1. Intro/Standards of Aseptic Technique

Question 1

What does the term “universal/standard precautions” mean?

Answer 1

All people are treated the same–> assume all people bloodborne pathogens

Question 2

What does aseptic technique mean? (general definition)

Answer 2

The way we handle the clean/sterile environment

Question 3

What is the difference between sterile and asepsis?

Answer 3

Asepsis: the practice of rendering the environment free from disease-producing pathogens

Sterile: completely free from living organisms, including spores

Question 4

What are the three designated traffic areas/patterns in a surgical suite?

Answer 4

• Unrestricted area
• Semi-restricted area
• Restricted area

Question 5

Describe the unrestricted area of the surgical suite. Who is allowed there? What activity happens there? What attire is worn there?

Answer 5

**Central point where patients and staff enter
Who: traffic is not limited, but only authorized personnel can enter the suite
What: non-sterile activity (admission, discharge, pre-op holding area, PACU, waiting room, office, practice sinks, trash removal
Wear: street clothes

Question 6

Describe the semi-restricted area of the surgical suite. Who is allowed there? What activity happens there? What attire is worn there?

Answer 6

**Support areas of the surgical suite
Who: authorized personnel
What: no sterile activity–> inside corridor, dirty utility room, and clean utility room
Wear: scrub suits, hair covers (bouffant), shoe covers
—> if cleaning instruments, add face mask, eyewear, and gloves

Question 7

Describe the restricted area of the surgical suite. Who is allowed there? What activity happens there? What attire is worn there?

Answer 7

Who: restricted personnel
What: STERILE ACTIVITY–> OR, clean core, scrub room
Wear: scrub suits, hats, shoe covers, face masks
–> additionally (based on specific area), eyewear, warm-up jacket

Question 8

You are going to be entering the restricted area of the TUSPM Ambulatory Surgical Center. How should you be dressed and what other apparel/appearance rules do you need to make sure you’re following?

Answer 8

• clean scrubs, warm-up jacket, clean hat, clean shoe covers (over serviceable shoes)
• no long-sleeve undershirts
• no bracelets, necklaces, dangling earrings, face piercings
• no nail polish/acrylic nails and nails must be short

Question 9

Who are the sterile members of the surgical team?

Answer 9

Surgeon, resident, 1st assist, and 2nd assist

Question 10

Who are the non-sterile members of the surgical team?

Answer 10

Anesthesiologist, nurse monitor (for local anesthesia cases), circulator, and patient

Question 11

What is the role of the circulator?

Answer 11

Act in a sterile manner to preserve sterility and advocate for patient

• inspects the integrity of drapes, gowns, instruments, and sterile backpacks, before and during surgical cases
• *Serves as the go-between person for the non-sterile members of the team and the sterile members**

Question 12

What are the three necessary factors for sterilizing instruments?

Answer 12

Time, temperature, and pressure
Time: 30mins
Temp: 250-270 degrees F
Press: 10-20lbs

Question 13

What is the difference between “sterilization” and “immediate use sterilization/Flash”?

Answer 13

Sterilization: autoclaving wrapped instruments in a regular gravity cycle, for about 30mins

Flash: autoclaving unwrapped instruments in a quick 3min cycle, no dry time–> emergency use only

Question 14

Recommended practice 1

Answer 14

All items within a sterile field must be sterile.

Question 15

Recommended practice 2

Answer 15

The edges of sterile packages are not sterile once the package is open.

Question 16

Recommended practice 3

Answer 16

Gowns are sterile chest to table level in the front, including the sleeves, to 2in above the elbow.
–> If standing away from the table, the gowns are considered sterile chest to waist in front.

**The axilla, neckline, and back are NOT considered sterile

Question 17

Recommended practice 4

Answer 17

Tables are considered sterile at table-top level only.

Question 18

Recommended practice 5

Answer 18

Movement is sterile-to-sterile (front to front), unsterile-to-unsterile (back to back) only.

Question 19

Recommended practice 6

Answer 19

Movements are air currents within and around a sterile field must be minimal to avoid contamination.

Question 20

How is it recommended that the non-sterile members should move through the operating room?

Answer 20

Non-scrubbed team members should move from unsterile-to-unsterile, maintaining a 2ft distance from any sterile field.

Question 21

Are the doors opened or closed during surgical procedures?

Answer 21

Doors are closed during surgical procedures to decrease microbial contamination from entering from the corridor.

Question 22

Recommended practice 7

Answer 22

Contamination occurs whenever a bacterial barrier is violated.
(AKA, whenever a sterile field or item is permeated, it is considered contaminated.)

Question 23

Recommended practice 8

Answer 23

If in doubt regarding an item’s sterility, consider it unsterile.

Question 24

What is “surgical conscience”?

Answer 24

Every surgical team member, sterile or non-sterile, whether witnessed or not, will point out known or suspected violations of sterile techniques and initiate corrective action.