Ch 13 - The Operating Room Flashcards
What are the 5 principles of conduct in an OR
- Sharing goals
- Having clear roles
- Mutual trust
- Effective communication
- Agreeing with measurable processes and outcomes
What is included in a surgical briefing and debriefing?
- Sign-In - Confirm patient, consent, procedues and site
- Briefing - Safety checks, steps of procedure, specific measures (ABx)
- Sign-Out - Name of procedure, swab count, sharps count, confirm samples to be submitted
- Debriefing - Review the procedure, any near-misses, if any different steps should have been taken, disclose the patient plan
What benefits are provided by a surgical checklist?
- Decrease intra-op surgeon delay >80%
- Improve patient surgical outcomes
- Decrease intra-op adverse effects
- Decrease post-op mortality
- Overall reduction in hospital mortality
What is the recommended way for sterile team members to change position?
Back-to-back or face-to-face with adequate space between them
What is the recommended ventilation within an OR?
- Horizontal, laminar air flow
- Minimum of 15 air exchanges per hour with a minimun 20% outdoor air
- 30-60% humidity
- Temperature 20-23C
Laminar airflow has been associated with a 61% decrease in room bacteria and 92% decrease at the wound site compared to conventional ventilation
Define surgical asepsis
Complete absense of contamination by pathogenic organisms
Define antiseptic and disinfectant
- Antiseptic - prevents or reduces the growth or action of pathogenic organisms on living tissue (Alcohols, Iodine)
- Disinfectant - Agents, usually chemical, that destroy most pathogenic organisms but not spores on inanimate objects. (Quaternarium ammonium compounts, phenols, chlorine and compounds)
What are the properties of an ideal drape?
- Blood and fluid resistant
- Lint free
- Anti-static
- Able to maintain an isothermic environment
What is the recommended gold-standard hand prep?
Well-formulated waterless hydroalcohol solutions
List the benefits of disposable gowns
- Less permeable to bacteria
- More economical
- Decrease surgical infection rate
Bacteria have been found to easily penetrate reusuable woven gowns within 30min
What are the three options for gloving?
- Closed
- Open
- Assisted
Assited gloving it the most sterile way. Closed and open gloving have been shown to cause contamination of the gown, particularly of the cuff, in 100% of cases compared to 0% with assisted