Ch 13 - The Operating Room

Question 1

What are the 5 principles of conduct in an OR

Answer 1

• Sharing goals
• Having clear roles
• Mutual trust
• Effective communication
• Agreeing with measurable processes and outcomes

Question 2

What is included in a surgical briefing and debriefing?

Answer 2

• 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

Question 3

What benefits are provided by a surgical checklist?

Answer 3

• Decrease intra-op surgeon delay >80%
• Improve patient surgical outcomes
• Decrease intra-op adverse effects
• Decrease post-op mortality
• Overall reduction in hospital mortality

Question 4

What is the recommended way for sterile team members to change position?

Answer 4

Back-to-back or face-to-face with adequate space between them

Question 5

What is the recommended ventilation within an OR?

Answer 5

• 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

Question 6

Define surgical asepsis

Answer 6

Complete absense of contamination by pathogenic organisms

Question 7

Define antiseptic and disinfectant

Answer 7

• 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)

Question 8

What are the properties of an ideal drape?

Answer 8

• Blood and fluid resistant
• Lint free
• Anti-static
• Able to maintain an isothermic environment

Question 9

What is the recommended gold-standard hand prep?

Answer 9

Well-formulated waterless hydroalcohol solutions

Question 10

List the benefits of disposable gowns

Answer 10

• Less permeable to bacteria
• More economical
• Decrease surgical infection rate

Bacteria have been found to easily penetrate reusuable woven gowns within 30min

Question 11

What are the three options for gloving?

Answer 11

• 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