Fundamentals - Practice & Skills, part 4: Sterile Field - Indications, Best Practices, and Preparation

by Meris Shuwarger July 22, 2021 Updated: July 29, 2021

Full Transcript

Hi, I'm Meris. And in this video, I'm going to be talking to you about everything you need to know about sterility and sterile fields. And we'll be following along with our Fundamentals of Nursing flashcards. These are available on our website, levelupRN.com, but if you already have a set and you want to follow along with me, I am starting on card number 53. So let's get started.

Okay. So first and foremost, what are the indications for sterile field? Do we do it with every patient? Absolutely not.

So we need to do a sterile field when we're doing a sterile procedure. These are going to be really invasive things. So, for instance, if the provider is starting a central line or a PICC line, when we are inserting a urinary catheter, be that a quick straight catheter or an indwelling one.

Any time we do tracheostomy care, we're actually providing care into a hole that goes directly into my patient's lungs, I need to provide really good sterile care there, and any kind of surgical procedure as well. So that's when we're going to use sterile field.

We're not going to do it for things like just passing medications or getting vital signs, though. That's going to be routine with clean gloves.

So you'll hear that called medical asepsis. Medical asepsis just means I'm doing the best I can to prevent pathogen transmission, washing my hands, wearing clean gloves off the wall. That's medical asepsis.

But surgical asepsis means that I am following strict sterile procedure to prevent transmitting pathogens.

So best practices, these are things that you've got to know for your exams and for clinical practice. One of the things is we don't ever turn our back on a sterile field.

If I turn my back, I'm not looking at it anymore, so I can't guarantee that nothing has touched it or fallen onto it or anything like that.

Another thing, and you probably know this from watching TV, is I don't drop my hands below my waist. Anything below the waist is considered to be non-sterile. Even if I'm wearing sterile gloves, they have to stay up here. So I can provide patient care all here, but the second I drop my hands, they are not sterile anymore.

I'm also not going to reach over my sterile field with anything that is not sterile. So if I take my hand and reach over my sterile field, and I have a sterile glove on, awesome, we're doing great. But as soon as my dirty sleeve or arm passes over the sterile field, it is no longer sterile.

I should not be talking or coughing or sneezing over the field. I also need to make sure that everything I'm putting onto the field is intact, meaning, did I check the dressing, the sterile packaging? Is that all intact? There were no holes or anything? That's very important.

Then remember, when you do set up a sterile field, there is an imaginary one-inch border that we consider to be non-sterile sterile. So that just gives us room to work, but that one inch, no more, no less, is going to be considered non-sterile of my sterile field.

And then also remember that if an object becomes wet, let's say I'm putting sterile solution into a sterile container but I accidentally splash some onto the drape, it's not sterile anymore. So any moisture on the field means that my field is no longer sterile. It has been contaminated.

Okay. So now, let's move on to card 54, where we talk about how to actually prepare a sterile field. You'll notice these are numbered bullets, meaning that we have put them in order for you.

So one of the things that I want to point out, I'm not going to go through each step, but the package should be positioned so that the topmost flap will open away from my body. When I open a sterile package, the first flap must open away from me. So I want that flap to point towards my body.

Then I will do one side and then the other before opening the one closest to me last.

When I pour sterile solutions, remember a few things here.

First is, I want to open the bottle and place the cap so that the inside is facing up on a nonsterile surface. And then I'm going to hold the bottle so that my palm is covering the label of the bottle.

Why does this matter? If anything were to splash, I don't want to get that on the label of the bottle because then I might not be able to read what it says anymore. Very important that I know what is in that container.

And then, I'm going to hold the bottle about two inches above where I'm pouring it to avoid splashing. And I should also pour that solution slowly.

I'm not just going to be dumping it in because that would encourage splashing.

So that's everything you need to know about best practices and indications and how to set up a sterile field.

I would definitely encourage you to practice these skills over and over again because it is just rote memory, muscle memory. I don't drop my hands.

When I was in skills, I literally sat around the house like this, trying to train myself not to drop my hands. So whatever it takes.

I hope this review was helpful. If you did find it helpful, please go ahead and like this video. It means the world to us. And if you have anything to add or a funny way to remember things, please drop me a comment. I would love to read that and see what you have to say.

I do want to let you know that the next video is going to be a really big one. We're going to be talking about bed baths, bed making, oral care, denture care, and seizure precautions which are very important to know.

So be sure that you subscribe to the channel so that you are the first to know when it posts. Take care and happy studying.

I invite you to subscribe to our channel and share a link with your classmates and friends in nursing school. If you found value in this video, be sure to hit the like button and leave us a comment. And let us know what you found particularly helpful.


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