DE LA SALLE LIPA
COLLEGE OF NURSING
Nursing Care Management 109
Procedural Checklist in Preparing a Sterile Field (OB tray set up)
Name: Year/Sec: Rating:
General Objective:
Given simulated situations/conditions, the students will be able identify instruments and to maintain
sterility and prevent contamination of the sterile field and sterile items.
Specific Objectives:
1. Familiarize with the supplies, instruments, and equipment’s
2. Identify and collect instrumentation and supplies needed for the first surgery
3. Demonstrate appropriate technique on how to maintain the sterile field
CRITERIA:
Item Weight Descriptors Verbal Interpretation
1 Excellent Performed the procedure with great ease and confidence, observing work
ethics (prudent, accepts criticisms and suggestions), able to rationalize
scientifically and shows diligence in documenting observations at all times.
0.5 Satisfactory Performed the procedure with less confidence and requires close supervision
observing work ethics (prudent, accepts criticisms and suggestions), able to
rationalize scientifically and shows minimal diligence in documenting
observations.
0 Needs Failed to perform the procedure, unable to function well and needs repeated
Improvement specific/ detailed guidance or direction.
I. Values Based 1.0 0.5 0 Remarks
1. Perform surgical hand scrubbing
2. Obtain the necessary equipment and supplies..
a. Dry hands and arms
b. Locate a suitable surface. Set up the field on a surface that is clean, flat,
dry, and free from drafts
c. Done gown and gloves
3. Setting up the Mayo stand and back table,
Create a sterile field using the
(1) preferred method, use a double-wrapped sterile package. Do not let
your hands pass over the sterile field or the wrapped sterile object while
you are establishing the field.
(a) Lay the package so that the flaps are on top
(b) Open the outer layer, usually a paper or plastic cover. This layer
forms a barrier between the work surface and the inner wrapper.
(c) Open the inner wrapper.
(2) Alternate method. Obtain package of sterile drapes or towels. Create a
sterile field by opening the sterile drapes or towels in the same manner
as a double-wrapped sterile package. The inside of the sterile drapes or towels
form the sterile field.
4. Open the wrapper so your hand and arm do not pass over any part of
the inside of the wrapper that has been exposed.
5. Use the inside of inner wrapper as the sterile field. The object that was
wrapped is now located inside a sterile field and is removed from the
sterile field using sterile technique.
6. Opening of the package
6.1 Using one hand lift the distal flap up and away from the package. Let
this flap drop gently.
COLLEGE OF NURSING
Nursing Care Management 109
Procedural Checklist in Preparing a Sterile Field (OB tray set up)
Name: Year/Sec: Rating:
General Objective:
Given simulated situations/conditions, the students will be able identify instruments and to maintain
sterility and prevent contamination of the sterile field and sterile items.
Specific Objectives:
1. Familiarize with the supplies, instruments, and equipment’s
2. Identify and collect instrumentation and supplies needed for the first surgery
3. Demonstrate appropriate technique on how to maintain the sterile field
CRITERIA:
Item Weight Descriptors Verbal Interpretation
1 Excellent Performed the procedure with great ease and confidence, observing work
ethics (prudent, accepts criticisms and suggestions), able to rationalize
scientifically and shows diligence in documenting observations at all times.
0.5 Satisfactory Performed the procedure with less confidence and requires close supervision
observing work ethics (prudent, accepts criticisms and suggestions), able to
rationalize scientifically and shows minimal diligence in documenting
observations.
0 Needs Failed to perform the procedure, unable to function well and needs repeated
Improvement specific/ detailed guidance or direction.
I. Values Based 1.0 0.5 0 Remarks
1. Perform surgical hand scrubbing
2. Obtain the necessary equipment and supplies..
a. Dry hands and arms
b. Locate a suitable surface. Set up the field on a surface that is clean, flat,
dry, and free from drafts
c. Done gown and gloves
3. Setting up the Mayo stand and back table,
Create a sterile field using the
(1) preferred method, use a double-wrapped sterile package. Do not let
your hands pass over the sterile field or the wrapped sterile object while
you are establishing the field.
(a) Lay the package so that the flaps are on top
(b) Open the outer layer, usually a paper or plastic cover. This layer
forms a barrier between the work surface and the inner wrapper.
(c) Open the inner wrapper.
(2) Alternate method. Obtain package of sterile drapes or towels. Create a
sterile field by opening the sterile drapes or towels in the same manner
as a double-wrapped sterile package. The inside of the sterile drapes or towels
form the sterile field.
4. Open the wrapper so your hand and arm do not pass over any part of
the inside of the wrapper that has been exposed.
5. Use the inside of inner wrapper as the sterile field. The object that was
wrapped is now located inside a sterile field and is removed from the
sterile field using sterile technique.
6. Opening of the package
6.1 Using one hand lift the distal flap up and away from the package. Let
this flap drop gently.
