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Patient Care II > Chapter 11: Surgical Asepsis > Flashcards

Chapter 11: Surgical Asepsis Flashcards

1
Q

METHODS OF REDUCING PATHOGENIC MICROORGANISMS IN
THE ENVIRONMENT AND INTERVENING IN THE PROCESS BY
WHICH MICROORGANISMS ARE SPREAD

A

MEDICAL ASEPSIS

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2
Q

THE PROCESS OF CREATING AND MAINTAINING AN AREA THAT IS
COMPLETELY FREE OF PATHOGENS

A

SURGICAL ASEPSIS

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3
Q

THE COMPLETE DESTRUCTION OF ALL ORGANISMS AND SPORES
FROM EQUIPMENT USED TO PERFORM PATIENT CARE OR
PROCEDURES

A

STERILIZATION

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4
Q

FOUR METHODS OF STERILIZATION

A
  • CHEMICAL
  • AUTOCLAVING (STEAM)
  • GAS
  • GAS PLASMA
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5
Q

THE IMMERSION AND SOAKING OF CLEAN OBJECTS IN A
BATH OF GERMICIDAL SOLUTION FOLLOWED BY A STERILE
WATER RINSE
* NOT RECOMMENDED FOR SURGICAL ASEPSIS
* ONE OF THE LESS SATISFACTORY METHODS BECAUSE CONTROL
OF EFFECTIVENESS FACTORS (TIME, SOLUTION STRENGTH AND
TEMPERATURE, AND CONTAMINATION DETECTION) IS DIFFICULT

A

CHEMICAL STERILIZATION

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6
Q

IS A DEVICE THAT PROVIDES STEAM
STERILIZATION UNDER PRESSURE.

A

AUTOCLAVE

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7
Q
  • THE MOST COMMONLY USED STERILIZATION METHOD
  • QUICKEST AND MOST CONVENIENT MEANS FOR ITEMS THAT
    CAN WITHSTAND HEAT AND MOISTURE
A

AUTOCLAVING

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8
Q

METHOD THAT USES A MIXTURE OF GASES HEATED TO 135°F
(57°C)

A

CONVENTIONAL GAS STERILIZATION

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9
Q
  • USED FOR ITEMS THAT CANNOT BE AUTOCLAVED
  • ELECTRICAL, PLASTIC, RUBBER ITEMS, AND OPTICAL WARE
  • TELEPHONES, STETHOSCOPES, BLOOD-PRESSURE CUFFS, AND
    OTHER EQUIPMENT USED IN ISOLATION ROOMS
A

CONVENTIONAL GAS STERILIZATION

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10
Q

WHAT ARE SOME DRAWBACKS FOR CONVENTIONAL GAS STERILIZATION

A

*GASES USED ARE POISONOUS.
* MUST BE DISSIPATED BY AERATION IN A CONTROLLED
ENVIRONMENT.
* PROCESS IS TIME-CONSUMING.

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11
Q
  • SAFER THAN CONVENTIONAL GAS STERILIZATION
  • NO TOXIC BY-PRODUCTS
A

GAS PLASMA TECHNOLOGY

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12
Q

ABLE TO STERILIZE HEAT/MOISTURE-SENSITIVE ITEMS IN
GREATER VOLUME
* MORE COST-EFFECTIVE THAN CONVENTIONAL GAS
* CANNOT COMPLETELY REPLACE GAS BECAUSE IT IS NOT
EFFECTIVE ON ITEMS WITH LONG, NARROW LUMINA
* CANNOT BE USED ON CELLULOSE ITEMS (LINENS, ETC.)

A

GAS PLASMA TECHNOLOGY

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13
Q

STERILITY INDICATORS

A
  • CHEMICAL INDICATORS THAT CHANGE COLOR WHEN
    STERILIZATION HAS OCCURRED
  • USED TO IDENTIFY WHETHER A PACK HAS BEEN STERILIZED
  • PLACED INSIDE AND OUTSIDE THE PACK TO SHOW THAT THE
    GAS, HEAT, STEAM, OR GAS PLASMA HAS PENETRATED TO
    ALL SURFACES
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14
Q
  • THE TAPE THAT SEALS THIS
    PACK WAS ORIGINALLY A PLAIN,
    LIGHT COLOR. THE STRIPES
    APPEARED ON THE TAPE WHEN
    CONDITIONS FOR STERILITY
    WERE ACHIEVED.
A

STERILITY INDICATORS

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15
Q

DEFINED AS A MICROORGANISM-FREE AREA PREPARED FOR
THE USE OF STERILE SUPPLIES AND EQUIPMENT

A

STERILE FIELD

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16
Q

STEPS TO ESTABLISH A STERILE FIELD

A

*PLACE THE PACK ON A CLEAN SURFACE WITHIN REACH OF
THE PHYSICIAN.
* JUST BEFORE THE PROCEDURE BEGINS, BREAK THE SEAL
AND OPEN THE PACK.
* UNFOLD THE FIRST CORNER AWAY FROM YOU; THEN
UNFOLD THE TWO SIDES.
* PULL THE FRONT FOLD DOWN TOWARD YOU AND DROP
IT.
* DO NOT TOUCH THE INNER SURFACE.
* THE INNER WRAP, IF THERE IS ONE, IS OPENED IN THE
SAME MANNER.
* YOU HAVE NOW ESTABLISHED A STERILE FIELD.

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17
Q

SURGICAL ASEPSIS:
STANDARD PRINCIPLES

A
  • ANY STERILE OBJECT OR FIELD TOUCHED BY AN UNSTERILE OBJECT OR
    PERSON BECOMES CONTAMINATED.
  • NEVER REACH ACROSS A STERILE FIELD.
  • ORGANISMS MAY FALL FROM YOUR ARM INTO THE FIELD.
  • INCREASES THE RISK OF BRUSHING THE AREA WITH YOUR UNIFORM
  • IF YOU SUSPECT AN ITEM IS CONTAMINATED, DISCARD IT.
  • INCLUDES DAMP ITEMS, ITEMS WITH BROKEN SEAL, AND ITEMS ON WHICH
    THE INDICATOR TAPE HAS NOT ASSUMED THE CORRECT COLOR
  • DO NOT PASS BETWEEN THE PHYSICIAN AND THE STERILE FIELD.
  • NEVER LEAVE A STERILE AREA UNATTENDED.
  • NO ONE WOULD KNOW IF FIELD WERE CONTAMINATED.
  • A 1-INCH BORDER AT THE PERIMETER OF THE STERILE FIELD IS
    CONSIDERED A “BUFFER ZONE” AND IS TREATED AS IF IT WERE
    CONTAMINATED
18
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 1 to 5

A
  1. OBTAIN A “SKIN-PREP SET” AND A BOTTLE OF ANTISEPTIC
    FOR PAINTING THE SKIN. THE PREPARATION SET INCLUDES A
    BASIN, LIQUID SOAP SUCH AS PHISODERM, GAUZE
    SPONGES, RAZOR, TOWEL, FORCEPS, AND MEDICINE CUP.
  2. PERFORM HAND HYGIENE.
  3. PLACE THE PATIENT IN A COMFORTABLE POSITION AND
    ENSURE PRIVACY.
  4. EXPLAIN WHAT IS TO BE DONE.
  5. EXPOSE AN AREA SLIGHTLY LARGER THAN THE
    PREPARATION SITE, KEEPING THE PATIENT AS COMPLETELY
    COVERED AS POSSIBLE TO PROVIDE COMFORT AND
    MODESTY.
19
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 6 to 10

A

NOTE: IF HAIR REMOVAL IS NOT ORDERED, OMIT STEPS 6 AND
7.
6. IF HAIR REMOVAL IS ORDERED, USE A DRY RAZOR TO SHAVE
A SMALL AREA AT A TIME. HOLD THE SKIN TAUT WITH ONE
HAND AND SHAVE WITH SHORT, FIRM STROKES IN THE
DIRECTION OF HAIR GROWTH. THE SAME CONCEPT APPLIES
IF USING AN ELECTRIC RAZOR.
7. WIPE THE AREA WITH A STERILE GAUZE SPONGE WETTED
WITH ALCOHOL, REMOVING ALL THE HAIR.
8. PERFORM HAND HYGIENE AND DON STERILE GLOVES.
9. POUR A LITTLE OF THE ANTISEPTIC INTO A WASTE
CONTAINER TO CLEANSE THE LIP OF THE BOTTLE.
10. FILL THE MEDICINE CUP WITH ANTISEPTIC.

20
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 11-15

A
  1. GRASP SEVERAL GAUZE SPONGES WITH THE FORCEPS AND
    DIP THEM INTO THE ANTISEPTIC.
  2. PAINT THE SKIN WITH THE ANTISEPTIC, STARTING IN THE
    CENTER OF THE AREA AND WORKING OUTWARD IN A
    CIRCULAR PATTERN. DO NOT SCRUB HARSHLY, BUT
    REMEMBER THAT FRICTION IS MORE EFFECTIVE THAN
    SOAP IN CLEANSING THE SKIN. DISCARD THE SPONGE.
  3. ALLOW THE SKIN TO DRY.
  4. REPEAT STEPS 12 AND 13.
  5. OPEN THE PACK CONTAINING THE STERILE DRAPE OR
    STERILE TOWELS. THE PHYSICIAN, WEARING STERILE
    GLOVES, WILL DRAPE THE AREA SURROUNDING THE
    PREPARED SITE.
21
Q

SURGICAL HAND SCRUB
steps 1-6

A
  1. WEAR SURGICAL ATTIRE AND APPROPRIATE PERSONAL PROTECTIVE
    EQUIPMENT.
  2. USING FOOT OR KNEE LEVER, ADJUST WATER FLOW AND TEMPERATURE.
  3. WET YOUR HANDS. ADD A FEW DROPS OF ANTIMICROBIAL SOAP AND MORE
    WATER AS NEEDED TO MAKE A LATHER.
  4. WASH YOUR HANDS AND FOREARMS THOROUGHLY. USE ONE BRUSH AND
    SOAP TO CLEAN YOUR HANDS AND NAILS, AND CLEAN UNDER YOUR NAILS
    WITH THE NAIL CLEANER UNDER RUNNING WATER.
  5. RINSE YOUR HANDS AND ARMS THOROUGHLY, KEEPING YOUR HANDS
    HIGHER THAN YOUR ELBOWS. TAKE CARE TO AVOID SPLASHING YOUR
    SCRUB CLOTHES BECAUSE THE DAMPNESS MAY LATER MOISTEN YOUR
    STERILE GOWN, CAUSING CONTAMINATION.
  6. USING THE SECOND BRUSH AND MORE SOAP, THE ACTUAL SCRUB BEGINS.
    THE PRESCRIBED NUMBER OF BRUSH STROKES IS USUALLY 15 STROKES TO
    THE NAILS OF EACH HAND AND 10 STROKES TO EACH AREA OF THE SKIN,
    WHICH USUALLY TAKES ABOUT 5 MINUTES.
22
Q

SURGICAL HAND SCRUB
steps 7-13

A
  1. THE FINGERS AND HANDS SHOULD BE VISUALIZED AS HAVING FOUR SIDES, AND
    EACH SIDE MUST BE EFFECTIVELY SCRUBBED. STARTING WITH THE FINGERNAILS,
    SCRUB THEM VIGOROUSLY, HOLDING THE BRUSH PERPENDICULAR TO THEM. THEN
    SCRUB ALL SIDES OF EACH FINGER AND THE PALMS AND BACKS OF THE HANDS.
    DIVIDE EACH FOREARM INTO THIRDS AND USE A CIRCULAR MOTION TO SCRUB EACH
    SIDE OF THE FOREARMS AND ELBOWS, UP TO 2 INCHES ABOVE THE ELBOWS.
  2. KEEP YOUR HANDS ABOVE YOUR ELBOWS WHILE SCRUBBING AND ADD SMALL
    AMOUNTS OF WATER AS NEEDED TO MAINTAIN A GOOD LATHER. WHEN SCRUBBING
    IS COMPLETED, DISCARD THE BRUSH.
  3. RINSE YOUR HANDS AND ARMS THOROUGHLY FROM FINGERTIPS TO ELBOWS IN ONE
    MOTION, ALLOWING THE WATER TO DRAIN OFF AT THE ELBOWS. TURN OFF THE
    WATER WITH THE FOOT OR KNEE CONTROL.
  4. KEEPING YOUR HANDS ABOVE THE ELBOWS AND AWAY FROM YOUR BODY, ENTER
    THE SURGICAL SUITE BY BACKING THROUGH THE DOOR.
  5. TO DRY, GRASP THE CORNER OF A STERILE TOWEL AND STEP BACK FROM THE
    FIELD, ALLOWING THE TOWEL TO FALL OPEN. BEND FORWARD AT THE WAIST AND
    HOLD YOUR ARMS AWAY FROM YOUR BODY AND ABOVE YOUR WAIST. DRY YOUR
    HANDS AND THEN YOUR ARMS THOROUGHLY, ROTATING THE TOWEL AS REQUIRED.
  6. TAKE CARE NOT TO CONTAMINATE THE STERILE FIELD, THE TOWEL, OR YOUR
    HANDS.
  7. YOU ARE NOW READY TO DON A STERILE GOWN AND GLOVES.
23
Q

SURGICAL SCRUB: ALCOHOL-BASED
HANDRUB METHOD
steps 1-7

A
  1. WEAR SURGICAL ATTIRE AND APPROPRIATE PERSONAL
    PROTECTIVE EQUIPMENT.
  2. USING FOOT OR KNEE LEVER, ADJUST WATER FLOW AND
    TEMPERATURE.
  3. WET HANDS AND ARMS AND LATHER WITH APPROVED NONANTIMICROBIAL AGENT.
  4. CLEAN FINGERNAILS UNDER RUNNING WATER USING
    DISPOSABLE NAIL CLEANER; DISCARD NAIL CLEANER.
  5. RINSE HANDS AND ARMS UNDER RUNNING WATER.
  6. DRY HANDS AND ARMS USING A PAPER TOWEL.
  7. DISPENSE OF THE MANUFACTURER’S RECOMMENDED AMOUNT
    OF ALCOHOL-BASED HAND RUB INTO THE PALM OF ONE HAND.
    DO NOT USE WATER WITH THE HAND PREP.
24
Q

SURGICAL SCRUB: ALCOHOL-BASED
HANDRUB METHOD
steps 8-13

A
  1. DIP THE FINGERTIPS OF THE OPPOSITE HAND INTO THE
    HAND PREP AND WORK IT UNDER THE NAILS.
  2. SPREAD THE REMAINING HAND PREP EVENLY OVER THE
    HAND AND FOREARM TO JUST ABOVE THE ELBOW,
    COVERING ALL SURFACES.
  3. USING ADDITIONAL HAND PREP, REPEAT STEPS 7–9 WITH
    THE OTHER ARM.
  4. REPEAT STEPS 7–10, IF RECOMMENDED.
  5. TO FACILITATE DRYING, CONTINUE RUBBING ANTISEPTIC
    HAND PREP INTO HANDS UNTIL DRY.
  6. KEEP SCRUBBED HANDS AND ARMS IN VIEW AND AVOID
    CONTAMINATION; ALLOW TO AIR DRY COMPLETELY BEFORE
    DONNING A STERILE GOWN AND GLOVES.
25
Q

STERILE GOWNING WITH CLOSED
GLOVING TECHNIQUE

A
  1. ASSISTANT OPENS GLOVES AND STERILE GOWN PACK.
  2. LIFT FOLDED STERILE GOWN, AND STEP BACK FROM
    TABLE. ALLOW GOWN TO UNFOLD WITH INSIDE OF GOWN
    TOWARD YOU.
  3. INSERT ARMS INTO SLEEVES.
  4. DO NOT ALLOW HANDS TO PROTRUDE THROUGH CUFFS.
  5. ASSISTANT FASTENS GOWN AT NECKLINE.
  6. WITH DOMINANT HAND REMAINING INSIDE SLEEVE, PICK
    UP GLOVE FOR NONDOMINANT HAND.
  7. INSERT NONDOMINANT HAND INTO GLOVE.
  8. STRETCH CUFF OF GLOVE OVER CUFF OF GOWN.
  9. WITH NONDOMINANT HAND, PICK UP SECOND GLOVE.
  10. STRETCH CUFF OF GLOVE OVER CUFF OF GOWN.
  11. CLOSED GLOVING IS COMPLETE.
  12. SEPARATE WAIST TIE FROM GOWN AND PASS TIE WITH
    TAB TO ASSISTANT.
  13. TURN IN A CIRCLE TO WRAP TIE AROUND YOUR WAIST.
  14. A SHARP TUG ON TIE WILL SEPARATE IT FROM THE
    CONTAMINATED TAB, ALLOWING YOU TO FASTEN THE TIE
    WITHOUT CONTAMINATING GOWN.
26
Q

OPEN GLOVING TECHNIQUE

A
  1. PERFORM HAND HYGIENE. OBTAIN GLOVES, AND
    CHECK FOR CORRECT SIZE.
  2. OPEN OUTER WRAP TO REMOVE FOLDED INNER WRAP.
  3. EXPOSE GLOVES WITH OPEN ENDS FACING YOU.
  4. OPEN INNER WRAP COMPLETELY, TAKING CARE NOT
    TO CONTAMINATE GLOVES OR WRAP IMMEDIATELY
    SURROUNDING GLOVES.
  5. WITH ONE HAND, GRIP CUFF FOLD OF GLOVE FOR
    OPPOSITE HAND.
  6. PUT ON FIRST GLOVE, TOUCHING ONLY INNER
    SURFACE OF FOLDED CUFF.
  7. USING GLOVED HAND, GRASP SECOND
    GLOVE UNDER CUFF.
  8. INSERT HAND INTO SECOND GLOVE.
  9. PUT ON SECOND GLOVE, AND UNFOLD
    CUFF.
  10. INSERT FINGERS UNDER CUFF OF FIRST
    GLOVE, AND UNFOLD CUFF.
  11. GLOVING COMPLETE. KEEP HANDS IN
    FRONT OF BODY
    AND AT SAFE DISTANCE FROM UNIFORM TO
    AVOID CONTAMINATION.
27
Q

DRESSING REMOVAL

A
  • PERFORM HAND HYGIENE AND DON GLOVES.
  • INFORM THE PATIENT OF WHAT YOU ARE ABOUT TO DO.
  • USE CARE IN REMOVING THE DRESSING TO PREVENT
    CROSS-CONTAMINATING THE WOUND AND YOURSELF.
  • REMOVE THE DRESSING GENTLY TO AVOID HURTING THE
    PATIENT.
  • PLACE THE SOILED DRESSING IN A PLASTIC BAG AND SEAL
    IT BEFORE ADDING IT TO THE BIOHAZARD CONTAINER.
  • REMOVE YOUR GLOVES FOLLOWING THE SAME
    PROCEDURE USED WITH ISOLATION TECHNIQUES.
  • PERFORM HAND HYGIENE
28
Q

SUPPLIES NEEDED FOR A STERILE DRESSING

A
  • PREPARE SUPPLIES:
  • STERILE GLOVES
  • STERILE DRAPE
  • STERILE GAUZE
  • TAPE
  • NORMAL SALINE
29
Q

APPLYING A STERILE DRESSING

A
  1. TELL THE PATIENT WHAT YOU PLAN TO DO.
  2. PERFORM HAND HYGIENE.
  3. TEAR SEVERAL STRIPS OF TAPE TO A CONVENIENT
    LENGTH.
  4. OPEN THE STERILE DRAPE PACK, PLACING THE
    DRAPE NEAR THE PATIENT.
  5. PARTIALLY OPEN THE DRAPE BY PULLING FROM THE
    CORNERS. THIS CREATES A SMALL STERILE FIELD
    FOR YOUR OTHER STERILE ITEMS.
  6. OPEN THE DRESSING PACKAGE AND ADD THE
    STERILE DRESSING TO YOUR STERILE FIELD.
  7. IF YOU WILL NEED TO CLEANSE AROUND
    THE WOUND, DROP STERILE GAUZE
    SPONGES INTO YOUR FIELD FOR THIS
    PURPOSE.
  8. TO MOISTEN THE GAUZE SPONGES, OPEN A
    SMALL VIAL OF STERILE NORMAL SALINE
    SOLUTION. RECHECK THE LABEL AND POUR
    A SMALL AMOUNT OF THE SALINE OVER THE
    SPONGES. DO NOT ALLOW LIQUID TO SOAK
    THROUGH TO THE STERILE TOWEL. CHECK
    THE LABEL FOR THE THIRD TIME BEFORE
    DISCARDING THE VIAL.
  9. DON STERILE GLOVES USING THE OPEN
    METHOD DESCRIBED FOR STERILE
    GLOVING.
  10. USE THE MOIST SPONGES TO CLEAN GENTLY
    AROUND THE WOUND.
  11. ALLOW THE AREA TO DRY COMPLETELY.
  12. APPLY THE DRESSING OVER THE WOUND,
    AND SECURE IT IN PLACE WITH TAPE.
  13. COVER THE PATIENT.
  14. DISPOSE OF ANY WASTE.
  15. REMOVE YOUR GLOVES.
  16. PERFORM HAND HYGIENE
30
Q

temporary molecule, portion of a molecule, or atom with unpaired electron(s) in its outer shell.

A

free radical

31
Q

refers to an awareness of sterile technique and the responsibility for telling the person in charge whenever you contaminate a field or observe its contamination by someone else.

A

sterile conscience

32
Q

Is the complete destruction of all organisms and spores from equipment used for patient care or procedures.

A

sterilization

33
Q

Process of creating and maintaining an area that is completely free of pathogens.

A

surgical asepsis

34
Q

is necessary when the radiographer is asked to assist with a sterile procedure by working within a sterile field.

A

surgical hand scrub

35
Q
  • product that provides a very high level of disinfection that persists for a prolonged period of time.
A

surgical hand rub-

36
Q

what should the degree be to kill off organisms

A

240-270 degrees F

37
Q

When scrubbing where do you start

A

start from the middle and make your way out

38
Q

how should you pass someone when sterile

A

Back to back or front to front

39
Q

what part of the gown is considered dirty

A

back of the gown

40
Q

mixed with water 1 to 10 ratio

A

bleach
1 part bleach 10 parts water

41
Q

how should you hold your hands

A

hold your hands together above your waist (below your waist is considered dirty)

42
Q

what is another way to disinfect that has not been mentioned in other steps

A

boiling something for 12 minutes

Patient Care II (6 decks)

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