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Patient Care ll (mine) > Chapter 11: Surgical Asepsis > Flashcards

Chapter 11: Surgical Asepsis Flashcards

1
Q

a device that provides steam sterilization under pressure, the most commonly used sterilization method

A

Autoclave

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2
Q

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

A

Free radical

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3
Q

the awareness of sterile technique and the responsibility for notifying those in charge whenever contamination occurs

A

sterile conscience

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4
Q

is a microorganism-free area prepared for the use of sterile supplies and equipment

A

sterile field

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5
Q

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

A

sterilization

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6
Q

is the process of creating and maintaining an area that is completely free of pathogens

A

surgical asepsis

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7
Q

a specific method of using a brush and antimicrobial soap to reduce the number of organisms on the hands and forearms and decrease the rate of microbial growth in the following hours

A

surgical hand scrub

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8
Q

an alternative to the conventional surgical hand scrub that involves the use of a non-antimicrobial soap, followed by drying the skin and applying a surgical alcohol- based skin rub

A

surgical hand rub

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9
Q

FOUR METHODS OF STERILIZATION

A
  • CHEMICAL
  • AUTOCLAVING (STEAM)
  • GAS
  • GAS PLASMA
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10
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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11
Q

IS A DEVICE THAT PROVIDES STEAM
STERILIZATION UNDER PRESSURE.
- Is an controlled environment

A

AUTOCLAVE

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12
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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13
Q

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

A

CONVENTIONAL GAS STERILIZATION

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13
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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14
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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15
Q

SAFER THAN CONVENTIONAL GAS STERILIZATION
NO TOXIC BY-PRODUCTS (primarily oxygen and water)

A

GAS PLASMA TECHNOLOGY

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15
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.)
- cleaned wrapped instruments
- kills both microorganisms and spores
- stripping atoms of electrons
- sterilize endoscopes, fiberoptic devices, microsurgical instruments, and powered instruments
- hydrogen peroxide

A

GAS PLASMA TECHNOLOGY

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15
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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16
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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17
Q

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

A

STERILE FIELD

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18
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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19
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

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20
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 1 to 5

A
  • 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.
  • PERFORM HAND HYGIENE.
  • PLACE THE PATIENT IN A COMFORTABLE POSITION AND
    ENSURE PRIVACY.
  • EXPLAIN WHAT IS TO BE DONE.
  • EXPOSE AN AREA SLIGHTLY LARGER THAN THE
    PREPARATION SITE, KEEPING THE PATIENT AS COMPLETELY
    COVERED AS POSSIBLE TO PROVIDE COMFORT AND
    MODESTY.
  • Start in the middle and work your way out
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21
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.

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22
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.
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23
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.
24
Q

SURGICAL HAND SCRUB
steps 7-13

A

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.
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.
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.
KEEPING YOUR HANDS ABOVE THE ELBOWS AND AWAY FROM YOUR BODY, ENTER
THE SURGICAL SUITE BY BACKING THROUGH THE DOOR.
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.
TAKE CARE NOT TO CONTAMINATE THE STERILE FIELD, THE TOWEL, OR YOUR
HANDS.
YOU ARE NOW READY TO DON A STERILE GOWN AND GLOVES.

25
Q

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

A

WEAR SURGICAL ATTIRE AND APPROPRIATE PERSONAL
PROTECTIVE EQUIPMENT.
USING FOOT OR KNEE LEVER, ADJUST WATER FLOW AND
TEMPERATURE.
WET HANDS AND ARMS AND LATHER WITH APPROVED NONANTIMICROBIAL AGENT.
CLEAN FINGERNAILS UNDER RUNNING WATER USING
DISPOSABLE NAIL CLEANER; DISCARD NAIL CLEANER.
RINSE HANDS AND ARMS UNDER RUNNING WATER.
DRY HANDS AND ARMS USING A PAPER TOWEL.
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.

26
Q

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

A

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

27
Q

STERILE GOWNING WITH CLOSED
GLOVING TECHNIQUE

A

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

28
Q

OPEN GLOVING TECHNIQUE

A

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

29
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

30
Q

SUPPLIES NEEDED FOR A STERILE DRESSING

A

PREPARE SUPPLIES:
STERILE GLOVES
STERILE DRAPE
STERILE GAUZE
TAPE
NORMAL SALINE

31
Q

APPLYING A STERILE DRESSING

A

TELL THE PATIENT WHAT YOU PLAN TO DO.
PERFORM HAND HYGIENE.
TEAR SEVERAL STRIPS OF TAPE TO A CONVENIENT
LENGTH.
OPEN THE STERILE DRAPE PACK, PLACING THE
DRAPE NEAR THE PATIENT.
PARTIALLY OPEN THE DRAPE BY PULLING FROM THE
CORNERS. THIS CREATES A SMALL STERILE FIELD
FOR YOUR OTHER STERILE ITEMS.
OPEN THE DRESSING PACKAGE AND ADD THE
STERILE DRESSING TO YOUR STERILE FIELD.
IF YOU WILL NEED TO CLEANSE AROUND
THE WOUND, DROP STERILE GAUZE
SPONGES INTO YOUR FIELD FOR THIS
PURPOSE.
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.
DON STERILE GLOVES USING THE OPEN
METHOD DESCRIBED FOR STERILE
GLOVING.
USE THE MOIST SPONGES TO CLEAN GENTLY
AROUND THE WOUND.
ALLOW THE AREA TO DRY COMPLETELY.
APPLY THE DRESSING OVER THE WOUND,
AND SECURE IT IN PLACE WITH TAPE.
COVER THE PATIENT.
DISPOSE OF ANY WASTE.
REMOVE YOUR GLOVES.
PERFORM HAND HYGIENE

32
Q

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

A

free radical

33
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

34
Q

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

A

sterilization

35
Q

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

A

surgical asepsis

36
Q

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

A

surgical hand scrub

37
Q

product that provides a very high level of disinfection that persists for a prolonged period of time.

A

surgical hand rub-

38
Q

what should the degree be to kill off organisms

A

240-270 degrees F

39
Q

When scrubbing where do you start

A

start from the middle and make your way out

40
Q

how should you pass someone when sterile

A

Back to back or front to front

41
Q

what part of the gown is considered dirty

A

back of the gown

42
Q

mixed with water 1 to 10 ratio

A

bleach
1 part bleach 10 parts water

43
Q

how should you hold your hand

A

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

44
Q

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

A

boiling something for 12 minutes

45
Q

methods of reducing pathogenic microorganisms in the environment and intervening in the process by which microorganisms are spread

A

medical asepsis

46
Q

What is the disadvantage of chemical sterilization?

A

Very easily contaminated only kills microorganisms does not kill pores

47
Q

What is the temperature used for autoclaving, making it an effective method in killing off microorganisms?

A

250 to 275 degrees F or (121 to 135 degrees C)

48
Q

outside of gloves is considered what?

A

sterile

49
Q

inside of gloves is considered what?

A

unsterile

49
Q

What is the other name for nosocomial infection

A

hospital acquired infection

50
Q

number one hospital acquired infection?

A

UTI

50
Q

It can effectively sterilize endoscopes, fiberoptic devices, microsurgical instruments, and powered instruments

A

gas plasma technology

51
Q

advantage is greater safety for central sterile supply department workers because there are no toxic fumes, by-products, or residues

  • compact mobile unit low temperature hydrogen peroxide
A

Gas plasma technology

52
Q

cannot sterilize instruments that have long, narrow lumina and not used for powders, liquids, or any cellulose maters: paper, cotton, or linen

A

gas plasma technology

53
Q

Most hospitals use what kind of identify to determine a pack has been sterilized

A

chemical indicators

54
Q

Hospitals use what to ensure all forms of microbial life are destroyed during the sterilization process

A

biological indicators (BIs)

55
Q

Suppliers of commerical sterile use what to destroy microorganisms?

A

cobalt 60 or an electron beam

56
Q

Packages are considered sterile when:

A
  • they are clean, dry, and have not been opened or punctured
  • their expiration date has not been exceeded
  • their sterility indicators have changed to a predetermined color, confirming sterilization
57
Q

If a procedure must be postponed what do you do with tray?

A
  • do not open tray
    if is already open
  • cover it immediately with a sterile drape or discard it
58
Q

are often used to achieve high-level disinfection of devices that come in contact with the mucous membranes, such as flexible fiberoptic endoscopes. High-level disinfection can be accomplished in less than an hour and is effective at destroying microorganisms, but will not kill spores.

A

chemical sterilization

58
Q
A

Patient Care ll (mine) (5 decks)

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