Establishing and Maintaining A Sterile Field Definition:: Action Rationale Performe D Remarks YES NO

Name: ___________________________________________________________________ Date: ______________
Evaluator/Signature: ________________________________________________________ Grade: _____________
ESTABLISHING AND MAINTAINING A STERILE FIELD

Definition:
Purposes:
1.
2.
Special Considerations:
1.
2.
a.
b.
c.
3.
4.
5.
Equipment:
● Package containing sterile drape
● Sterile equipment as needed, eg, wrapped sterile gauze, a wrapped sterile bowl, antiseptic solution and sterile forceps
PERFORME
ACTION RATIONALE D REMARKS
YES NO
MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

A. Arranging a Sterile Field
1. Wash hands.
2. Choose a flat, hard, dry surface and clear

sufficient area on which to prepare a sterile
field.
3. Before sterilization, objects are wrapped and

the wrapper when opened provides a sterile
field.
4. Determine the sterility of the package, ensure that
the package is dry, check the expiration dates and
look for indications that it has been previously
opened.
B. Opening a Sterile Pack
5. Place the package in the center of the work
area so that the top flap of the wrapper opens
away from you.
6. Reaching around the package (not over it),
pinch the first flap on the outside of the
wrapper between your thumb and index
finger. With some folded packages, it may be
necessary to grasp the uppermost flap at each
corner. Pull the flap open, laying it flat on the
far surface.
7. Side flaps are opened one at a time, opening
the top one first. Use the right hand for the
right flap, and the left hand for the left flap.
8. Pull the fourth flap toward you by grasping
the corner that is turned down. Make sure
that the flap does not touch your uniform.
PERFORME
YES NO

C. Opening a wrapped package while holding it.
9. Hold the package in one hand with the top flap
opening away from you.
10. Open the package as described above using
the other hand, pulling the corners of the
flaps well back.
Note: Inside the wrapper is considered sterile

except for the 1 inch border around the edges,
and may be used as base for sterile field or as a
field to add additional items.
D. Closing a wrapped package
11. Pick up the flap closest to you, handling it at
the corner, and lay it over the contents. Make
sure the corner is folded toward you, as it
was before the flap was opened.
12. Select the side you opened third. Pinch the
side flap from the underside and lay it over
the contents. Use right hand for the right flap
and left hand for the left flap.
13. Repeat for the other side.
14. Pinch the far flap from the underside

by reaching around the package and bring the
flap over the contents. Tuck it in loosely.
15. Use the rewrapped package immediately.
16. Reopen the package by using the method

above.
ACTION RATIONALE PERFORME REMARKS

D

YES NO
E. Opening commercially prepared packages
17. If the flap of the package has an
unsealed corner, hold the container in one
hand, and pull back on the flap with the other
hand.
18. If the package has a partially sealed edge,

grasp both sides of the edge, one with each
hand and pull apart gently.
19. Rewrap the sterile package as required by
reversing the order to unwrapping. Close the
proximal flap first to prevent reaching across
the sterile field, the side flaps next and the
distal part last.
F. Establishing a sterile field by using a drape
20. Open the package containing the
drape as described above.
21. Pluck the corner of the drape that is folded
back on the top using one hand.
22. Slowly lift the drape out of the cover and

permit it to open freely without touching any
articles. Discard the cover.
23. With the other hand, gently pick up another

corner of the drape holding it well away from
the body.
24. Put the drape on a clean, dry surface, placing

the bottom farthest from you.
25. Allow the top half of the drape to be placed

over the work surface last.

PERFORME
YES NO
26. Grasp the 1-inch border around the edge to
position as needed.
G. Adding necessary supplies

A. To add wrapped supplies to a sterile
field.
27. Open each wrapped package as described
above.
28. With the free hand, grasp the corners of the

wrapper and hold them against the wrist of
the other hand.
29. Place the sterile bowl, drape and other

supplies on the sterile field by approaching
from an angle rather than holding the arm
over the field.
30. Discard the wrapper.
B. To add commercially packed supplies.

31. Open each package.
32. Hold the package 15 cm (6 in.) above the

field and permit the contents to drop on the
field. Keep in mind that 2.5 cm (1 in.) around
the edge of the field is considered
contaminated.
C. To add sterile solution to a sterile bowl

33. Before pouring any liquid, read the label,
name of the solution three times to make sure
you have the correct solution.
34. Obtain the exact amount of the solution as
possible.
PERFORME
YES NO
35. Remove the lid or cap from the bottle and
invert the lid before placing it on a surface
that is not sterile.
36. Hold the bottle so that the label is uppermost.
37. Hold the bottle of fluid at a height of 10-15

cm (4-6 in) over the bowl and to the side of
the sterile field so that as little of the bottle as
possible is over the field.
38. If the bottle had been previously opened,
pour small amount of liquid into a waste
receptacle without letting the tip of the bottle
to touch the receptacle. Carefully pour the
solution so as not to splash the liquid.
39. Replace the lid securely on the bottle if you

plan to use it again, label it with date and
time of opening.
H. Handling sterile forceps

40. Keep the tips of wet forceps lower than the
wrist at all times unless wearing sterile
gloves.

41. Hold sterile forceps above waist level.
42. Hold sterile forceps within sight.
43. When using forceps to lift sterile supplies out

of a commercially prepared package, be sure
that the forceps do not touch the edges or
outside of the package.
PERFORME
YES NO
44. When the handles of the forceps were in
contact with the bare hands, position the
handles outside the sterile area.
45. Deposit a sterile item on a sterile field
without permitting moist forceps to touch the
sterile field when the surface under the
absorbent sterile field is unsterile and a
barrier drape is not used.
46. Discard disposable forceps after use
or send reusable forceps from repacking and
sterilization or immersing them in a solution.
Learner’s Reflection: (What did you learn most of the activity? What is its impact Instructor’s Comments:
to you?)


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Name: ___________________________________________________________________ Date: ______________

Evaluator/Signature: ________________________________________________________ Grade: _____________

ESTABLISHING AND MAINTAINING A STERILE FIELD

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

2. Choose a flat, hard, dry surface and clear

3. Before sterilization, objects are wrapped and

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

Note: Inside the wrapper is considered sterile

14. Pinch the far flap from the underside

16. Reopen the package by using the method

ACTION RATIONALE PERFORME REMARKS

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

18. If the package has a partially sealed edge,

22. Slowly lift the drape out of the cover and

23. With the other hand, gently pick up another

24. Put the drape on a clean, dry surface, placing

25. Allow the top half of the drape to be placed

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

G. Adding necessary supplies

28. With the free hand, grasp the corners of the

29. Place the sterile bowl, drape and other

30. Discard the wrapper.

B. To add commercially packed supplies.

32. Hold the package 15 cm (6 in.) above the

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

36. Hold the bottle so that the label is uppermost.

37. Hold the bottle of fluid at a height of 10-15

39. Replace the lid securely on the bottle if you

H. Handling sterile forceps

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

42. Hold sterile forceps within sight.

43. When using forceps to lift sterile supplies out

MATERNAL AND CHILD HEALTH NURSING COMPETENCY WORKBOOK 41

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Name: _____________________________________________________ Date:

Evaluator/Signature: ____________________________________________ Grade: _