Welcome to preparing a sterile field in sterile gloving.
So in this skill, I'm going to show you how to prepare a sterile field.
Now this is going to be used for lots of common nursing procedures,
inserting a Foley catheter, for example.
Then I'm going to show you how to add sterile items to that field
and also how to sterile glove.
So before we get started, we've got to open our sterile kit.
Now, this will turn into your sterile field
and I'll show you that shortly.
Now before we take off, I want to talk to you quickly about clean
versus sterile equipment.
So we talk about clean equipment, this is going to be something
you're going to use in routine care, for example,
like just gloves, that are typically placed on the wall in your patient room.
This is for routine maintenance care.
Now when we're talking about sterile equipment,
this is something that's typically encased in a package.
Now we do this because we want to reduce the amount of microbes
or organisms that gets to the equipment.
So we're going to need our sterile kit number one,
then we're going to need like a hard table or hard surface,
typically your bedside table we're going to work from.
Now before we even get started,
when you get your equipment, you want to make sure you inspect it closely.
So we want to look for any wetness, any soiled marks,
we want to make sure there's no weird tears or openings
on that package or the package is damaged at all.
Then we want to make sure that as an end date
that the expiration date is still good.
So just think about this way, you don't want to eat spoiled or expired food,
or most of us don't anyway.
But when we are using equipment,
expiration date is really important because that's going to make sure
that equipment is safe and effective for our patient.
And lastly, on most equipment, there's going to be some sort of enclosure,
maybe like an intact sterile tape,
we want to make sure this is still sealed.
That way, we know that the equipment is still sterile.
So we open a sterile kit before any procedure, we want to do our hand hygiene.
Then we want to remove the plastic covering of the package.
And then we want to make sure we place that package on a clean dry surface.
This may seem like a no- brainer, but in the hospital,
these bedside tables are used for eating for patients, all kinds of things,
we want to make sure that where we are going
to lay our sterile field, it's nice and clean.
Next, once we open that kit,
we're going to take the top flap and we're going to open that
furthest away from our body.
Then there will be two side flaps that you're going to see
and you want to take one side flap,
open that outward,
then we're going to take the next flap we see on the side
and also open that outward as well.
Now lastly, you're going to take the final flap
and take that one, open it towards your body.
Notice even in that motion, I move back a little bit,
we want to be conscious not to lean over the sterile field.
Let's take a look at opening our sterile kit.
So if you remember before we get started,
we want to take a look at that equipment
and make sure it's safe to use.
So first of all, take a look at your package.
Make sure it's not wet, it's not soiled,
the package itself is not damaged,
then we want to remember to check our expiration date.
So this is really important on use of patients
because if it's out of date, we cannot guarantee
that that's safe to use on a patient.
Also, some sterile equipment for example,
may have like a sterile tape like this.
If it does, make sure this is intact and not opened.
That way we can ensure sterility of the equipment.
Now once we've inspected our package,
let's now open our sterile kit.
And first, we're going to perform our hand hygiene.
Now once we do this, we can remove the plastic covering of the package.
We're going to have to take off this intact tape here and peel this open.
We're going to remove this package from the plastic covering
and open this up.
And we can get this out of our way.
Alright, so once I've got my package open,
I'm going to take this top flap.
I'm going to grasp the outside of this and open that flap first.
Now before we get started, one thing to keep in mind,
you're thinking, "Okay, this is a sterile item.
I don't have gloves on, I'm touching the outside."
So why this is acceptable is because this outside portion
is what's going on the table and not used on our patient.
Alright, so let's look at this top flap.
We're going to grasp this and open away from our body.
So one thing to remember about sterile kits and these field,
it's really tricky because sometimes this will try to
go flat back open on your sterile field.
So a little trick I like to do is take these corners,
and fold them kind of on the outside and curl them,
so they don't flop back this way.
The other thing you just saw me do is touch the outside.
We'll talk about that in just a second.
So once I've taken the top flap and open it away from my body,
there's two side flaps, and I'm going to take each one and open those.
So I'm grasping the outside of the package,
opening this up
and I'm curling these underneath themselves,
so they don't flop backwards.
I'm taking my neck next flap
and opening this as well.
And this can be tricky, as you can see.
So notice I'm touching these edges
and really trying to make sure these curled down.
Then I'm going to take my final flap
and I'm going to open this toward my body.
Now watch when I do that,
I'm going to move away because I do not want to interrupt my sterile field.
So now this is open, a trick I want to show you,
it's really important that we have this in the way
that we can perform our patient care.
This is an ideal so I can take the edges
and move this appropriately or move it side to side.
Now a really important concept was sterile field.
Well, there's a few.
First one is notice you saw me touch that and you're thinking,
"Yeah, I thought you weren't supposed to do that."
But you have a 1-inch border on a sterile field that is acceptable to touch.
So again, you have a 1-inch border around this sterile field
that is not considered sterile and we can use this to move our package if need be.
So let's say I need to move it up my table,
I can touch this 1-inch and maybe move it
forward or back or wherever I need it.
Now that this is open,
I cannot touch anything inside this sterile field
and anything inside this one inch border
because everything inside the package is sterile.
And remember, I don't want to leave this
and I want to maintain eye contact on it at all times.