SETTING UP OF STERILE TROLLEY FOR SURGERY

INTRODUCTION

Clean PersonThe Clean Person is designated to open and touch non-sterile items to
maintain the integrity of the sterile person and surgeon.

Sterile PersonThe Sterile Person is designated to handle all sterile instruments and
materials that will be used in surgery. The Sterile Person also passes instruments to the
surgeon.

PURPOSES
a) Preparation for surgery.
b) Time management.
c) Preventing hazards/cross infection
EQUIPMENTS REQUIRED
Equipment
Mayo stand
Surgical table
Sterile surgical drape
Sterile surgical instrument packs
or complete sterile surgical kits
Sterile surgical towels
Fenestrated drape
Sterile gauze
Sterile gloves
Sterile basin
PROCEDURE
S.NO.
1.
2.

Rationale
To set up the surgery tray
To make the patient lie
down for surgery
To cover the instrument tray
To set up for the surgery
To use in surgery
To cover the patient
To clean the site during
surgery
To prevent infection

CARE ACTION
Pre-procedure
Check surgery routine.

3.

Identify the operating room and OT team members and

patient.
Ensure functioning of all equipments/ machines

4.

Check tray labels and sterilization indicators.

Intra-procedure
1

RATIONALE
To ensure proper
identification

To prevent delays /hazards.

1.

PERFORM SURGICAL HAND WASH

2.

7.

Put on sterile gloves while setting up for any surgical

procedure.
Set a Mayo stand and tray directly to the right of the
To ease accessibility
scrub nurse or scrub physician who will be assisting in
the surgery.
Cover the Mayo stand and instrument tray with a sterile
drape by carefully opening each side. Avoid touching the
inside of the surgical drape where the instruments will be
placed.
Clean person partially removes the first, non-sterile paper
layer in a way that the second, sterile paper layer is
exposed and available for the sterile person to grab.
Sterile person grabs the sterile, wrapped tray and unwrap To prepare sterile field.
the second layer. Then, sterile person places the tray on
the end of the operating table
Unwrap towels using sterile technique

8.

Place one large towel over the surgery tray.

9.

This area will be used as the sterile workspace for sterile

instruments.
Open carefully the basic sterile instrument setup for the
surgical procedure that is being done.
Arrange the instruments accordingly to the specific
surgery and surgeon's requirements, do not overlap
instruments or overcrowd instruments.
Unwrap catheters, sutures and fill syringes using sterile
technique, and place them on the surgery tray.
Each syringe should be prepared using sterile technique

3.

4.

5.

6.

10.
11.

12.
13.
14.
15.
16.
17.

Place sterile gauze on the sterile tray and a fenestrated

drape.
Place on the utility stand any other additional surgical
equipment that will be needed for the procedure.
Place a sterile surgical basin in the ring stand next to the
Mayo stand.
Place duplicate or additional unopened sterile
instruments in the surgical theatre in case they are needed
quickly.
Post-procedure
2

To prevent cross infection

To avoid delays

1.

Check all articles are in sequence.

2.

Ensure counting of forceps/blades/gauzes/pads.

3.

Ensure maintenance of field of sterilization.

4.

Ensure Presence of circulating nurse.

To maintain chain of
sterilization

NURSING ALERTS
1. When dropping items into a sterile field, hold the packaging about three inches above the
sterile tray.
2. Pre packaged instrument trays or kits may have all surgical instruments, towels and gauze
already included. In most cases, opening these trays allows the packaging to become the
sterile drape.
3. If you contaminate the sterile tray, you must discard the tray and start over with a new
setup.
4. If there will be a lapse between setting up the tray and performing the surgical procedure,
remove your sterile gloves and put on a fresh pair when the procedure begins.
5. Preparing surgical instruments, for both minor and major surgery, requires in-depth
knowledge of surgical assisting and correct instrument-handling technique.
REFERENCES
3

 Taylor C (2015). Nursing Foundation. 8th Edition. Mosby Publishers. 65-75.

Alberta Health. 2012. Standards for Cleaning, Disinfection and Sterilization of Reusable
Medical Devices for Health Care Facilities and Settings.