Asepsis Flashcards
What is the point of using aseptic techniques? What are some examples?
prevent infection in the patient
sterilization of equipment, gowns, drapes; surgical suite preparation; patient preparation; surgical team preparation
How was surgical technique developed? How is this used currently?
Joseph Lister, a British surgeon, found a way to prevent infection in wounds during/after surgery - he was the first to apply Germ Theory to surgery
Lister’s Antisepsis System is the basis of modern infection control
What is the difference between asepsis, antisepsis, and sterility?
ASEPSIS = absence of pathogenic microbes in living tissue that cause disease - PREVENT wound contamination by destroying organisms before they enter the wound
ANTISEPSIS = destruction of most microorganisms on animate/living objects - patient skin prep/surgical scrubbing
STERILITY = absence of all forms of microbial life on inanimate objects
What are antiseptics? Barriers?
ANTISEPTICS = inorganic chemical compounds that combat sepsis by inhibiting the growth of microorganisms without necessarily killing them - skin resident flora
BARRIERS = materials used to reduce or inhibit the migration or transmission of microorganisms in the environment, personnel attire/gowns, furniture, patient drapes, equipment and supply packaging, and ventilating filters
What is the meaning of contaminated? Cross-contamination?
CONTAMINATED = carrying or infected by microorganisms
CROSS-CONTAMINATION = transmission of microorganisms from patient to patient or from inanimate object to patient
What is the difference between decontamination and disinfection?
DECONTAMINATION = cleaning and disinfecting or sterilizing processes carried out to make contaminated items safe to handle
DISINFECTION = chemical or mechanical (friction) destruction of pathogens
What is the irreducible minimum?
microbial burden cannot get any lower - an item is sterile to its highest degree
What are spatial relationships in the OR?
awareness of sterile, unsterile, clean, and contaminated areas, objects, and individuals and their proximity to one another
What standard procedures are followed in the veterinary hospital?
procedures followed to protect personnel from contact with the blood and bloody fluids of patients
What is a sterile field? Sterile technique? Terminal sterilization and disinfection?
STERILE FIELD = area around the site of incision into tissue or the site of introduction of an instrument into a body orifice that has been prepared using sterile supplies throughout the surgical procedure
STERILE TECHNIQUE = method by which contamination with microorganisms is prevented to maintain sterility throughout the surgical procedure
TS&D = procedures carried out for the destruction of pathogens at the end of the surgical procedure in the OR after the patient has been removed
What must be kept in mind when using aseptic and sterile techniques?
complete absence of microorganisms cannot be reached in a hospital environment, but using aseptic techniques will help control pathogens and decrease the risk of infection
What are the 4 main outcomes of using aseptic and sterile techniques?
- decreased infection rate
- minimize sources of contamination
- block transmission of microorganisms
- reduce patients’ risk of exposure to microorganisms that cannot be removed
Why are aseptic and sterile techniques important for complicated procedures?
these procedures are much longer and there is a higher chance of contamination
What are some animal sources of contamination? Inanimate sources?
ANIMAL: skin, hair, nasopharynx, oral cavity, ear pinnae, vulva, prepuce, anus
INANIMATE: fomites (hair clipper, scrubs), air, hospital structures (walls, floors, furniture, equipment)
How can airborne sources of contamination be minimized during long procedures?
minimization of talking and walking in the surgery room
(more people in room = more movement = more air movement and possibility of bacteria on skin)
What is the primary aerial bacterial source in the OR?
the surgeon
How can we reduce pathogenic microorganism spread in the hospital?
- regular hand washing by hospital staff
- use of nonsterile/sterile gloves when handling likely sources of pathogens, like high-risk patients, equipment, and hospital surfaces
- cleaning or disposal of equipment between patients
- containment of contaminated supplies and equipment
- proper storage of equipment
- regular equipment cleaning protocols
- scheduled cleaning of hospital surfaces
- proper maintenance of hospital heating, ventilation, and AC systems
- minimizing unnecessary traffic
- isolation of patients with known pathogenic microorganisms
How is asepsis used in surgery?
- surgeon preparation (scrubbing, drying, gowning, gloving)
- patient preparation (hair removal, skin preparation, draping)
- instrument sterilization
- sterile technique
- maintaining safe environment in OR
What are the 3 purposes of scrubbing before surgery?
- remove dirt and oil
- reduce transient bacterial population
- depression of skin’s resident bacterial population
Scrub brushes used to be common practice for pre-surgical scrubbing. What is commonly used now? Why?
alcohol rubs that are just as effective
- able to decrease scrubbing time (patient is down much less longer)
- heavy scrubbing can lead to skin damage, changes in microbial flora, and increased bacterial counts/shedding
Scrubbing can be broken down into what 5 practices?
- removal of all jewelry, put on surgery cap, mask, and booties (nail polish must be fresh and fake nails are not allowed)
- make way to sink and open new scrub brush
- basic hand washing
- clean fingernails
- scrub
What are the main 2 methods of scrubbing?
- anatomic timed method
- counted brush stroke method
What are the basic steps to using antiseptic alcohol rubs?
- remove all jewelry
- basic hand wash if first application of the day
- clean fingernails
- apply hand antiseptic (3 pump application)
How are hands dried after scrubbing?
- pick up sterile towel from pack on the table
- unfold towel and hold lengthwise
- use one end of the towel to dry one hand/arm
- bring dry hand to opposite end of the towel and repeat step 3
- drop towel onto the ground
Where should hands be kept while drying them after scrubbing?
above waist and below shoulders
What is the difference in the material used to make reusable cloth gowns and disposable gowns?
REUSABLE = woven cotton material
DISPOSABLE = non-woven fiber material
What are the pros and cons to using reusable/cloth gowns?
PROS: cheap, easily found
CONS: fabric is instantly permeable to bacteria when wet, with each washing the pores will widen and decrease effectiveness
What should be kept in mind when using a disposable gown?
- gown ties on the side
- assistant ties neck/collar
- glove up before tying up your own waist tie (twirl!)
Why are sterile surgical gloves used? How are they able to slide onto hands easily?
another barrier between the surgical team member and patient
inner surfaces are lubricated with adherent coating of hydrogel
What should be avoided when opening sterile gloves for the surgeon?
- dropping them onto the opened gown pack before scrubbing
- placing them onto the sterile field before the surgeon’s hands have been dried
What is the most common gloving technique for surgery? Why?
closed technique
ensures hand never comes into contact with the outside of the gown or glove
Open gloving technique:
How is assisted gloving started?
scrub personal always gloves the other person’s right hand first
What is not considered sterile in the OR?
- body parts: back, neck, shoulders, axillae, anything below waist
- anything below the table height
- wet gowns or drapes
- anything under drapes
- the patient
What are the main 3 reasons that patients are draped?
- eliminates the passage of microorganisms between nonsterile and sterile areas
- minimizes skin exposure to decrease risk of contamination
- maintains sterile field around surgery site
What are the main 2 types of drapes?
- reusable - huck towels, fenestrated cloth
- disposable - paper, plastic, combo
Why are instruments sterilized? What are 6 common ways this is done?
removes microorganisms and lower contamination risk
steam, chemical, plasma, peracetic acid, ionizing radiation, cold chemical sterilization
What are the 9 sterile technique principles?
- use only sterile items in the sterile field
- sterile scrubbed personnel are gowned and gloved
- sterile personnel operate within the sterile field
- sterile drapes are used to create a sterile field
- all items used in a sterile field must be sterile
- all items introduced onto a sterile field should be opened, dispensed, and transferred by methods that maintain sterility and integrity
- sterile fields are areas set up for procedures and are free from microorganisms
- a sterile field should be maintained and monitored constantly
- surgical staff should be trained to recognize when they have broken technique and should know what to do next
