1、Aseptic Techniques 无菌技术,Union HospitalWangying,2,11/21/10,Objective:,Master principle of aseptic techniqueMaster the procedures of aseptic technique,3,11/21/10,Aseptic technique: the practices which prevent microorganisms invading human beings, and sterile objects and areas from being contaminated d
2、uring medical procedures and nursing interventions.,4,11/21/10,Skill of Aseptic Techniques:,Apply Sterile Transfer Forceps/Tissue Forceps无菌持物钳镊的使用 Apply Sterile Container无菌容器的使用 Pour Sterile Solution取无菌溶液 Use Sterile Package无菌包的使用 Prepare Sterile Treatment Tray铺无菌盘 Don and Remove Sterile Gloves戴脱无菌手
3、套,5,11/21/10,Apply sterile transfer forceps 无菌持物钳的使用,Sterile transfer forceps/tissue forceps:be used to take and transfer sterile itemsFour types of transfer forceps: three forked forceps transfer forceps long tissue forceps short tissue forceps,6,11/21/10,short tissue forceps,transfer forceps,long
4、tissue forceps,three forked forceps,7,11/21/10,the solution level should be 23 cm above the joint pivot,23cm,Soaking sterile forceps in anticeptic solution,sterile container with bigopening and cover,only one pair of forceps in a container,joint pivot,8,11/21/10,Advantages of dry-style maintenance,t
5、o reduce contaminationto save hospital cost to reduce the toxicity of chemical disinfectants to body,9,11/21/10,Procedures :,Wash and dry hands, wear mask Check the expiration date of forceps container. Open the lid of the sterile container Hold the sterile transfer forceps with one hand (hold the t
6、issue forceps by upper 1/3), close the tips of the forceps， move it to the center of the container, and take it out of the container vertically.,10,11/21/10,Procedures :,Keep the forceps tips downward. Do not reverse the direction. (avoid the antiseptic solution flowing backward and thus contaminati
7、ng the forceps tips.)Close the forceps tips after being used (to avoid touching the edge of the container opening) and immediately put it back to the container vertically. Loosen the joint pivot when soaking the forceps in the solution. (to make it saturated by the antiseptic solution),11,11/21/10,P
8、rocedures :,When taking the sterile items from a far distance, the sterile container should be carried with the sterile forceps. (avoid the sterile forceps exposing to air for too long)The sterile forceps, container and aseptic solution should be changed and sterilized two times every week.(However,
9、 the sterile forceps frequently used should be changed and sterilized every day.),12,11/21/10,Key points:,Do not use sterile forceps to take oily gauze in case the oil adheres to the forceps tips and affects the disinfection effect.Do not use the sterile forceps to do dressing or disinfect skin to a
10、void contamination.,13,11/21/10,Apply Sterile Container 使用无菌容器,Sterile containers are containers sterilized to hold sterile items.,14,11/21/10,Vocabulary:,Sterile bowl 无菌碗Sterile tray 无菌盘Sterile tin 无菌罐Sterile grooves 无菌储物槽,15,11/21/10,Sterile grooves,Sterile bowl,Sterile tin,16,11/21/10,Procedures:
11、,Wash and dry hands, wear mask and check the label (including expiration date, name) of the container . When taking objects from the container, take the cover away from the container horizontally, keep the inner side of the cover upward in the flat sterile table or downward in the hand.,Opening ster
12、ile container,17,11/21/10,Procedures:,After the objects have been taken out, immediately reverse the cover, make its inner side downward and cover the container carefully. (to avoid the content exposed to air for too long)When taking sterile container such as sterile bowl, hold it by its bottom with
13、 one hand or both hand .(never touch the inner surface of the sterile container),Handing sterile container,18,11/21/10,Pouring Sterile Solution 倒无菌溶液,19,11/21/10,Equipment Needed(用物 ),treatment tray 治疗盘 sterile transfer forceps 无菌传物钳 sterile tin 无菌罐 sterile bowl 无菌治疗碗 sterile solution 无菌溶液 a kidney
14、basin 弯盘 cotton sticks 棉签 scissors 剪刀 a bottle-opener 起瓶器 treatment card 治疗卡 rag 抹布 disinfectants 消毒剂 record card 记录卡 a pen 笔,20,11/21/10,Procedure,Check treatment card, assemble all the equipment needed. Clean the treatment tray and working surface.Clean the dust on the outside of the bottle.Check
15、the label of the sterile solution (name , concentration, dosage and expiration date).Check if the lid is loose, if there is any crack on the bottle and the clearance of the solution.(Discard if unclear or leaks and visible particulate are found.),21,11/21/10,Procedure,Wash and dry hands, wear mask.O
16、pen the aluminum lid with a bottle-opener. Take a sterile bowl and place it in the treatment tray.Check the date of sterilization and check if the cap of the bowl is wet or worn out, take the cap away from the bowl. (inner side out side),22,11/21/10,Procedure,Disinfect the rubber lid, disinfect the
17、first three fingers of one hand.(disinfect thumb, index finger and middle finger of two hands. Use the thumb and index finger to turn the rim of the rubber lid over upward.) Check the label of the sterile solution once again. Pull the rubber lid out with the disinfected fingers. Have the label of th
18、e bottle against the nurses palm of hand. (Pull the rubber lid out with the index and middle fingers of one hand.),23,11/21/10,Procedure,Pour a small amount of solution into the kidney basin to clean the lip of the bottle.Pour the needed amount of solution into the sterile bowl from the same place o
19、f the lip. Pour slowly to avoid spill.Insert the rubber lid into the bottle immediately.Recap the sterile bowl.,Pouring Sterile Solution,24,11/21/10,Procedure,Disinfect (the inner surface of) the rubber lid and the outer surface of the opening of the bottle(, recap the solution bottle). Use sterile
20、gauze to wrap the rubber lid.Check the label for the third time. (name of the solution, concentration, dosage and expiration date),25,11/21/10,Procedure,Take note of the dates and time of opening the bottle and sign your name.Take note of the date and time of preparingthe aseptic solution and sign y
21、our name.Coordinate the equipment.Wash hands and take off the mask.,26,11/21/10,Estimated time to complete the skill: 5 minutes,27,11/21/10,Rationale and Key Points:,Do not pour the solution back into the bottle.Do not put the items into the bottle to dip the solution. The solution in the opened bot
22、tle can be kept sterile for 24 hours, the solution in the sterile bowl can be kept sterile for 4 hours.,28,11/21/10,Use Sterile Package 使用无菌包,29,11/21/10,Folding treatment towel vertically,vertically fold the towel three times to make 6 folds and horizontally fold once, one of the edge faces outside
23、,30,11/21/10,Procedures:,wash and dry hands, wear mask. Pack sterile package. Place the items to be sterilized in the center of the double wrapper. Put an indicator card in it.Fold the flap, the nearest from the nurse comes first, then fold the left, right side flaps, and at last fold the farthest f
24、lap from the nurse. Tie the items contained in the cloth with a string in “cross” shape, not too tight or too loose. Tap the indicator strip and label on the package with the packages name and sterile dates.,31,11/21/10,Procedures:,Open sterile package Check the name of the package and the steriliza
25、tion date. See whether the sterile package is damp and damaged or not. Place the package on a clean ,dry and flat surface, untie the string and roll it below the package, open the outer wrapper of the sterile package according to its original creases with your hands and open the inner wrapper of the
26、 sterile package with the sterile transfer forceps.,32,11/21/10,Procedures:,Open sterile packageTake out the needed items with a sterile forceps and put them on a prepared sterile area.Fold the packaged according to its original creases and tie it in “一”shape. Note down the date and time of package
27、opening.,33,11/21/10,Procedures:,If the items in the sterile package need be taken out for one time, Hold it with right hand and open the wrapper with left hand to expose the items, catch the wrapper withthe right hand and hold its corners with the other and pour the items to the sterile area.,Placi
28、ng sterile items on sterile field,34,11/21/10,Key points:,There are labels indicating the name of the objects and sterilization date on the outer side of wrapper. The expiration duration is 1-2 weeks. Do not use the package if the expiration date is over.When opening the package, do not touch the in
29、ner side of the wrapper and the sterile items.If the package has been tied in “一” shape, it means that the package has been opened and the remaining items need to be used within 24 hours.,35,11/21/10,Key points:,If the items are contaminated or the wrapper is wet, re-sterilization is needed.When pou
30、ring the items, make the sterile surface of the wrapper face the sterile area.,36,11/21/10,Prepare Sterile Treatment Tray (铺无菌盘),Purpose: sterile treatment tray is to drape a sterile treatment towel on a clean and dry treatment tray to form a sterile area and place sterile items onto it.,37,11/21/10
31、,Equipment Needed -two hands method(双手法),Treatment tray 治疗盘 sterile transfer forceps 无菌持物钳 Sterile tissue forceps 无菌持物镊 sterile tin (sterile gauze be kept in it)无菌罐(内装无菌纱布) Sterile package (with 2 pieces of treatment towel and chemical indication card in it and chemical indication strip on its outer
32、 wrapper)无菌包(内有无菌治疗巾,灭菌指示卡,包外贴化学指示胶带) kidney basin 弯盘 2 record cards 记录卡2张 a pen 记录笔 a clean rag 清洁抹布,38,11/21/10,Procedures:,Assemble all the equipment needed. Clean treatment tray and working surface, place the treatment tray in appropriate place.Wash and dry hands, wear mask.,39,11/21/10,Procedur
33、es:,Check if the chemical indication strip change its color.Check the name of the package and date of sterilization, check if the sterile package is loose, damp of damaged.,40,11/21/10,Procedures:,Open sterile package:1 Place the package on a clean, dry and flat place, untie the string and roll it u
34、nder the package.2 Open the outer wrapper of the package according to its original creases with your hands, that is open the flap farthest from the nurse first, then the left and right of the outer wrapper.(外左右)3 Then take sterile forceps, open the flap nearest from you with your left hand, then ope
35、n the inner wrapper of the sterile package according to its original creases with sterile forceps4 Check if the chemical indication card change its color.,41,11/21/10,Procedures:,Pick up a treatment towel with sterile forceps and place it on your left hand.Fold the inner wrapper of the package accor
36、ding to its original creases with sterile forceps, then return the sterile forceps. Hold the outer surface of towel at two corners with thumb and index finger of two hands, gently open and place it with double folds in the treatment tray.,42,11/21/10,Procedures:,Fold the outer wrapper of the package
37、 with your hands, tie the package in“一”shape.Fan fold the upper layer of the towel with its edges toward outside. The inside of the sterile towel will be made to a sterile area. Place sterile items onto the sterile area. Pull the top layer of the towel to cover them, making the edges of the two laye
38、rs parallel.,43,11/21/10,Procedures:,Fold the edge of the towel upward twice and then fold the both sides of edges of towel downward once.1Note down the date and time of preparing sterile treatment tray and name of the sterile items and sign your name. 2 Note down the date and time of opening steril
39、e package and name of sterile items and sign your name.,44,11/21/10,Procedures:,This sterile package should be used in priority. The sterile package can be kept sterile for 24 hours.Coordinate the equipment.Wash hands and remove the mask.,45,11/21/10,Estimated time to complete the skill: 5 minutes,4
40、6,11/21/10,Rationale and Key Points:,Purpose: sterile treatment tray is to drape a sterile treatment towel on a clean and dry treatment tray to form a sterile area and place sterile items onto it.,47,11/21/10,Key points:,The working surface for preparing sterile treatment tray should be clean and dr
41、y.Protect the sterile towel from being moist.Your hands or other unsterile items can not touch the inner side of the sterile towel.The sterile treatment tray can be kept sterile for 4 hours.,48,11/21/10,One hand and one sterile forceps method(一手一钳法),single-laying treatment tray,Double-laying treatme
42、nt tray,49,11/21/10,Equipment Needed(用物),Treatment tray 治疗盘 sterile forceps 无菌持物钳sterile tin (sterile gauze be kept in it)无菌罐(内装无菌纱布)Sterile package (with 2 pieces of treatment towel and chemical indication card in it and on its outer wrapper) 无菌包(内有无菌治疗巾,灭菌指示卡,包外贴化学指示胶带)kidney pan 弯盘 2 record cards
43、 记录卡2张 a clean rag 清洁抹布,50,11/21/10,Procedures:,Assemble all the equipment needed. Take equipment out and place them on the working surface.Clean treatment tray and working surface, place the treatment tray in appropriate place.Wash and dry hands, wear mask.,51,11/21/10,Procedures:,check if the chem
44、ical indication strip change its color.Check the name of the package and date of sterilization, check if the sterile package is loose, damp or damaged .,52,11/21/10,Procedures:,Open sterile package:1 Place the package on a clean, dry and flat place, untie the string and roll it under the package.2 O
45、pen the outer wrapper of the package according to its original creases with your hands, that is open the flap farthest from you first, then the left , the right side of the wrapper.(外左右)3 Then take sterile forceps, open the flap nearest from you with your left hand, then open the inner wrapper of th
46、e sterile package according to its original creases with sterile forceps4 Check if the chemical indication card change its color.,53,11/21/10,Procedures:,Pick up a treatment towel with sterile forceps and place it on the left side of the inner wrapper. Hold the two outer corners of the top edge of s
47、terile towel with sterile forceps and your left hand, open the towel gently, lay it on the treatment tray from outer to inner side.Fold the inner wrapper according to its original creases with sterile forceps and fold the flap nearest from you of outer wrapper with your left hand.Place sterile items
48、 onto the sterile area.,54,11/21/10,Procedures:,Open the sterile package again.1 Open the nearest flap from you of the outer wrapper with your left hand.2 Open the inner wrapper with sterile forceps.Hold the two outer corners of the top edge of sterile towel with sterile forceps and your left hand,
49、open another towel gently, lay it on the first sterile towel from inner to outer side, making the edges of the two towels parallel.,55,11/21/10,Procedures:,Fold the inner wrapper of the package according to its original creases with sterile forceps, then return the sterile forceps into the sterile c
50、ontainer.Fold the outer wrapper with your hands, tie the package in“一” shape.Fold the edge of the towels nearest from you upward ,then the left side, the farthest side and last the right side.1Note down the date and time of preparing sterile treatment tray and name of the sterile items and sign your name.2 Note down the date and time of opening package and name of the sterile items and sign your name.,
