2. Principles of Surgical Asepsis Flashcards
- Sterile technique and general rules of aseptic technique
> IDEAL GOAL: to prevent transmission of microorganism into body druing invasive procedures
-sterile personnel are gowned and gloved
-sterile personel touch only sterile items/areas
-sterile drapes are used to create sterile field
-use only sterile items within sterile field
-all sterile items should be opened, dispensed and transferred by methods that maintain sterility
-field should be monitored constantly and surgical staff should be able to recognize when they have broken technique and act accordingly
> General rules of aseptic technique:
-surgical team members remain within sterile area
-talking and movement by all personnel is kept to minimum
-nonscrubbed personnel touch only non sterile items and do not reach over sterile areas
-drapes should be moisture proof
-if surgical team begins surgery seated, they should remain seated until it has been completed
-gowns are considered sterile only from mid-chest to waist and from gloved hand to 5cm above elbow
-items of questionable sterility are considered contaminated
- Levels of sterility and disinfection (with examples)
Levels 1-3
1. Critical=equipment/materials entering body beneath skin or MM requires sterilization and are handled using sterile technique (ex. SUTURE MATERIALS, intravenous catheters)
- Semicritical=equipment coming into contact with skin/mucous membranes without penetration must be cleaned and disinfected (ex. ENDOTRACHEAL TUBES)
- Noncritical=instruments that contact mucous membranes or intact skin not directly associated with surgery should be cleaned and disinfected (ex. LARYNGOSCOPE)
- Preparation of surgical packs, sterilization
-instruments and linens must be cleaned of gross contamination
-instruments cleaned manually or with ultrasonic cleaning equipment
-linens laundered
-as soon as possible after surgery
immersing instruments for long periods of time in any solution can prove damaging (NEVER LONGER THAN 20MIN)
-cleaning is followed by packaging and sterilization
STERILIZATION= any equipment or supplies that come in contact with body tissues or blood must be sterile > methods: steam, chemicals, plasma, ionizing radiation, cold chemical sterilization
Steam sterilization
-destroys all known microorganisms by coagulation and cellular protein denaturation
-practical and dependable
-heat-tolerant medical supplies and packaging
-autoclave: gravity displacement sterilizer (15-30 min at 121 degree), pre vacuum sterilizer (3-4 min at 132-135 degree)
Autoclave
press red button
Sterilization indicators
-allow monitoring of effectiveness of sterilization
-indicators may undergo chemical or biological change in response to time and temperature
-not always trustworthy
-failure to achieve sterility may be result of:
>improper cleaning, mechanical failure, improper use of equipment, poor loading technique, not understanding concepts of sterilization processes
surgeon getting equipments in sterile manner 2 options
-single layer: non sterile person open> sterile take equipment
-double packaging: nonsterile open first - surgeon take 2nd package thus it is sterile
- Preparation of patient and operative site (until draping can be performed)
-Patient: treatment of any infections if elective surgery, dietary restrictions, excretions, confirmation of patient’s identity, surgical procedure and surgical site, treatment of hair
-Operative site: preoperative preparation reduces number of bacteria and likelihood of infection, sterilizing skin without impairing its natural protective function and interfering with wound healing is impossible, antisepsis
- Preparation of surgical team and the surgeon
-finger clipped
-hand wash: start fingers toward elbow 3x wash , ideal time 2-7min scrub hands > flush > dry > antiseptic > wait for effect to kick in
-new gap, gloves, gown, shoes, mask: restricted area > assistant will help with gloves on back: gown remain sterile; assistant only touch piece of paper that comes with gown
>gloves: sterile
