Page 54 - policy and procedure infection control

Policies and Procedures on Infection Control

6. The air is part of the sterile field. If procedures are performed in a properly designed
procedure room or operation theatre, the content of micro-organisms in it is considered
minimal and instruments are not rendered non-sterile on exposure to air. However
exposure to air for a long duration (e.g. by leaving sets open for long periods) increases
the risk of contamination by dust and other particles

4.1.6 Maintaining sterility of instruments / disposable items during a procedure
1. The non-touch technique is also used to ensure that instruments or items remain
sterile during a procedure. The person opening packets / envelopes must ensure
that the inside of the packet is not touched.
2. He / she transfers it by letting it drop on to the sterile field. Another method is for the
person receiving the item to grasp the item or the inside package from the packet
with a gloved hand or sterile forceps without touching the exterior of the packet.
3. The entire sterile instruments / disposable items (such as lines and catheters) should
lie within a sterile field. Special care must be taken when using long lines or wires
e.g. guide wires.
4. Problems arise when the sterile catheter or tubes need to be connected to non-
sterile connectors. Below are some of the situations when some of these problems
occur and how they can be resolved:
o When inserting a central line, introduce the IV catheter and all connecting tubes
into the sterile field. After the catheter is inserted, pass the end of the intravenous
tubing (used to puncture the IV solution bag) to the assistant.
o The assistant connects the tubing to the bag and the fluid is run in to prime the
line. The other end remains sterile in the sterile field and is then connected to the
intravenous catheter.
o A similar technique is used when inserting chest drains, peritoneal dialysis
catheters and urinary catheter. Place all tubes and containers into the sterile
field.
o The person performing the procedure should secure the connections before passing
the containers (underwater seal bottles /urine containers /dialysate bags) to the
assistant

Ministry of Health Malaysia 43