9 Sterile Technique and Infection Control
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 9.1: Aseptic Techniques, Proper Attire, and Hygiene
- 1. Review guidelines related to sterile technique
- 2. Clearly define terms related to sterile technique
- 3. Explain the concepts of barriers and containment
- 4. Demonstrate sterile techniques
- 5. Describe surgical attire
- 6. Demonstrate methods of hand hygiene using the correct technique
Lesson 9.2: Aseptic Technique in the Operating Room
- 7. Demonstrate correct gowning and gloving techniques
- 8. Demonstrate how to introduce sterile items onto the sterile field
- 9. Demonstrate and describe methods used to maintain the sterile field
- 10. Demonstrate the principles of Standard Precautions
- 11. Describe important components of the OSHA Bloodborne Pathogens Standard
- 12. Discuss the purpose and procedures used in transmission-based precautions
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Classroom Preparation
Lesson 9.1: Aseptic Techniques, Proper Attire, and Hygiene
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Review guidelines related to sterile technique
- 2. Clearly define terms related to sterile technique
- 3. Explain the concepts of barriers and containment
- 4. Demonstrate sterile techniques
- 5. Describe surgical attire
- 6. Demonstrate methods of hand hygiene using the correct technique
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 9.1: Aseptic Techniques, Proper Attire, and Hygiene
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Practice Guidelines Terms Used in the Guidelines ANSWER – Textbook • Review Questions 1, 2, 5 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Important Terms Related to Sterile Technique Sterility The Sterile Field Contamination Disinfection Antisepsis ANSWER – Textbook • Review Question 7 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Important Terms Related to Sterile Technique Barriers • Functional Zones of the Operating Room • The Operating Room Environment: HVAC Temperature and Humidity Air Changes and Filtering Air Pressure and Flow ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Personal Cleanliness Routine Handwashing • Hand Hygiene Hand Lotions and Creams Dermatitis and Other Skin Conditions ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Purpose • The Scrub Suit Personal Clothing Worn Under the Scrub Suit Personal Hand-held Electronic Equipment Identification Badges • Head Covering Guidelines: Head Covering • Shoes, Shoe Covers, and Boots Guidelines: Shoes • Protective Eyewear and Face Shields Guidelines: Protective Eyewear and Face Shields • Surgical Mask Guidelines: Surgical Mask • Non-Sterile Cover Jacket Guidelines: Long-sleeved Cover Jackets • Lab Coats and Cover Gowns Guidelines: Lab Coats and Cover Gowns • Laundering Surgical Attire Guidelines: Laundering Surgical Scrub Attire ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • Introduction to Surgical Hand Antisepsis • Surgical Hand Scrub Guidelines for Performing Surgical Hand Scrub Guidelines for Performing the Surgical Hand Scrub (CDC) • Surgical Hand Rub Guidelines for Performing Surgical Hand Rub ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 9.1: Aseptic Techniques, Proper Attire, and Hygiene
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | GUIDELINES FOR STERILE TECHNIQUE: SLIDES 4-5 | • Introduction • Practice Guidelines Terms Used in the Guidelines |
| 2 | TERMS: SLIDES 6-9 | • Important Terms Related to Sterile Technique Sterility The Sterile Field Contamination Disinfection Antisepsis |
| 3 | BARRIERS AND CONTAINMENT: SLIDES 10-12 | • Important Terms Related to Sterile Technique Barriers • Functional Zones of the Operating Room • The Operating Room Environment: HVAC Temperature and Humidity Air Changes and Filtering Air Pressure and Flow |
| 4 | STERILE TECHNIQUE: SLIDES 13-16 | • Personal Cleanliness Routine Handwashing • Hand Hygiene Hand Lotions and Creams Dermatitis and Other Skin Conditions |
| 5 | SURGICAL ATTIRE: SLIDE 17 | • Purpose • The Scrub Suit Personal Clothing Worn Under the Scrub Suit Personal Hand-held Electronic Equipment Identification Badges • Head Covering Guidelines: Head Covering • Shoes, Shoe Covers, and Boots Guidelines: Shoes • Protective Eyewear and Face Shields Guidelines: Protective Eyewear and Face Shields • Surgical Mask Guidelines: Surgical Mask • Non-Sterile Cover Jacket Guidelines: Long-sleeved Cover Jackets • Lab Coats and Cover Gowns Guidelines: Lab Coats and Cover Gowns • Laundering Surgical Attire Guidelines: Laundering Surgical Scrub Attire |
| 6 | SURGICAL HAND HYGIENE: SLIDES 18-19 | • Introduction to Surgical Hand Antisepsis • The Surgical Hand Scrub Guidelines for Performing Surgical Hand Scrub Guidelines for Performing the Surgical Hand Scrub (CDC) • The Surgical Hand Rub Guidelines for Performing Surgical Hand Rub |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • Discuss the standards and recommendations of aseptic technique with the class. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (50 min) • Break the class into three groups. Designate one as the sterile group, the second as a nonsterile group, and the third as the surgically clean group. Using a board or large sheets of paper, have the members of each group list items that fall into their group’s category. Share and discuss the results with the class. • Appropriate Settings: Traditional/online/flipped classroom |
| 3 | DISCUSS (30 min) • Using the board (or the computer setup for PowerPoint slides), list three types of barriers. Have students offer examples of each type of barrier. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | PRESENT (50 min) • In pairs, students will present a PowerPoint presentation on principles of sterile technique. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | ROLE PLAY (50 min) • Have students put on scrub suits (including head coverings) correctly and in the proper order. Students should monitor each other (with instructor supervision) for proper use of scrub suits and head coverings. To foster critical thinking, ask the students, “What areas of the surgical suite are you dressed for?” They should be allowed in all the areas except the operating room itself. Appropriate Settings: Traditional classroom |
| 6 | DEMONSTRATE (30 min) • Divide students into pairs. Demonstrate the proper hand wash, surgical rub, and surgical scrub using the correct method. Each student will have the opportunity to demonstrate the correct technique. (Use the bathrooms for hand wash, have a station set up for surgical hand rub, and have students at scrub sink.) Appropriate Settings: Traditional classroom |
Critical Thinking Question
What are the differences among sterile, nonsterile, surgically clean, and aseptic?
Discussion Guidelines: Sterile indicates that an object is free from all microorganisms, including spores; being nonsterile is the opposite – not free of microorganisms; surgically clean refers to tissue surfaces (skin) – surgically clean is reducing microbes to an irreducible minimum. Aseptic is simply without sepsis or without disease and usually refers to the techniques we use to accomplish sterility. Therefore, aseptic is the practices and techniques used to keep a surgical environment sterile; sterile and nonsterile refer to items and surfaces; and surgically clean refers to tissues/skin.
You wake up and discover that you ache and feel uncomfortable. You really want to go back to bed, but know that other members of the operating room team are depending on you to be there for a very full and busy day. You go to work, only to find that another member of the team is out sick and you’ll have extra assignments today. As you begin to prepare for your first operating room session, your nose starts running heavily and you start sneezing frequently. Do you keep on working? Do you tell your supervisor about your worsening condition and request to go home? What are the considerations that enter into your decision? How does surgical conscience contribute to your decision?
Discussion Guidelines: Students might discuss reasons why a surgical technologist should not work while ill. The possibility of spreading the illness to other health care personnel and the patient is great. And there is the possibility that, while ill, a surgical technologist may not perform at his or her optimum level and will make mistakes that can cause harm to the patient. This is a violation of surgical conscience.
Classroom Preparation
Lesson 9.2: Aseptic Technique in the Operating Room
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 7. Demonstrate correct gowning and gloving techniques
- 8. Demonstrate how to introduce sterile items onto the sterile field
- 9. Demonstrate and describe methods used to maintain the sterile field
- 10. Demonstrate the principles of Standard Precautions
- 11. Describe important components of the OSHA Bloodborne Pathogens Standard
- 12. Discuss the purpose and procedures used in transmission-based precautions
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 9.2: Aseptic Technique in the Operating Room
STUDENT PREPARATION (1 hr)
| 7 | READ – Chapter Heading(s) • Part IV: Drying the Hands, Gowning, and Gloving • Drying the Hands • Unassisted Gowning • Closed (Unassisted) Gloving Guidelines: Unassisted Gowning and Gloving • Open Gloving • Assisted Gowning and Gloving Gowning Other Team Members Gloving Other Team Members Guidelines: Gowning and Gloving Others • Surgical Helmet System ANSWER – Textbook • Review Question 3 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Opening a Surgical Case Guidelines: Opening a Surgical Case or Invasive Procedure • Creating the Sterile Field Draping the Back Table Opening Envelope-wrapped Packs Instrument Trays Basins Peel Pouches Sharps Fluids Small Wrapped Packages Guidelines: Opening Sterile Items ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • Breaks in Sterile Technique Removing Gown and Gloves Contaminated Instruments and Equipment Guidelines: Contamination of the Sterile Field • Covering the Sterile Setup Technique for Covering a Sterile Setup Guidelines: Covering the Sterile Field • Movement Within and Around the Sterile Field Guidelines: Movement Around the Sterile Field ANSWER – Textbook • Review Questions 4, 6 • Case Study ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 | READ – Chapter Heading(s) • Standard Precautions Guidelines: Standard Precautions • Personal Protective Equipment (PPE) Guidelines: Personal Protective Equipment ANSWER – Textbook • Review Questions 8, 10 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 11 | READ – Chapter Heading(s) • OSHA Bloodborne Pathogens Standard Patient Care Equipment and Linens Sharps Injury Risk Reduction Neutral Zone and No Touch Technique Guidelines: Sharps Safety Human Factor Post exposure Prophylaxis Components of Post exposure Prophylaxis Guidelines: OSHA Bloodborne Pathogens Standard ANSWER – Textbook • Review Question 11 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 12 | READ – Chapter Heading(s) • OSHA Bloodborne Pathogens Standard Transmission-Based Precautions Hazardous Waste ANSWER – Textbook • Review Question 9 ANSWER – Workbook • Chapter 9 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 9.2: Aseptic Technique in the Operating Room
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 7 | GOWNING AND GLOVING: SLIDES 21-22 | • Part IV: Drying the Hands, Gowning, Gloving • Drying the Hands • Unassisted Gowning • Closed (Unassisted) Gloving Guidelines: Unassisted Gowning and Gloving • Open Gloving • Assisted Gowning and Gloving Gowning Other Team Members Gloving Other Team Members Guidelines: Gowning and Gloving Others • Surgical Helmet System |
| 8 | STERILE FIELD: SLIDES 23-24 | • Opening a Surgical Case Guidelines: Opening a Surgical Case or Invasive Procedure • Creating the Sterile Field Draping the Back Table Opening Envelope-wrapped Packs Instrument Trays Basins Peel Pouches Sharps Fluids Small Wrapped Packages Guidelines: Opening Sterile Items |
| 9 | MAINTAINING A STERILE FIELD: SLIDE 25 | • Breaks in Sterile Technique Removing Gown and Gloves Contaminated Instruments and Equipment Guidelines: Contamination of the Sterile Field • Covering the Sterile Setup Technique for Covering a Sterile Setup Guidelines: Covering the Sterile Field • Movement Within and Around the Sterile Field Guidelines: Movement Around the Sterile Field |
| 10 | STANDARD PRECAUTIONS: SLIDE 26 | • Standard Precautions Guidelines: Standard Precautions • Personal Protective Equipment (PPE) Guidelines: Personal Protective Equipment |
| 11 | OSHA BLOODBORNE PATHOGENS STANDARD: SLIDE 27 | • OSHA Bloodborne Pathogens Standard Patient Care Equipment and Linens Sharps Injury Risk Reduction Neutral Zone and No Touch Technique Guidelines: Sharps Safety Human Factor Post exposure Prophylaxis Components of Post exposure Prophylaxis Guidelines: OSHA Bloodborne Pathogens Standard |
| 12 | TRANSMISSION-BASED PRECAUTIONS: SLIDES 28-29 | • OSHA Bloodborne Pathogens Standard Transmission-Based Precautions Hazardous Waste |
Learning Activities (choose one or more to equal 50 min)
| 7 | PRACTICE (50 min) • Practice donning and removing sterile attire. Appropriate Settings: Traditional classroom |
| 8 | DEMONSTRATE (50 min) • Instructor demonstrates passing and receiving items, opening peel pouches, opening basins, opening small items, and distributing solutions. Students should try these methods under the supervision of the instructor. • Appropriate Settings: Traditional classroom |
| 9 | ROLE PLAY (50 min) • Assign a student to play the role of a patient. The “patient” lies down on a table or surgical table. Using string or yarn, have the “patient” hold one end of each of two pieces of yarn. Two other students should stretch out the yarn to show the area of the sterile field for an abdominal procedure. Ask students to discuss whether there would be any changes in the sterile field if the procedure were surgery on either a foot or an eye. • Appropriate Settings: Traditional/online/flipped classroom |
| 10 | DISCUSS (30 min) • Discuss the duty of health care providers to protect their patients and themselves against infectious disease. • Appropriate Settings: Traditional/online/flipped classroom |
| 11 | PRACTICE (30 min) • Have students practice the no touch technique used for handling sharps. • Appropriate Settings: Traditional classroom |
| 12 | DISCUSS (30 min) • Discuss as a class the guidelines for handling and disposing of waste in the operating room environment. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
You are preparing the operating room for use in an emergency surgical case. Time is short, and the patient in critical condition is on the way. You find that one needed package of instruments has drops of a clear liquid on the outside of the package wrapping. Obtaining a replacement package of instruments will take long enough to delay the surgery. What do you do? Why? What principles govern your decision?
Discussion Guidelines: Students might discuss the risk to a patient in critical condition if the surgical instruments are not sterile. Remind students that here is a situation in which the surgical conscience and considerations of patient safety play a role.
Assessments
Chapter 9: Sterile Technique and Infection Control
ASSESSMENTS BY OBJECTIVE
| 1-12 | Workbook • Chapter 9 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 9 – Graded quizzes (Mastery Levels 1, 2, and 3) |
