Surgical asepsis eliminates all microorganisms including spores, whereas medical asepsis only reduces their number.
Before you read
Test yourself first: 3 questions
Question 1 of 3
Which describes correct surgical hand antisepsis/asepsis principle?
Answer: B. Once an item or field is sterile, it must stay within the sterile field and in view; turning your back on the field or letting it get wet (strike-through) contaminates it.
Question 2 of 3
During a surgical procedure, the sponge/instrument count is incorrect. The team should:
Answer: B. An incorrect count requires searching and, if not resolved, an X-ray before closing to prevent a retained foreign object (a sentinel event). Closing anyway is unsafe.
Question 3 of 3
During the preoperative time-out immediately before incision, which action is the primary purpose of this surgical safety step?
Answer: A. The time-out, a core Universal Protocol step, is a final verification by the entire surgical team to confirm the correct patient, correct procedure, and correct surgical site before the incision is made. It is performed after the patient is prepped and draped and requires active participation from all team members.
Keep the streak going with more questions like these, each with a full rationale.
What is surgical asepsis?
It contrasts with medical asepsis (clean technique), which only reduces the number of organisms. The principle is total absence of microbes within the sterile zone.
Key points to remember
- Surgical asepsis eliminates all microorganisms including spores, whereas medical asepsis only reduces their number.
- It is required for surgery, catheter insertion, central line placement, and invasive sterile dressing changes.
- A surgical scrub uses friction from fingertips to elbows, keeping hands above the elbows so water runs downward.
- After scrubbing, hands are held up and away from the body to prevent contamination.
- Sterile items contacting non-sterile surfaces, or any wet sterile field, are considered contaminated.
- The sterile gown is considered sterile only from chest to waist in front and from the hands to just above the elbows.
Nursing priorities
- Perform a surgical scrub with friction, keeping hands higher than elbows throughout.
- Dry hands and don sterile gown and gloves without touching non-sterile surfaces.
- Maintain awareness of sterile boundaries on the gown and field at all times.
- Discard and replace any item or field whose sterility is in question.
Patient teaching
- Explain to patients that the masked, gowned setup exists to prevent surgical-site infection.
- Ask patients not to touch sterile drapes or instruments during the procedure.
Red flags: report now
- When sterility is uncertain, treat the item or field as contaminated and replace it.
- Never lower scrubbed hands below the elbows or below waist level.
- Report any contamination event during a sterile procedure immediately.
References
Clinical references for this topic
