infection control
Establishing and Maintaining a Sterile Field
A sterile field is a work area kept free of microorganisms for a procedure that breaks the skin, so only sterile things may touch it.
14 steps6 criticalLimit 5 minAlways tested
Steps
- 1Check the order and policy for a sterile field, and tell the patient how to help: lie still, do not talk over the field and do not touch sterile objects
- 2Critical stepPerform hand hygiene, gather all supplies, and check that equipment is sterile
- 3Check every package for damage, moisture, holes or tears, expiry date and the right indicator color; do not use it if anything is wrong
- 4Disinfect the work surface and let it dry completely, then place the package on it at waist level
- 5Critical stepRemove and discard the outer wrapper, and open the field as close to the time of the procedure as possible
- 6Critical stepOpen the first flap away from your body, touching only the very edge, with your arm not over the field
- 7Critical stepOpen the side flaps one at a time with one hand, keeping your body and arms off the field and not letting a flap flip back onto it
- 8Open the last flap toward you, keeping every part of your body off the field, and lay it flat
- 9Treat the outer 1 inch of the field as contaminated, and place items inside it
- 10Add sterile items by peeling or opening the package and dropping them gently onto the field without touching the packaging or border; have a second person in sterile gloves handle heavy items
- 11If solution is needed, pour sealed, unexpired sterile solution into a sterile bowl from the side of the field, without splashing
- 12Critical stepPut on sterile gloves away from the sterile field, if the procedure needs them
- 13Critical stepKeep the field in view and between waist and shoulder level; do not turn away from it or leave the room
- 14Do not use any item that falls below waist level, touches the border, gets wet or touches something non-sterile; replace it
What graders are watching for
Tips
- Contaminated zones: the outer 1 inch of the field, anything below waist level or above shoulder level, and anything you have not been watching.
- Moisture wicks contamination into a sterile field, so use a dry surface, avoid splashing, and do not use a package or field that is wet.
- Sterile gloves may come inside the kit, and they are put on away from the sterile field so they cannot touch it.
Common mistakes
- Setting the package on a damp surface so moisture wicks contamination into the field.
- Reaching over the field to open a flap, so your arm is above sterile contents.
- Letting an item touch the outside of its package or the former seal while adding it.
- Turning away or leaving the room and then using the field anyway.
Practice this skill
Practise the sequence with critical-step highlighting and a rationale for each step.
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Sources and how we check them: How we verify.