| Procedure-2 Basic procedures of aseptic technique Assessing 1. Sterile items: check the sterilization dates of sterile items and the number of gloves, check the color of indicator tape being in the presence of or absence of change. 2. Environment: environment being in the presence or absence of clean, dry and spacious. 3. Equipment: the equipment being in the presence of or absence of meeting demand for the procedure, in good order and match the principles of procedures of aseptic technique. Planning 1. Expected objectives: (1) Finish the procedure in the given time correctly. (2) Match the principles of procedures of aseptic technique. 2. Preparing: (1) The nurse: the unit, cap, shoes and mawww.med126.com/wsj/sk, wash your hands and file nails. (2) Assemble equipment: a sterile container and sterile forceps, a cup with sterile gauzes, swabs, disinfectants, a bottle of sterile solution, a sterile package, a sterile bowel, a bunker containing sterile articles, a pair of sterile gloves, a curved basin, a pen and paper, small bowels, two clean tray. (3) Assemble equipment shall be arranged according to used order and meet convenient principles. (4) Environment: the place for the sterile procedure should be clean, dry, spacious, avoid sweeping the floor before the sterile procedure for 30minutes and avoid unnecessary people coming and going. Action 1. Recheck the sterilization dates and effects of the sterile articles. 2. Pick up the sterile package, untie the tape and roll it below the package. Open the flap, the farthest from the nurse comes first, then open the side flaps, and at last open the nearest flap from the nurse. Check the disinfected indicator, hold a sterile drape with the sterile forceps, and place it on one hand and return the sterile forceps to the sterile container. Close the cover by touching only the outer of the package and reverse the opening order. 3. Applying the sterile treatment tray with one drape. (1) Hold the outer surface of drape at two corners with both hands, gently open and place the drape with double folds in the tray. Hold the outer surface of the upper layer of the drape at two corners with both hands, fanfold it with its edge toward outside and the inside of the sterile drape will be made to a sterile area. (2) Hold sterile items with sterile forceps and place them in the sterile 医学全.在线www.med126.comarea of the tray. Hold the outside of the drape at two corners with both hands to cover the sterile items and align the upper layer edges of the drape with lower layer edges of the drape. Fold the opening end of drape twice upward, tuck the sides of the drape in and chart the date and time of applying the tray. The sterile tray is considered as sterile for 4 hours. (3) Wrap the sterile package with one tape and write the opening date and time in the label or paper of the package when the sterile items are still left. 4. Applying the sterile treatment tray with two drapes. (1) Read the label on the sterile package and open the sterile package as the way as applying the sterile treatment tray with one drape. Hold a sterile drape with the sterile forceps onto free hand and return the sterile forceps to the sterile container. Close the cover by touching only the outer of the package and reverse the opening order. Hold the outside of the drape at two corners with both hands, gently open, and place it in the tray evenly from opposite side of the tray to near side and make the sterile side upward. (2) Pick up the sterile bowel package with left hand, open the other three corners in turn and grasp the forth corner at last with right hand. Expose the sterile bowel and place it onto the sterile tray securely. (3) Determine the right and sterility of the solution by checking the name, dosage and expiration of the label on the bottle and the clearness of the solution. Open the cap of the bottle with a bottle-opener bottle. Use the thumb and index finger or two thumbs to turn the rim of the plug over upward. Use the index and middle fingers of the other hand to pull the plug out. Have the label of the bottle against the operator’s palm of hand, pour a small amount of solution into a kidney basin, pour the sterile solution needed into the sterile container and then insert the plug into the bottle. (4) Remove the lid of the sterile container carefully. Place the inner surface of the lid upward in the flat sterile table or hold the outer surface of the lid with one hand. Take the sterile item out from the sterile container with the sterile forceps, cover it immediately and place it onto the sterile area. Hold a sterile drape with the sterile forceps onto free hand and return the sterile forceps to the sterile container. Hold the outside of the drape at two corners with both hands, gently open, and place it in the tray evenly from near side of the tray to opposite side and then the surpass parts of the drapes are folded upward. Disinfect the inner surface of the plug and the outer surface of the opening of the bottle and put the plug down. Write the dates of bottle opened in the label of the bottle with a pen and return it to the original place. The solution is considered as sterile for 24 hours after being opened. Place the sterile gloves on the sterile tray. (5) Take off the gloves from the sterile tray, open a small part of the upper layer of the sterile drape and expose the sterile gauzes. Recheck the size and sterile effect and dates of the sterile wrapper, open the wrapper and apply the powder to the hands from the powder pack. Lift up and hold the sides of the wrapper with both hands and take out two gloves simultaneously, touching only the tops of the cuffs. Slip one hand into one glove and pull the glove over the hand carefully. Slip the bare hand into the other glove by placing gloved fingers under the cuff. Adjust the fingers of the gloves by touching the outside of the gloves and turn both cuffs of the gloves over the cuffs of the uniform sleeves. Lift up the gauze from the tray, wipe clean the powder on the gloves and then hold the sterile bowel with both hands. (6) Grasp one glove by the outside of the cuff with the other gloved fingers, take it off with the wrong side out, grasp the inside of the other glove in the bare fingers and take it off with the wrong side out after having finished the procedure. Dispose the used equipment and replace the unused equipment. Evaluating 1. Have finished the procedure in the given time correctly and skillfully. 2. Performance the sterile idea during the procedure. 3. Insist on the sterile principles during the procedure. Principles of aseptic technique ● The environment of aseptic technique should be clean, spacious and disinfected at regular intervals. Sterile items should be properly placed. Cleaning should have been completed at 30 minutes before the commencement of any sterile procedure and other health personnel are limited to go about so as to prevent the dust from floating. ● The health personnel should wear a cap and a mask, file nails short, wash hands. If necessary, wear a gown and sterile gloves before performing the sterile procedure. ● Health personnel should first know which area is sterile, which area is unsterile, and what is sterile item while performing any sterile procedure. ● Sterile items must be separated from unsterile items, and have an obvious label. Sterile items should not be exposed to the air and stored in the sterile containers. Sterile package should have a label with its name and the sterile dates written on it. Arrange sterile items in order according to the expirations of the items. The wrapped sterile packages are usually kept 7-14 days. The sterile item should be sterilized again when it has been damp or beyond the expiration. ● Allow yourself to keep some distance away from the sterile field while performing the sterile procedure. ● Hold sterile items with sterile forceps. Avoid reaching across or touching a sterile field with bare hands or arms. The sterile zone is confirmed to the table top or to above waist level. Anything that hangs, falls or touches below these levels is considered as contaminated. Avoid coughing, sneezing, or unnecessary talking near or over a sterile field. When there is a doubt about the sterility of any item, it must be considered as not sterile. Unsterile items should be put far from the sterile field. The sterile item taken from the sterile container should be considered as unsterile and not be replaced in the container. ● Assemble sterile equipment only supplies one patient each time. | 
