無菌技術(shù)（18） ppt課件

AsepticTechniques無菌技術(shù) UnionHospitalWangying 2 11 21 10 Objective MasterprincipleofaseptictechniqueMastertheproceduresofaseptictechnique 3 11 21 10 Aseptictechnique thepracticeswhichpreventmicroorganismsinvadinghumanbeings andsterileobjectsandareasfrombeingcontaminatedduringmedicalproceduresandnursinginterventions 4 11 21 10 SkillofAsepticTechniques ApplySterileTransferForceps TissueForceps無菌持物鉗 鑷的使用ApplySterileContainer無菌容器的使用PourSterileSolution取無菌溶液UseSterilePackage無菌包的使用PrepareSterileTreatmentTray鋪無菌盤DonandRemoveSterileGloves戴 脫無菌手套 5 11 21 10 Applysteriletransferforceps無菌持物鉗的使用 Steriletransferforceps tissueforceps beusedtotakeandtransfersterileitemsFourtypesoftransferforceps threeforkedforcepstransferforcepslongtissueforcepsshorttissueforceps 6 11 21 10 shorttissueforceps transferforceps longtissueforceps threeforkedforceps 7 11 21 10 thesolutionlevelshouldbe2 3cmabovethejointpivot 2 3cm Soakingsterileforcepsinanticepticsolution sterilecontainerwithbigopeningandcover onlyonepairofforcepsinacontainer jointpivot 8 11 21 10 Advantagesofdry stylemaintenance toreducecontaminationtosavehospitalcosttoreducethetoxicityofchemicaldisinfectantstobody 9 11 21 10 Procedures Washanddryhands wearmaskChecktheexpirationdateofforcepscontainer OpenthelidofthesterilecontainerHoldthesteriletransferforcepswithonehand holdthetissueforcepsbyupper1 3 closethetipsoftheforceps moveittothecenterofthecontainer andtakeitoutofthecontainervertically 10 11 21 10 Procedures Keeptheforceps tipsdownward Donotreversethedirection avoidtheantisepticsolutionflowingbackwardandthuscontaminatingtheforcepstips Closetheforceps tipsafterbeingused toavoidtouchingtheedgeofthecontaineropening andimmediatelyputitbacktothecontainervertically Loosenthejointpivotwhensoakingtheforcepsinthesolution tomakeitsaturatedbytheantisepticsolution 11 11 21 10 Procedures Whentakingthesterileitemsfromafardistance thesterilecontainershouldbecarriedwiththesterileforceps avoidthesterileforcepsexposingtoairfortoolong Thesterileforceps containerandasepticsolutionshouldbechangedandsterilizedtwotimeseveryweek However thesterileforcepsfrequentlyusedshouldbechangedandsterilizedeveryday 12 11 21 10 Keypoints Donotusesterileforcepstotakeoilygauzeincasetheoiladherestotheforceps tipsandaffectsthedisinfectioneffect Donotusethesterileforcepstododressingordisinfectskintoavoidcontamination 13 11 21 10 ApplySterileContainer使用無菌容器 Sterilecontainersarecontainerssterilizedtoholdsterileitems 14 11 21 10 Vocabulary Sterilebowl無菌碗Steriletray無菌盤Steriletin無菌罐Sterilegrooves無菌儲物槽 15 11 21 10 Sterilegrooves Sterilebowl Steriletin 16 11 21 10 Procedures Washanddryhands wearmaskandcheckthelabel includingexpirationdate name ofthecontainer Whentakingobjectsfromthecontainer takethecoverawayfromthecontainerhorizontally keeptheinnersideofthecoverupwardintheflatsteriletableordownwardinthehand Openingsterilecontainer 17 11 21 10 Procedures Aftertheobjectshavebeentakenout immediatelyreversethecover makeitsinnersidedownwardandcoverthecontainercarefully toavoidthecontentexposedtoairfortoolong Whentakingsterilecontainersuchassterilebowl holditbyitsbottomwithonehandorbothhand nevertouchtheinnersurfaceofthesterilecontainer Handingsterilecontainer 18 11 21 10 PouringSterileSolution倒無菌溶液 19 11 21 10 EquipmentNeeded 用物 treatmenttray治療盤steriletransferforceps無菌傳物鉗steriletin無菌罐sterilebowl無菌治療碗sterilesolution無菌溶液akidneybasin彎盤cottonsticks棉簽scissors剪刀abottle opener起瓶器treatmentcard治療卡rag抹布disinfectants消毒劑recordcard記錄卡apen筆 20 11 21 10 Procedure Checktreatmentcard assemblealltheequipmentneeded Cleanthetreatmenttrayandworkingsurface Cleanthedustontheoutsideofthebottle Checkthelabelofthesterilesolution name concentration dosageandexpirationdate Checkifthelidisloose ifthereisanycrackonthebottleandtheclearanceofthesolution Discardifunclearorleaksandvisibleparticulatearefound 21 11 21 10 Procedure Washanddryhands wearmask Openthealuminumlidwithabottle opener Takeasterilebowlandplaceitinthetreatmenttray Checkthedateofsterilizationandcheckifthecapofthebowliswetorwornout takethecapawayfromthebowl innersideoutside 22 11 21 10 Procedure Disinfecttherubberlid disinfectthefirstthreefingersofonehand disinfectthumb indexfingerandmiddlefingeroftwohands Usethethumbandindexfingertoturntherimoftherubberlidoverupward Checkthelabelofthesterilesolutiononceagain Pulltherubberlidoutwiththedisinfectedfingers Havethelabelofthebottleagainstthenurse spalmofhand Pulltherubberlidoutwiththeindexandmiddlefingersofonehand 23 11 21 10 Procedure Pourasmallamountofsolutionintothekidneybasintocleanthelipofthebottle Pourtheneededamountofsolutionintothesterilebowlfromthesameplaceofthelip Pourslowlytoavoidspill Inserttherubberlidintothebottleimmediately Recapthesterilebowl PouringSterileSolution 24 11 21 10 Procedure Disinfect theinnersurfaceof therubberlidandtheoutersurfaceoftheopeningofthebottle recapthesolutionbottle Usesterilegauzetowraptherubberlid Checkthelabelforthethirdtime nameofthesolution concentration dosageandexpirationdate 25 11 21 10 Procedure Takenoteofthedatesandtimeofopeningthebottleandsignyourname Takenoteofthedateandtimeofpreparingtheasepticsolutionandsignyourname Coordinatetheequipment Washhandsandtakeoffthemask 26 11 21 10 Estimatedtimetocompletetheskill 5minutes 27 11 21 10 RationaleandKeyPoints Donotpourthesolutionbackintothebottle Donotputtheitemsintothebottletodipthesolution Thesolutionintheopenedbottlecanbekeptsterilefor24hours thesolutioninthesterilebowlcanbekeptsterilefor4hours 28 11 21 10 UseSterilePackage使用無菌包 29 11 21 10 Foldingtreatmenttowelvertically verticallyfoldthetowelthreetimestomake6foldsandhorizontallyfoldonce oneoftheedgefacesoutside 30 11 21 10 Procedures washanddryhands wearmask Packsterilepackage Placetheitemstobesterilizedinthecenterofthedoublewrapper Putanindicatorcardinit Foldtheflap thenearestfromthenursecomesfirst thenfoldtheleft rightsideflaps andatlastfoldthefarthestflapfromthenurse Tietheitemscontainedintheclothwithastringin cross shape nottootightortooloose Taptheindicatorstripandlabelonthepackagewiththepackage snameandsteriledates 31 11 21 10 Procedures OpensterilepackageCheckthenameofthepackageandthesterilizationdate Seewhetherthesterilepackageisdampanddamagedornot Placethepackageonaclean dryandflatsurface untiethestringandrollitbelowthepackage opentheouterwrapperofthesterilepackageaccordingtoitsoriginalcreaseswithyourhandsandopentheinnerwrapperofthesterilepackagewiththesteriletransferforceps 32 11 21 10 Procedures OpensterilepackageTakeouttheneededitemswithasterileforcepsandputthemonapreparedsterilearea Foldthepackagedaccordingtoitsoriginalcreasesandtieitin 一 shape Notedownthedateandtimeofpackageopening 33 11 21 10 Procedures Iftheitemsinthesterilepackageneedbetakenoutforonetime Holditwithrighthandandopenthewrapperwithlefthandtoexposetheitems catchthewrapperwiththerighthandandholditscornerswiththeotherandpourtheitemstothesterilearea Placingsterileitemsonsterilefield 34 11 21 10 Keypoints Therearelabelsindicatingthenameoftheobjectsandsterilizationdateontheoutersideofwrapper Theexpirationdurationis1 2weeks Donotusethepackageiftheexpirationdateisover Whenopeningthepackage donottouchtheinnersideofthewrapperandthesterileitems Ifthepackagehasbeentiedin 一 shape itmeansthatthepackagehasbeenopenedandtheremainingitemsneedtobeusedwithin24hours 35 11 21 10 Keypoints Iftheitemsarecontaminatedorthewrapperiswet re sterilizationisneeded Whenpouringtheitems makethesterilesurfaceofthewrapperfacethesterilearea 36 11 21 10 PrepareSterileTreatmentTray 鋪無菌盤 Purpose steriletreatmenttrayistodrapeasteriletreatmenttowelonacleananddrytreatmenttraytoformasterileareaandplacesterileitemsontoit 37 11 21 10 EquipmentNeeded twohandsmethod 雙手法 Treatmenttray治療盤steriletransferforceps無菌持物鉗Steriletissueforceps無菌持物鑷steriletin sterilegauzebekeptinit 無菌罐 內(nèi)裝無菌紗布 Sterilepackage with2piecesoftreatmenttowelandchemicalindicationcardinitandchemicalindicationstriponitsouterwrapper 無菌包 內(nèi)有無菌治療巾 滅菌指示卡 包外貼化學指示膠帶 kidneybasin彎盤2recordcards記錄卡2張apen記錄筆acleanrag清潔抹布 38 11 21 10 Procedures Assemblealltheequipmentneeded Cleantreatmenttrayandworkingsurface placethetreatmenttrayinappropriateplace Washanddryhands wearmask 39 11 21 10 Procedures Checkifthechemicalindicationstripchangeitscolor Checkthenameofthepackageanddateofsterilization checkifthesterilepackageisloose dampofdamaged 40 11 21 10 Procedures Opensterilepackage 1 Placethepackageonaclean dryandflatplace untiethestringandrollitunderthepackage 2 Opentheouterwrapperofthepackageaccordingtoitsoriginalcreaseswithyourhands thatisopentheflapfarthestfromthenursefirst thentheleftandrightoftheouterwrapper 外 左 右 3 Thentakesterileforceps opentheflapnearestfromyouwithyourlefthand thenopentheinnerwrapperofthesterilepackageaccordingtoitsoriginalcreaseswithsterileforceps4 Checkifthechemicalindicationcardchangeitscolor 41 11 21 10 Procedures Pickupatreatmenttowelwithsterileforcepsandplaceitonyourlefthand Foldtheinnerwrapperofthepackageaccordingtoitsoriginalcreaseswithsterileforceps thenreturnthesterileforceps Holdtheoutersurfaceoftowelattwocornerswiththumbandindexfingeroftwohands gentlyopenandplaceitwithdoublefoldsinthetreatmenttray 42 11 21 10 Procedures Foldtheouterwrapperofthepackagewithyourhands tiethepackagein 一 shape Fanfoldtheupperlayerofthetowelwithitsedgestowardoutside Theinsideofthesteriletowelwillbemadetoasterilearea Placesterileitemsontothesterilearea Pullthetoplayerofthetoweltocoverthem makingtheedgesofthetwolayersparallel 43 11 21 10 Procedures Foldtheedgeofthetowelupwardtwiceandthenfoldthebothsidesofedgesoftoweldownwardonce 1 Notedownthedateandtimeofpreparingsteriletreatmenttrayandnameofthesterileitemsandsignyourname 2 Notedownthedateandtimeofopeningsterilepackageandnameofsterileitemsandsignyourname 44 11 21 10 Procedures Thissterilepackageshouldbeusedinpriority Thesterilepackagecanbekeptsterilefor24hours Coordinatetheequipment Washhandsandremovethemask 45 11 21 10 Estimatedtimetocompletetheskill 5minutes 46 11 21 10 RationaleandKeyPoints Purpose steriletreatmenttrayistodrapeasteriletreatmenttowelonacleananddrytreatmenttraytoformasterileareaandplacesterileitemsontoit 47 11 21 10 Keypoints Theworkingsurfaceforpreparingsteriletreatmenttrayshouldbecleananddry Protectthesteriletowelfrombeingmoist Yourhandsorotherunsterileitemscannottouchtheinnersideofthesteriletowel Thesteriletreatmenttraycanbekeptsterilefor4hours 48 11 21 10 Onehandandonesterileforcepsmethod 一手一鉗法 single layingtreatmenttray Double layingtreatmenttray 49 11 21 10 EquipmentNeeded 用物 Treatmenttray治療盤sterileforceps無菌持物鉗steriletin sterilegauzebekeptinit 無菌罐 內(nèi)裝無菌紗布 Sterilepackage with2piecesoftreatmenttowelandchemicalindicationcardinitandonitsouterwrapper 無菌包 內(nèi)有無菌治療巾 滅菌指示卡 包外貼化學指示膠帶 kidneypan彎盤2recordcards記錄卡2張acleanrag清潔抹布 50 11 21 10 Procedures Assemblealltheequipmentneeded Takeequipmentoutandplacethemontheworkingsurface Cleantreatmenttrayandworkingsurface placethetreatmenttrayinappropriateplace Washanddryhands wearmask 51 11 21 10 Procedures checkifthechemicalindicationstripchangeitscolor Checkthenameofthepackageanddateofsterilization checkifthesterilepackageisloose dampordamaged 52 11 21 10 Procedures Opensterilepackage 1 Placethepackageonaclean dryandflatplace untiethestringandrollitunderthepackage 2 Opentheouterwrapperofthepackageaccordingtoitsoriginalcreaseswithyourhands thatisopentheflapfarthestfromyoufirst thentheleft therightsideofthewrapper 外 左 右 3 Thentakesterileforceps opentheflapnearestfromyouwithyourlefthand thenopentheinnerwrapperofthesterilepackageaccordingtoitsoriginalcreaseswithsterileforceps4 Checkifthechemicalindicationcardchangeitscolor 53 11 21 10 Procedures Pickupatreatmenttowelwithsterileforcepsandplaceitontheleftsideoftheinnerwrapper Holdthetwooutercornersofthetopedgeofsteriletowelwithsterileforcepsandyourlefthand openthetowelgently layitonthetreatmenttrayfromoutertoinnerside Foldtheinnerwrapperaccordingtoitsoriginalcreaseswithsterileforcepsandfoldtheflapnearestfromyouofouterwrapperwithyourlefthand Placesterileitemsontothesterilearea 54 11 21 10 Procedures Openthesterilepackageagain 1 Openthenearestflapfromyouoftheouterwrapperwithyourlefthand 2 Opentheinnerwrapperwithsterileforceps Holdthetwooutercornersofthetopedgeofsteriletowelwithsterileforcepsandyourlefthand openanothertowelgently layitonthefirststeriletowelfrominnertoouterside makingtheedgesofthetwotowelsparallel 55 11 21 10 Procedures Foldtheinnerwrapperofthepackageaccordingtoitsoriginalcreaseswithsterileforceps thenreturnthesterileforcepsintothesterilecontainer Foldtheouterwrapperwithyourhands tiethepackagein 一 shape Foldtheedgeofthetowelsnearestfromyouupward thentheleftside thefarthestsideandlasttherightside 1 Notedownthedateandtimeofpreparingsteriletreatmenttrayandnameofthesterileitemsandsignyourname 2 Notedownthedateandtimeofopeningpackageandnameofthesterileitemsandsignyourname 56 11 21 10 Procedures Thissterilepackageshouldbeusedinpriority Thesterilepackagecanbekeptsterilefor24hours Coordinatetheequipment Washhandsandremovethemask 57 11 21 10 Estimatedtimetocompletetheskill 5minutes 58 11 21 10 RationaleandKeyPoints Purpose steriletreatmenttrayistodrapeasteriletreatmenttowelonacleananddrytreatmenttraytoformasterileareaandplacesterileitemsontoit 59 11 21 10 Keypoints Theworkingsurfaceforpreparingsteriletreatmenttrayshouldbecleananddry Protectthesteriletowelfrombeingmoist Yourhandsorotherunsterileitemscannottouchtheinnersideofthesteriletowel Thesteriletreatmenttraycanbekeptsterilefor4hours 60 11 21 10 DonandRemoveSterileGloves 61 11 21 10 EquipmentNeeded packagedsterileglovesincorrectsize無菌手套powder滑石粉nailscissors ifneeded 指甲剪kidneypan彎盤supplyforwashinghands洗手設(shè)備acleanrag清潔抹布 Donningsterilegloves 62 11 21 10 Procedures Checkandtrimfingernailsifneeded Keepfingernailsshorttoavoidpuncturingthegloves Cleananddryworkingsurface Washanddryhandsandwearmask 63 11 21 10 Procedures Checkthesizeanddateofsterilizationofthesterileglovespackage checkifthepackageismoistorwornout