Practical: Preparation of a sterile field using standard-ANTT technique

Question 1

What is the equipment required for preparing a sterile field?

Answer 1

Dressing trolley, sterile dressing pack, cleaning solution, pair of sterile gloves, alcohol cleaning wipes, disposable plastic apron, alcohol swab

Question 2

What is the 1st step?

Answer 2

Check patient identity and ensure that he/she has given consent and is in an appropriate place for the procedure.

Question 3

What is the 2nd step?

Answer 3

Wash your hands or use alcohol hand gel (if already washed).

Question 4

What is the 3rd step?

Answer 4

Clean trolley systematically with approved alcohol wipes (1st top, then poles, then bottom shelf, working from back to front) and leave to dry.

Question 5

What is the 4th step?

Answer 5

Collect your equipment (sterile pack, cleaning solution, sterile gloves, alcohol swab and disposable plastic apron) making sure it is clean, dry and the packaging is not torn or damaged. Check sterility indications/expiry dates.

Question 6

What is the 5th step?

Answer 6

Place equipment on bottom shelf of trolley, to maintain the top shelf as a clean working area.

Question 7

What is the 6th step?

Answer 7

Take the trolley to patient; position the patient accordingly, keeping him/her covered until ready / loosen dressing if applicable (not in simulation)

Question 8

What is the 7th step?

Answer 8

Clean your hands with alcohol gel.

Question 9

What is the 8th step?

Answer 9

Put on a disposable plastic apron, to reduce possible contamination of your clothes.

Question 10

What is the 9th step?

Answer 10

Open the outer cover of the sterile pack and slide the contents, without touching them, onto the top shelf of the clean trolley.

Question 11

What is the 10th step?

Answer 11

Open the sterile inner wrapper, being careful to only touch the corners, outside surface or underneath of the wrapper to create an aseptic field. This ensures that areas of potential contamination are kept to a minimum. Your procedure tray should now be sitting in the middle of the sterile wrap.

Question 12

What is the 11th step?

Answer 12

Arrange the contents of the procedure tray by carefully picking up the sterile bag by one edge of its open end, and placing your other hand in the bag ensuring it covers your hand and lower arm (which should be the side nearest to the patient); keeping hold of the bag to ensure that it does not slip down your arm, use the sterile bag as a ‘glove’ to arrange the contents, maintaining a sterile field at all times.

Question 13

What is the 12th step?

Answer 13

Remove old dressing with hand covered in sterile bag. Invert the sterile bag, so that the old dressing remains encased by the bag. Remove the self-adhesive backing strip and stick bag to dressing trolley (on side nearest patient) below the top shelf / sterile field. This is now the disposal bag for the remainder of the procedure for any waste other than sharps.

Question 14

What is the 13th step?

Answer 14

Open any additional sterile dressings or solutions and drop or pour them onto the procedure tray, ensuring you do not touch the contents. If opening a saline sachet, clean perforation area with an alcohol swab.

Question 15

What is the 14th step?

Answer 15

Clean your hands with alcohol hand gel.

Question 16

What is the 15th step?

Answer 16

Put your gloves on (these may be part of the pack or may have to be added) ensuring the outer surfaces remain sterile.

Question 17

What is the 16th step?

Answer 17

Undertake procedure using a Standard-ANTT (aseptic non-touch technique) of key-sites and key-parts. Once procedure is completed and patient is comfortable, dispose of aseptic field by wrapping the remaining contents in the wrapping paper and place them in the rubbish bag.

Question 18

What is the 17th step?

Answer 18

Remove your gloves (turn them inside out to keep contaminated surface contained) and apron and dispose in clinical waste bin. Remove whichever item is the most contaminated first. Place into clinical waste.

Question 19

What is the 18th step?

Answer 19

Wash and dry your hands.

Question 20

What is the 19th step?

Answer 20

Clean trolley using agreed wipes, decontaminate hands, and complete the patient’s records.

Question 21

At which stages should you wash / decontaminate your hands?

Answer 21

2, 7, 14, 18, 19