授課題目

Unit 5 Aseptic Technique

授課形式

lecture and demonstrate

授課時間

2006、9、28-29

授課學(xué)時

3 hours

教學(xué)目的

與 要 求

Objective：

1.Explain the concept：Aseptic technique   Aseptic supply   Non-aseptic supply 

Aseptic field   Non-aseptic field

2.Expound the principle of aseptic technique， understand the meaning(內(nèi)含) of aseptic concept

3.Apply the aseptic technique correctly and memorize the precaution

基本內(nèi)容

1. Concept : Aseptic technique  Aseptic supply  Non-aseptic supply 

Aseptic field   Non-aseptic field

2.The principle of aseptic technique

3. The six aseptic techniques

重 點

難 點

1.The principle of aseptic technique

2. The six kinds of aseptic techniques

主要教學(xué)

媒 體

power point

courseware (DVD)

主 要 外

語 詞 匯

有關(guān)本內(nèi)容的新進(jìn)展

Disposal aseptic articles are used during the procedure of aseptic technique .  

主要參考資料或相關(guān)網(wǎng)站

1.姜安麗.護(hù)理學(xué)基礎(chǔ)（英中文版雙語教材).北京：人民衛(wèi)生出版社，2005

2.殷磊.護(hù)理學(xué)基礎(chǔ).北京：人民衛(wèi)生出版社，2002

3.Sandraf.Smith,Donnaj.Duell, Barbarac.Martin. Clinical Nursing Skills: Basic to advanced skills. 5^th ed. Prentice-Hall, Inc, 2000

網(wǎng)站：www.100md。com/Html/WestMed/books/053/05305045.htm

系、教研室

審查意見

課后體會

雙語教學(xué)對非英語專業(yè)的教師是一個挑戰(zhàn)；從備課到上講臺授課整個過程經(jīng)歷了很多困難和挫折，但我們也有很大的收獲，并取得了一些經(jīng)驗。就本章“無菌技術(shù)”而言，因為有了規(guī)范的教材，學(xué)生可以系統(tǒng)預(yù)習(xí)，課堂效果較好；另外無菌技術(shù)是一個操作技能的內(nèi)容，在用英語講授的同時配合形體語言，學(xué)生基本能聽懂和理解。但其中少部分理論性較強(qiáng)的內(nèi)容用全英講授，學(xué)生難以全部理解，所以下次授課時要注意用雙語解釋。在授課中有與學(xué)生的交流，但感覺還不夠，形式也有些欠缺。以后課堂上要創(chuàng)造更多的形式和機(jī)會與學(xué)生交流，這樣一方面可以鍛煉學(xué)生口語，另一方面也可以促使學(xué)生用英語思考問題，并可活躍課堂氣氛。

教學(xué)內(nèi)容

時間分配和

媒體選擇

Unit 5   Aseptic Technique

Concepts

Aseptic technique is used to prevent microorganisms from invading human beings, and sterile articles and fields from being contaminated during medical procedures and nursing interventions. Aseptic technique is an important basic technique to prevent nosocomial infections. The procedure regulations are established according to scientific principles. All hospital personnel should master it to a skilled extent and abide by them strictly to guard the safety of clients.

Lecture: For example to the importance of aseptic technique

Aseptic supply include articles which has been sterilized physically or chemically.

Non-aseptic supply include articles which have not been sterilized or

these aseptic articles which were been contaminated.

Aseptic field is a sterilized field which has not been contaminated.

Non-aseptic field is a non-sterilized field or a field sterilized but contaminated again.

Principle of Aseptic Technique

Lecture(demonstrate or for example to every principle演示or 舉例)

The surroundings should be clean, roomy and disinfected.30 minutes before the aseptic procedures, stop cleaning the surroundings and minimize moving to prevent dust from floating.

Put on cap and mask, trim fingernails and wash hands before aseptic procedures, don aseptic gloves if it is necessary.

Place aseptic articles and non-aseptic articles separately. Keep aseptic articles in sterile containers or sterile packages. Once taken out of the container or package, aseptic articles can not be put back even having never been used. There is a label on the container or package, and it should be clear with the name and sterile date. Expiration date is 7 days. If it comes to the expiry date or the package is wet, re-sterilize it.

Keep away from the aseptic field (about 20-30cm) during procedures. Use sterile transfer forceps or tissue forceps to fetch sterile items. Keep hands and arms above the waist level. Do not touch sterile items or field with non-sterile item, hands or forearms. Do not reach across sterile field.

Use sterile items during aseptic procedures. Non-sterile item or potentially contaminated item is inhibited.

A set of aseptic supply is only used once upon a client.

Aseptic Techniques

Ⅴ－Ⅰ  Applying Sterile Transfer Forceps

【Purpose】 

To fetch or transfer sterile article

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

There are four types of forceps: three-forked forceps, transfer forceps, long and short tissue forceps. There are two maintenance methods for the sterile transfer forceps. One is to soak the sterile transfer forceps in disinfector. The disinfectant container should have a big opening and cover. The solution level should be 2-3 cm above the joint pivot or 1/2 of the length of the tissue forceps. There can only be one pair of forceps in a container.

Question :What is dry storage

Another is dry storage. It is to use sterile dry container to contain sterile forceps. Before treatment, open the sterile package to take out the sterile forceps then put it in dry container. Change the forceps every 4 hours.

【Procedure】

Demonstrate the procedure(演示操作步驟)

1.  Wash and dry hands, put on mask. Rationale: keep hands clean.

2.  Check the sterilization date and open the cover of the container where the sterile forceps are soaked. Rationale: Do not fetch or put it back to the container from the opening of the closed cover

3.  Hold the sterile forceps and move it to the center of the container, close the tips of the forceps and take it out vertically.www.med126.com Rationale: When taking out the forceps from the container, do not touch the edge and the inner surface of the container over the solution level to avoid contamination.

4.  Keep the forceps tip downward, do not reverse the direction. Rationale: Avoid the disinfectant solution flowing backward and contaminating the forceps tips.

5.  After using, close the forceps tip and put it back to the container immediately and vertically. Loosen the joint pivot when soaking the forceps in the solution. Rationale: Do not touch the edge of the container and loosen the joint pivot to make it saturated by the disinfector.

6.  If fetch the sterile items in the distance, bring the forceps together with the container. Rationale: Avoid the sterile forceps exposed to air for too long.

7.  Disinfect the sterile forceps and its container, and also change the disinfector twice a week. Rationale: Keep the sterileforceps in sterile state. Do not use sterile forceps to take oily gauze in case the oil adheres to the forceps tips and affects the disinfection effect. Do not use the sterile forceps to do dressing or disinfect skin to prevent contamination.

Ⅴ－Ⅱ  Applying Sterile Container

【Purpose】

To conserve sterile article in sterilized containers and keep them aseptic

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

Sterile therapeutic bowl

Sterile kidney tray

Tin and grooves

【Procedure】

1.   Wash and dry hands, put on mask.

2.   Check the sterilization date.

3.   When taking sterile items from the container, take the cover away from the container horizontally, keep the inner side of the cover upward on the table or downward in the hand (Figure 5-2). The sterile items should be taken out by the sterile transfer forceps. Rationale: Prevent the opening of the container from being contaminated or dust from entering the container. Do not touch the edge of the cover and the inner side when holding the cover.

Question :Why can not touch the edge of the cover

4.   Cover the container immediately after taking out the items. Rationale: Avoid the contents exposed to air too long.  

5.   When holding a sterile container such as sterile therapeutic bowl, hold it by its bottom (Figure 5-3). Rationale: Do not touch the edge and the inner side of the container.

Ⅴ－Ⅲ  Using Sterile Package

【Purpose】 

To conserve sterile articles in sterilized package and keep them aseptic

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

Thick and tight-woven double-layered wrapper

Therapeutic towel

【Procedure】

Demonstrate the procedure(演示操作步驟)

1. Wash and dry hands, put on mask.

2.   Pack sterile package:

Place the items in the center of the wrapper. Fold the first wrapper flap, then fold the tow side wrapper flaps and the fourth flap, tie the package with a string (Figure 5-4). Paste a label with name on the package. Rationale: Pack glassware with cotton pad and then wrap it with wrapper.

3.   Open sterile package:

(1)   Check the name and the sterilization date of the package. Rationale: The expiration date is 7 days. If the expiration date is over, do not use it.

(2)   Place the package on a clean, dry and flat place, untie the string and tuck it, grasp the outside surface of wrapper and open it according to its original creases. Rationale: When opening the sterile package, do not touch the inner side of the wrapper and contents of the package.

(3)   Take out the needed items with a sterile forceps and put them on a prepared field.

(4)   If the items are remained, fold the package according to its original creases and tie it, note down the date and time of opening. Rationale: The remaining items need to be used within 24 hours. If the items are contaminated or the wrapper is wet, re-sterilize them.

(5)   If the sterile items need be taken out for one time, hold it with one hand and open the wrapper by grasping its corners with another hand to expose the items, deliver the items to the sterile field (Figure 5-5).

Ⅴ－Ⅳ  Preparing Sterile Therapeutic Tray

【Purpose】 

To lay a sterile therapeutic towel on a clean and dry therapeutic tray to form a sterile field and place sterile items onto it

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

Therapeutic tray

Sterile therapeutic towel

【Folding treatment towel】

Vertical method: Fold the towel twice vertically and fold twice horizontally, one of the edges facing outside;

Horizontal method: Fold the towel once horizontally and fold it twice vertically, then fold once again horizontally.

【Procedure】

Demonstrate the procedure(演示操作步驟)

1. Wash and dry hands, put on mask.

2.   Fetch a sterile package with the therapeutic towel in it. Check the name and the sterilization date.

3.   Prepare therapeutic tray (clean the tray):

Single layer method (Figure 5-6)

(1) Open a sterile package, take out a therapeutic towel with sterile forceps and place it in the therapeutic tray. Rationale: The remaining therapeutic towel needs to be used within 24 hours.   

(2) Grasp the outer side of two top corners with both hands and gently shake the towel open, then lay it on the therapeutic tray, let the edge of the top layer like a fan and faces outside. Rationale: Do not touch the inner side of the therapeutic towel.

(3) Place sterile items to the sterile field and pull the top layer of the towel to cover them, fold the end edges of the towel upward twice and then fold the both sides of edges downward once. Rationale: Keep the therapeutic tray sterile for 4 hours.

Double layer method (Figure 5-7)

(1)Take out sterile therapeutic towel, grasp the outer side of two top corners with both hands, shake the towel open gently, place it on the therapeutic tray from far

to near side, then to far side to form a double-layer bottom. Let the edge of the top layer like a fan and faces outside.

Question :What does the meaning of “the top layer like a fan and faces outside”

(2)Place sterile items onto the towel, pull the top layer to cover them, then fold the three edges of towel (it is the same as the single layer method).

Ⅴ－Ⅴ  Pouring Sterile Solution

【Purpose】

To be used for medical procedures and nursing interventions

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

Sterile solution in a sealed bottle

Sterile therapeutic bowl

Antiseptic solution（Anerdian)

Tin（with swabs)

Trash can

【Procedure】

Demonstrate the procedure(演示操作步驟)

1.  Wash and dry hands, put on mask.

2.  Fetch a sealed bottle containing sterile solution. Clean the dust of the bottle. Get rid of the aluminium lid with an opener after checking. Rationale: .Before pouring sterile solution, check the name of the solution, dosage, concentration and expiration date carefully. Check whether the lid of the bottle is loose, and whether there is any crack on the bottle. Ensure the quality of the solution.

3.  Turn up the edge of the rubber lid with thumb and forefinger. Pull rubber lid with thumb forefinger and middle finger of one hand, pull it out of the bottle. Hold the bottle with another hand, with itsgydjdsj.org.cn/job/ label facing up, and

pour a small amount of solution to clean the lip (Figure 5-8). Rationale: Do not touch the lip of the bottle and the inner side of the rubber lid.

4.Pour the needed amount of solution into a sterile container from the cleaned place of the lip. Then put the rubber lid back and disinfect it，turn down the edge of the rubber lid. Rationale: When pouring sterile solution, do not let the lip of the bottle touch anything to prevent contamination.

5.Take note of the date and time of opening. Rationale: The solution in the opened bottle can be kept sterile for 24 hours.

Ⅴ－Ⅵ   Donning and Taking off Sterile Gloves

【Purpose】

To guarantee the sterile effect during the strict medical procedures and nursing interventions

【Equipment】

Show the picture or real object of equipment and explain (展示圖片or用物并解釋)

Packaged sterile gloves

【Procedure】

Demonstrate the procedure(演示操作步驟)

1. Take off wrist watch. Wash and dry hands. Put on mask.

2. Choose appropriate size of gloves. Check sterilization date on the gloves package Rationale: Do not use gloves beyond expiration date.

3. Place the gloves package on a clean, dry table and open it. Open the gloves sack to take the powder package out and apply powder on the hands. Rationale: If the gloves are prepowdered, you need not apply powder to hands before donning gloves.

4. Don sterile gloves:

Picking sterile glove out one by one

(1) Lift the two outer layer of the package with both hands. Grasping the folded cuff (inside of glove) of the first glove with one hand and take it out. Slip the other hand into the glove and don it carefully (Figure 5-9).

(2) Take out another glove from package by placing gloved finger under cuff. Place the ungloved fingers into the second glove. Gently pull the glove over the hand as before. Rationale: When donning gloves, do not touch any non-sterile item.

Picking tow sterile gloves out together

(1) Lift the two outer layer of the package with both hands. One hand grasps the folded cuff of the two gloves, and take it out（Figure 5-10).

(2)Don one glove first. Then place the gloved finger under the cuff. Slip the ungloved hand into the glove and don it well.

5. Adjust the gloves and pull the cuffs up. Rationale: Keep both hands above waist. The gloved hand can not touch the inner side of the other glove. Change gloves immediately if they are worn out.

6. Take off gloves:

(1) Grasp one glove on its outer surface with the gloved hand, and pull it off by turning it inside out; then insert the bare hand into the inside of the glove and peel glove off by turning it inside out. Rationale: Ensure the outside of gloves does not touch skin surface.

(2) Soak the gloves in the antiseptic solution and wash hands.

Watch the video of demonstration of aseptic technique，

Summary

1.Explain the concept：Aseptic technique   Aseptic supply  

Non-aseptic supply   Aseptic field  

Non-aseptic field

2.Expound the principle of aseptic technique，understand the meaning(內(nèi)含) of aseptic concept

3.Master the methods of aseptic technique and memorize the precaution

Exercise

1.What the expiration date of no contaminated and opening sterile package is ?（24h)

2.What the expiration date of no contaminated and opening sterile solution is ?（24h)

3.What the expiration date of no contaminated sterile therapeutic tray is ? (4h)

4.What the expiration date of no contaminated and on opening sterile package is ?（1w)

5’

power point

15’

power point

20’

power point

video

10’

power point

lecture

15’

power point

video

15’

power point

l

15’

power point

video

15’

power point

video 6’

4’

power point