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Aseptic Techniques: What Are The Stages Of An Aseptic Technique? What Are The Principles Of An Aseptic Technique In The Operating Room?

Introduction:

Asepsis is a term that is used for the prevention of spreading of infections. The procedure or technique used to prevent the metastasize or spread of infection is known as Aseptic Technique. Asepsis aims to attain an environment that is free from infectious diseases. Every Healthcare facility has its own set of procedures for attaining asepsis techniques. The most common examples of health care centers include surgery rooms (OTs), clinics, OPDS, ICUs, and outpatient care centers. According to the Association of Perioperative Registered, aseptic technique is still of greatest importance, to maintain the sterile techniques.

Various Types of aseptic Techniques:

To prevent the spreading of infections aseptic techniques are used, following types of aseptic techniques,

1. Disinfection:

Disinfection is the procedure of cleaning and killing harmful bacteria and microorganisms. Demolition and inactivation of infectious agents are known as disinfection, while the agents that are used to demolish or destruct the agents are termed as disinfectants or germicides. The treatment of disinfection methods includes chlorine dioxide, chlorination, and chloramines. 

2. Sterilization:

Sterilization is another form of aseptic technique to make an object or pieces of equipment free from viruses, bacteria, and microorganisms. The methods of sterilization includes,

  1. Heat (by electrical or gas heat)- In this method, infected materials are subject to the boiling water for 15-20 minutes and exceed the temperature of water to kill the spores, bacteria, and microorganisms.
  2. Steam – It is a very simple method to disinfectant the objects and it is used in the three ways,
  3. Current steam- In this method, steam is generated at the standard atmospheric pressure, and a temperature of 100C then allows it to escape.
  4. Saturated steam- It is also known as pure steam and it is generated by the temperature of boiling water in a closed container or vessels to accumulate the steam under the existing pressure.
  5. Superheated steam- This method of steam is in two ways,

3. Chemical treatment:

To destruct the bacteria various types of chemicals are used for asepsis, these are

  1. Bacteriostatic agents (antiseptics) – It is a chemical agent that stops the growth and reproduction of bacteria and microorganisms.
  2. Insecticides- Insecticides work in many different ways and it is formulated to kill the insects.
  3. Deodorants- Deodorants are used to remove the smell by decomposing, absorbing the bacteria. Deodorants work as antiperspirants to reduce the sweat, but it does not destroy the organism.
  4. Hydrocyanic acid gas- It is a weak poisonous acid and it is used in effective fumigating but with very careful handling. 
  5. Radiation– Radiation sterilization inactivates the bacteria and microorganisms very effectively and it is mostly used for the wrapping.

4. Cleaning of equipment:

This type of asepsis helps the people to save from germs and it may reduce the microorganisms, various equipment, such as needles (always be disposed of). Again usage of needles become a source of spreading infections between the patients. Each equipment should be clean properly within an appropriate manner. It also must be sure that all healthcare staff washes their hands properly by aseptic technique because it also helps to prevent the infections. 

5. The centers for disease control and prevention (CDC):

Centre of disease control also facilitates the basic rules for, it may includes

What are the stages of an aseptic technique?

1. Hand hygiene:

Hand hygiene is an initial and effective way of aseptic techniques. You should wash your hand with an alcohol-based hand rub before starting any procedures or techniques to prevent contamination. Hand hygiene prevents the spread of infections and germs. You should repeatedly wash your hand immediately if you are in doubt of contamination or touch before any sterile. 

2. Equipment storage:

Sterilized equipment and instruments must be stored in a dry and clean environment because sterilized and clean objects never are placed on wet places, probably there are chances of contamination of equipment. The equipment always is placed in direct sunlight or room temperature environments as this affects the packaging or quality of sterilized equipment. 

3. Preparing equipment:

Before performing any techniques or procedures, preparing the equipment of aseptic technique in a clean place without any contamination, the appropriate surface should be selected for preparing the equipment (such as trolley, procedure tray, and detergent cleaning wipes). All sterilized packaging should always be inspected to ensure any damages or infections, rather than expiry date should be checked just to be sure of the validity of equipment.

4. Environment:

For sterile techniques, a clean environment must be necessary; that’s why any procedure carried out in that location or environment where we maintain the privacy and dignity of patients with managing proper aseptic techniques. We always take care of the location to perform any sterile procedures for reducing the risk of airborne microorganisms.

5. Use of aprons and gloves:

Disposable aprons and gloves give a perfect barrier between contaminated uniforms and the procedure. Uses of aprons reduce the risk of contamination that may arise or have a chance to perform the procedure. Always remember, during any procedures you should wear double-gloves to protect from any mishaps. The use of single non-sterile gloves increases the risk of contact with the patient’s blood or body fluids. 

6. Maintaining a sterile field:

The sterilized field must need to be maintained during any procedures by using equipment with carefully opening the sterile packets to prevent contamination. If you used any sterile equipment, you should use only the corner side of sterile equipment to open it. After opening sterile equipment, you should gently place it into the sterile field. 

7. Equipment disposal:

After performing the procedures, you should dispose of all waste appropriately in the waste stream bin (such as needles, blades, suture cutters, and scissors). After disposed of all waste safely, wear off your apron and gloves then dispose of it. Once you dispose of all wastes, wash your hands appropriately, then document the procedure in the patient’s record.

What the aseptic technique used for?

Aseptic technique is used in numerous health care settings to prevent the spread of infections, microorganisms, and germs. The aseptic technique is the cleaning technique to stop the spreading of microorganisms between the people and places. These techniques reduce the risk of infections for the contamination of direct sources of patients. To prevent infections, we should follow the principles of aseptic techniques. 

What are the principles of aseptic technique in the operating room?

The earliest goal of the surgical team is to prevent surgical site infections and sterile the equipment in the operating room. These all cleaning activities include patient assessment in sterile environments, disinfection and sterilization of instruments, environmental cleaning, and the use of standard precautions. Aseptic techniques greatly reduce the risk of patients to surgical site infections.

The principles of aseptic technique play the greatest role to maintain the goal of asepsis in the operating room and it may include the following principles,

Principle -1 

Scrubbed persons function-

The surgical team is made up of the members, i.e. sterile and nonsterile. Sterilized (scrubbed) members work directly in the operating room, while the nonsterile (unscrubbed) members work in the back of the sterile (scrubbed) surgical field. All team members wear scrub gowns. Scrubbed persons should wear sterilized gown, gloves, and mask in a sterilized field.

Principle -2

Sterile curtains used to maintain a sterile field

Sterile surgical drapes set up an aseptic barrier to reduce the spreading of microorganisms from non-sterile fields to sterile areas. The sterile drapes always are placed on the patient’s incisional exposed site, furniture,  and equipment are included in the sterile field. Only scrubbed people handle sterile drapes. After the positioning of sterile drapes, it should not be rearranged.

Principle -3

All items must be sterile-

It should be necessary that all items, instruments, and equipment must be sterilized and not mixed with non sterilized items that are contaminated. Sterilization and disinfection techniques provide the highest assurance that all sutures, supplies, and drapes are free from microorganisms.  To assure the disinfectant and sterilization, you should inspect the package integrity. 

Principle -4

Introduced items on the sterile field should be opened and transferred by maintaining sterility-

All sterile instruments, items, or equipment should be passed out to the sterile field by preserving integrity methods. All sterile items throw onto the sterile field and it may displace other sterile items, penetrate the drape, and roll off the sterile field. You should margin the safety of sterilized item whenever you open a peel package

Principle -5

Sterile field maintained and monitored constantly and appropriately-

The main goal and responsibility of the operating room staff should be to monitor and maintain the sterilized techniques appropriately. The members of the operating room should make every possible effort to reduce the risk of contamination and to spread of microorganisms and team members always remember the one thing, if there is any doubt or conflict regarding sterilization, then they consider it non-sterilized. By the proper monitoring and maintaining the sterilized techniques, the chances of airborne contamination and infections may be reduced. That address these issues for the surgical team to follow.

Principle -7

Policies for maintaining sterilized techniques must be written, and reviewed annually within the practice setting-

These strongly recommended applications for aseptic techniques used as instructions for developing policies and the procedures within the practice setting. The ongoing education of perioperative personnel introduced the policies for maintaining the sterilized techniques appropriately and the training of aseptic techniques required skilled and experienced surgical personnel.

What are the basic precautions for non-sterilized staff?

The unsterilized members should be taken following precautions to prevent the sterile techniques,

What extra precautions needed to check the packaging of sterile fields?

The extra precautions to checked the packaging of sterile field are,

Summary- 

Health care workers should practice all principles of aseptic techniques. To follow the principles of aseptic techniques appropriately or carefully, you should prevent the spread of microorganisms and transfer of infections. Surgical teams also need good practical skills to prevent infections. It is the responsibility of all health care providers. They must have trained in aseptic techniques and develop strong skills to prevent from any source of infections. Healthcare providers always follow the instructions of asepsis procedures to decontaminate the environment. To get the best outcomes of sterilized techniques, you should follow the basic principles of asepsis (such as hand hygiene, gloves, aprons, and use of all sterilized equipment). 

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