

Surgical attire can include such as items as sterile gloves, caps, masks, gowns or waterproof aprons, and protective eyewear.

To maintain the sterile field, guidelines for the sterility of the gown have been established:

The gown is considered sterile in front from chest to the level of the sterile field.

The sleeves are considered sterile from 2” above the elbow to the stockinette cuff, and therefore the cuff must be covered at all times, by sterile gloves.

The areas not considered sterile, for various monitoring reasons, include the neckline, shoulders, areas under the arms, and the back of the gown.

To preserve the sterility of the gloved hands, they should be kept within the sterile boundary of the gown, and since the axillary region is not sterile, the arms should never be crossed with hands positioned into the axilla.

Should either of these barriers be compromised, they must be discarded, and a new gown, gloves or both be applied, depending on the nature of the break in aseptic technique.