Sterile Technique

Purpose

This document provides guidance on the principles and processes of sterile technique. Sterile technique involves the use of specific actions to reduce the level of environmental contamination in the room and to maintain sterility by preventing contamination of the sterile field and sterile items during operative and other invasive procedures. Thoughtful and diligent implementation of sterile technique is a cornerstone of perioperative nursing practice and a key strategy in the prevention of surgical site infections (SSIs).

All individuals who are involved in operative or other invasive procedures have a responsibility to provide safe patient care.^1-3  Surgical patients are at risk for SSIs; thus, perioperative team members are required to mindfully practice the principles of sterile technique to reduce the level of contaminants in the environment and prevent sterile field contamination.³  Adhering to the principles and processes of sterile technique is a matter of ethical obligation, individual conscience, professional practice, and patient advocacy that applies to all members of the perioperative team.^1,3-5  All perioperative team members and leaders have a duty to promote a culture of safety by creating an environment in which any perioperative team member is encouraged to identify, question, or stop practices believed to be unsafe and to learn from unintentional mistakes without fear of repercussions.^2,3,6 

Some medical devices or processes serve dual purposes, such as use of surgical masks as personal protective equipment (PPE) and to prevent contamination of the sterile field. Therefore, recommendations for some topics are covered in more than one guideline. As an example, PPE is covered in the Guideline for Transmission-Based Precautions⁷  and in this guideline.

The following are outside the scope of this document:

• surgical attire selection,

• hand hygiene processes,

• extended use and reuse of surgical masks,

• selection of unidirectional airflow devices integrated into the design of the surgical suite,

• the effects of forced-air warming equipment,

• environmental contamination originating from the sterile field, and

• product evaluation.

Refer to the AORN Guideline for Surgical Attire,⁸  Guide line for Hand Hygiene,⁹  Guideline for Transmission-Based Precautions,⁷  Guideline for Design and Maintenance of the Surgical Suite,¹⁰  Guideline for Prevention of Hypothermia,¹¹  Guideline for Environmental Cleaning,¹²  and Guideline for Medical Device and Product Evaluation¹³  for additional guidance.