Guidelines in Practice: Sterile Technique.
isolation technique
powered air‐purifying respirator (PAPR)
sterile field
sterile technique
surgical wound classification
Journal
AORN journal
ISSN: 1878-0369
Titre abrégé: AORN J
Pays: United States
ID NLM: 0372403
Informations de publication
Date de publication:
Oct 2024
Oct 2024
Historique:
received:
06
05
2024
accepted:
06
05
2024
medline:
25
9
2024
pubmed:
25
9
2024
entrez:
25
9
2024
Statut:
ppublish
Résumé
Sterile technique is the collective actions taken to reduce potential contaminants in the OR and maintain a sterile field during operative or other invasive procedures. Practicing and applying the principles of sterile technique is a cornerstone of perioperative nursing and providing safe patient care. The recently updated AORN "Guideline for sterile technique" provides perioperative nurses with information on the principles of and processes associated with sterile technique. This article provides an overview of the guideline and discusses recommendations for actions to take before preparing the sterile field, while preparing and maintaining the sterile field, for limiting movement, for surgical wound classification, and for quality. It also includes a scenario describing the implementation of isolation technique (ie, clean closure) for colon procedures. Perioperative nurses should review the guideline in its entirety and apply the recommendations when practicing sterile technique.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
238-247Informations de copyright
© AORN, Inc, 2024.
Références
Guideline for sterile technique. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2025. In press.
Appendix E: AORN Evidence Rating Model. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2024:xxi.
Guideline for surgical attire. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2025. In press.
Siegel JD, Rhinehart E, Jackson M, Chiarello L; Health Care Infection Control Practices Advisory Committee. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control. 2007;35(10 suppl 2):S65‐S164. https://doi.org/10.1016/j.ajic.2007.10.007
Howard RA, Lathrop GW, Powell N. Sterile field contamination from powered air‐purifying respirators (PAPRs) versus contamination from surgical masks. Am J Infect Control. 2020;48(2):153‐156. https://doi.org/10.1016/j.ajic.2019.08.009
Gilat R, Mitchnik I, Beit Ner E, et al. Bacterial contamination of protective lead garments in an operating room setting. J Infect Prev. 2020;21(6):234‐240. https://doi.org/10.1177/1757177420947466
Dalstrom DJ, Venkatarayappa I, Manternach AL, Palcic MS, Heyse BA, Prayson MJ. Time‐dependent contamination of opened sterile operating‐room trays. J Bone Joint Surg Am. 2008;90(5):1022‐1025. https://doi.org/10.2106/jbjs.g.00689
Guideline for design and maintenance of the surgical suite. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2024:79‐142.
Birgand G, Azevedo C, Rukly S, et al. ARIBO Study Group. Motion‐capture system to assess intraoperative staff movements and door openings: impact on surrogates of the infectious risk in surgery. Infect Control Hosp Epidemiol. 2019;40(5):566‐573. https://doi.org/10.1017/ice.2019.35
Sunagawa S, Koseki H, Noguchi C, et al. Airborne particle dispersion around the feet of surgical staff while walking in and out of a bio‐clean operating theatre. J Hosp Infect. 2020;106(2):318‐324. https://doi.org/10.1016/j.jhin.2020.07.016
Mittal A, Blackburn AZ, Katakam A, Bedair HS, Melnic CM. Dual surgical setup associated with reduced infection recurrence for hip and knee arthroplasty after two‐stage exchange. J Am Acad Orthop Surg. 2024;32(2):68‐74. https://doi.org/10.5435/jaaos‐d‐23‐00317
Markel TA, Gormley T, Greeley D, Ostojic J, Wagner J. Covering the instrument table decreases bacterial bioburden: an evaluation of environmental quality indicators. Am J Infect Control. 2018;46(10):1127‐1133. https://doi.org/10.1016/j.ajic.2018.02.032
Smith EB, Raphael IJ, Maltenfort MG, Honsawek S, Dolan K, Younkins EA. The effect of laminar air flow and door openings on operating room contamination. J Arthroplasty. 2013;28(8):1482‐1485. https://doi.org/10.1016/j.arth.2013.06.012
Pop‐Vicas AE, Abad C, Baubie K, Osman F, Heise C, Safdar N. Colorectal bundles for surgical site infection prevention: a systematic review and meta‐analysis. Infect Control Hosp Epidemiol. 2020;41(7):805‐812. https://doi.org/10.1017/ice.2020.112
Guideline for team communication. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2025. In press.
Singh S, Podila S, Pyon G, Blewett J, Jefferson J, McKee R. An analysis of 3,954 cases to determine surgical wound classification accuracy: does your institution need a Monday morning quarterback? Am J Surg. 2020;220(4):1115‐1118. https://doi.org/10.1016/j.amjsurg.2020.04.017
Butler MW, Zarosinski S, Rockstroh D. Improvement of surgical wound classification following a targeted training program at a children's hospital. J Pediatr Surg. 2018;53(12):2378‐2382. https://doi.org/10.1016/j.jpedsurg.2018.08.037
ANSI/ASHRAE Standard 52.2‐2017: Method of Testing General Ventilation Air‐Cleaning Devices for Removal Efficiency by Particle Size. American Society of Heating, Refrigerating and Air‐Conditioning Engineers (ASHRAE); 2017.
Sommerstein R, Rüegg C, Kohler P, Bloemberg G, Kuster SP, Sax H. Transmission of Mycobacterium chimaera from heater–cooler units during cardiac surgery despite an ultraclean air ventilation system. Emerg Infect Dis. 2016;22(6):1008‐1013. https://doi.org/10.3201/eid2206.160045