Teaching Sterile Field Setup in Nursing Labs: The 10 Most Common Breaks in Sterility

Maintaining a sterile field is essential for preventing infections during invasive procedures, and nursing students must learn to recognize and avoid the most common mistakes that compromise sterility.

Key things to know:

• What a sterile field is and why it is critical for preventing infections during clinical procedures
• The importance of maintaining strict sterile technique during wound care, catheterization and other invasive tasks
• Why reaching outside the sterile field or passing hands over it can introduce contamination
• How lowering hands below waist level or losing sight of the sterile field can break sterility
• The difference between sterile and non-sterile gloves when handling instruments and supplies
• Why the one-inch border around the sterile field is considered contaminated
• How moisture, improper package opening and non-sterile items can compromise sterile equipment
• The importance of recognizing and immediately addressing any potential break in sterility

Every nursing student learns about various sterile techniques to prevent infections in their patients. It doesn’t matter if they are performing wound care, central line care, or a Foley catheter insertion. Any time a foreign instrument is placed inside a patient’s body, there is always the risk of an infection. That is why proper sterilization is critical to avoid life-threatening infections in patients. 

What is the Sterile Field?

A sterile field is a medical term referring to a clinical environment that is set up to be free of microorganisms, bacteria, and contamination. Every element within the environment is sterilized, such as the drapes, gloves, medical instruments, gowns, and even the patient’s skin. 

Nurses must establish a sterile field whenever an invasive procedure is going to be done on a patient. It is the best way to prevent an infection of the patient’s bloodstream, wound, surgical site, or urinary tract. 

The Top 10 Most Common Breaks

Teaching students how to set up a sterile field in a nursing laboratory is critical. Unfortunately, most students accidentally or unknowingly break the sterile field numerous times over the course of their training. 

As their instructor, you must educate them on all the various ways that they could break the sterile field, and then call them out when they do. It is the only way they will learn from their mistakes. 

Below are the top 10 most common breaks in sterility in a simulated nursing laboratory:

1) Reaching Outside the Sterile Field

One of the most common mistakes made in nursing labs is reaching outside the perimeter of the sterile field to grab extra supplies, equipment, or other items. Anything outside the sterile field is likely to have contamination because the outer environment has not been sterilized. 

For this reason, if a student’s hand or arm passes over the sterile field, they risk contaminating it with bacteria and microorganisms from the outside. The student doesn’t even need to make full contact with an item to risk contaminating the field. 

2) Dropping Hands Below Waist Level

Students learn to keep their sterile gloved hands above the waist level of the patient. They are also supposed to keep their hands within sight at all times.

Unfortunately, it is common for students to accidentally lower their hands below waist level when stepping away or grabbing some equipment. They risk contaminating their hands or gloves when they do this.  

If you catch any student doing this, tell them to replace their gloves with new sterile gloves immediately. 

3) Looking Away from the Sterile Field

As previously stated, students must keep the sterile field within their line of sight. It is the only way to ensure total sterility. 

Of course, it is easy for students to look away from the sterile field without even thinking about it. They may subconsciously walk away or turn around, causing a potential contamination of the sterile field from airborne particles. 

Teach students to ask for assistance if they need to grab an item or do something else outside the sterile field. That way, they can remain focused on the sterile field the entire time. 

4) Using Non-Sterile Gloves to Touch Sterile Items

Many beginner nursing students will forget to use sterile gloves rather than non-sterile gloves when inserting a Foley catheter or conducting some other procedure in the sterile field. It is okay for a student to use a non-sterile hand for stability purposes, but that hand cannot touch the catheter or any of the sterile instruments. 

Make sure your students understand the difference between the non-sterile stabilizing hand and the dominant sterile hand. Have them practice using each repeatedly until they know the difference without thinking. 

5) Touching the One-Inch Edge of the Sterile Field

The one-inch border along the edge of the sterile field is considered to be contaminated because it is closest to the contaminants of the surrounding non-sterile environment. Students will often place sterile instruments somewhere on the edge and then pick them back up again. That risks contamination. 

There is no designed marker outlining the one-inch edge. Students must learn to identify the border within their minds and avoid putting any objects there. 

6) Exposing Sterile Items to Moisture

Water and moisture can bring bacteria to sterile items if they are exposed to them. It is common for sterile drapes and barriers within the sterile field to become wet, resulting in bacterial contamination of the sterile equipment. 

Students may accidentally expose sterile items to water if they pour sterile solutions incorrectly or put damp materials somewhere inside the sterile field. Sometimes, condensation may even form underneath the sterile supplies within the field. 

7) Improperly Opening Sterile Kits or Packages

Students have a tendency to open sterile kits and packages incorrectly. Some examples include opening the package toward the body or touching the inner surface of the package. 

Teach your students the correct way to open packages. For instance, they must open the packages away from the body first, then open them from the sides, and then finally on the edge. It may take several practice attempts before they can do it. 

8) Unknowingly Placing Non-Sterile Objects onto the Field

Some students may assume an item is sterile because it looks clean. That will prompt them to place the item on the field without thinking that anything is wrong. 

However, every item should be considered non-sterile and contaminated unless it comes from packaging clearly labeled as sterile. No one knows what contaminants may be on something not labeled as sterile. 

9) Not Acknowledging a Potential Contamination Situation

Many beginner students won’t recognize when the sterile field has been potentially contaminated because they have not been trained to do so. Either that or they notice the break in sterility but don’t say anything because they are not sure.  

Make your students feel comfortable acknowledging and calling out any potential contamination situation that they recognize during their simulation training. That way, they can learn how to correct the mistake each time sterility is compromised.  

10) Facial Fluids Contaminating the Field

New students will frequently cough, sneeze, or talk without a mask on while inside the sterile field. These actions will definitely contaminate it with their respiratory droplets, which are filled with microorganisms.

Remind your students to wear authorized sterile face masks when conducting any sterile procedure within the field. 

Get Sterile Medical Supplies for Your Nursing Lab Today

Pristine Medical is one of the biggest providers of sterile medical supplies for simulation nursing laboratories in schools. It has everything you need to stock your nursing laboratory for your students, including sterile gloves, gowns, drapes, and more.