Adding Sterile Items to a Sterile Field

Goal: The sterile field is created without evidence of contamination, the sterile supplies are not contaminated, and the patient remains free of exposure to potential infection- causing microorganisms.

1. Identify the patient. Explain the procedure to the patient.

2. Perform hand hygiene.

3. Check that the sterile, packaged drape and supplies are dry and unopened. Also note expiration date, making sure that the date is still valid.

4. Select a work area that is waist level or higher.

5. Prepare sterile field as described in Skill 4-3 or Skill 4-4.

6. Add sterile item:

To Add an Agency-Wrapped and Sterilized Item a. Hold agency-wrapped item in the dominant hand, with top flap opening away from the body. With other hand, reach around the package and unfold top flap and both sides. b. Keep a secure hold on item through the wrapper with the dominant hand. Grasp the remaining flap of the wrapper closest to the body, taking care not to touch the inner surface of the wrapper or the item. Pull the flap back toward the wrist, so the wrapper covers the hand and wrist. c. Grasp all the corners of the wrapper together with the nondominant hand and pull back toward wrist, covering hand and wrist. Hold in place. d. Hold the item 6" above the surface of the sterile field and drop onto the field. Be careful to avoid touching the surface or other items or dropping onto the 1″ border. To Add a Commercially Wrapped and Sterilized Item: a. Hold package in one hand. Pull back top cover with other hand. Alternately, carefully peel the edges apart using both hands. b. After top cover or edges are partially separated, hold the item 6" above the surface of the sterile field. Continue opening the package and drop the item onto the field. Be careful to avoid touching the surface or other items or dropping onto the 1″ border. c. Discard wrapper.

To Add a Sterile Solution: a. Obtain appropriate solution and check expiration date. b. Open solution container according to directions and place cap on table with edges up. c. If bottle has previously been opened, “lip” it by pouring a small amount of solution into waste container. d. Hold bottle outside the edge of the sterile field with the label side facing the palm of your hand and prepare to pour from a height of 4″ to 6″ (10 to 15 cm). The tip of the bottle should never touch a sterile container or dressing. e. Pour required amount of solution steadily into sterile container positioned at side of sterile field or onto dressings. Avoid splashing any liquid. f. Touch only the outside of the lid when recapping. Label solution with date and time of opening.

7. Continue with procedure as indicated.