Name: Honey Bee S.

Platolon Date: December 9, 2021

Subject: NSG 125.6 (Operating Room/OR)

“ETIQUETTE AND PRINCIPLES”

PRINCIPLES OF STERILE TECHNIQUE:

1. All articles used in an operation have been sterilized previously.

➢ Commercially packaged sterile supplies are marked as sterile; other packaging will
be identified as sterile according to agency policy.
➢ Check packages for sterility by assessing intactness, dryness, and expiry date prior
to use.
➢ Any torn, previously opened, or wet packaging, or packaging that has been dropped
on the floor, is considered non-sterile and may not be used in the sterile field.

2. Persons who are sterile touch only sterile articles; persons who are not sterile
touch only unsterile articles.

➢ Sterile OR personnel come in direct contact with persons who wears gowns and
gloves only. The items that they will touch are the sterile equipment’s. Any supply
brought by an unsterile staff should transfer the item in a sterile manner. Unsterile
OR personnel (circulator), should not directly come in contact with a gowned and
gloved person.

3. Sterile persons avoid leaning over an unsterile area; non-sterile persons avoid
reaching over a sterile field. Unsterile persons do not get closer than 12 inches
from a sterile field.

➢ In case where a solution has to be poured into a sterile basin, the unsterile OR
personnel should only hold the lip of the bottle over the basin to prevent any contact
with the sterile area.
➢ To prevent the circulator from reaching over a sterile area when pouring solutions,
the scrub person places the basin and glasses or any container for solutions near
the edge of the table. This prevents the circulator from reaching over the sterile
area by just standing near the edge of the table to fill the container with the liquid
solution.

4. If in doubt about the sterility of anything consider it not sterile. If a non-sterile

person brushes close, consider yourself contaminated.

➢ Known sterility must be maintained throughout any procedure.

5. Gowns are considered sterile only from the waist to shoulder level in front and
the sleeves to 2 inches above the elbows.
a. Keep hands in sight or above waist level away from the face.
b. Arms should never be folded.
c. Articles dropped below waist level are discarded.
➢ Keep all sterile equipment and sterile gloves above waist level. Table drapes are
only sterile at waist level. the front of the gown between the operative table and the
chest to be the area of greatest sterility and we strongly advise scrubbed personnel
to avoid contacting the surgical field with their elbow creases to minimize the risk of
infection.

6. Sterile persons keep well within the sterile area and follow those rules from
passing:
a. Face to face or back to back.
b. Turn back to a non-sterile person or when passing.
c. Face a sterile area when passing the area.
d. Ask a non-sterile person to step aside rather than trying to crowd past him.
e. Step back away from the sterile field to sneeze or cough.
f. Turn head away from sterile field to have perspiration mopped from brow.
g. Stand back at a safe distance from the operating table when draping the
patient.
h. Members of the sterile team remain in the operating room if waiting for the
case.
i. Do not wander around the room or go out in the corridors.

➢ Maintaining a sterile field is an important component of infection prevention. These

set of practices that are performed before, during and after invasive procedures
reduce the number of potentially infectious microbes and help to reduce the risk of
post procedure infection.

7. Sterile persons keep contact with sterile areas to a minimum.

a. Do not lean on the sterile tables or on the draped patient.
b. Do not lean on the nurse’s mayo tray.

➢ Sterile fields must always be kept in sight throughout entire sterile procedure. Never
turn your back on the sterile field as sterility cannot be guaranteed.

8. Non-sterile persons — when you are observing a case, please stay in the room
until the case is completed. Do not wander from room to room as traffic in the
operating room should be kept as a minimum. Patient privacy needs to be
respected.

➢ Maintain a safe space or margin of safety between sterile and non-sterile objects
and areas. Refrain from reaching over the sterile field. Keep operating room (OR)
traffic to a minimum, and keep doors closed in order to give the patient a privacy.

9. Keep non-essential conversation to a minimum.

➢ When suspicion arises as to the safety of a product, healthcare organizations must

provide critical information such as patient information, date, description of the case
involving the medical device and brand information like product code, model
number, serial number and expiration date.
 10. The circulating nurse is in charge of the room - If you have any questions, please
refer them to her, the supervisor or your instructor. Ask circulating nurse when it is
an appropriate time to ask questions so that explanations/rationale can be given.

➢ Circulating nurse is responsible for managing all nursing care within the operating
room, observing the surgical team from a broad perspective, and assisting the team
to create and maintain a safe, comfortable environment for the patient's surgery.

DISCUSS YOUR UNDERSTANDING OF ETIQUETTE IN THE OR

The concepts of operating room etiquette that I learned and understand is that you,
as an OR personnel, must prioritize the sterility of the area, yourself, and the equipment.
Standard operating room etiquettes are infection-prevention guidelines that apply to all
patient care in any healthcare setting, regardless of whether the patient is suspected or
confirmed to be infected. Apart from the sterilization of instruments and equipment, as well
as the cleaning and disinfection of the operating room, maintaining discipline and following
particular etiquette while in the theatre is critical. These guidelines are followed to keep
health-care workers from becoming infected and to keep them from transferring diseases to
patients. The most crucial thing to remember in the OR is to avoid contaminating the sterile
field. The goal of establishing a sterile field around the surgical site is to limit the number of
germs present and, as a result, the risk of infection and consequences.

References:

https://opentextbc.ca/clinicalskills/chapter/surgical-asepsis/
https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/principles-
sterility/
https://nurseslabs.com/principles-of-sterile-technique/