Chapter 17 Aseptic technique Flashcards
product or method free of microbiological organisms
aseptic
surgical
medical
two types of asepsis
protection from infection using sterile technique before, during and after surgery
surgical asepsis
angiography
arthrography
hysterosalpingogram
operating room
myelogram
surgical technique procedures
reduction of infectious agents, decrease possibility of infection, but not necessarily to zero
clean technique
medical asepsis
protect from infection and eliminate all harmful microorganisms
goal of sterile technique
number one priority for sterile technique
hand washing
considered microorganism free
sterile field
are not suffiecient to prevent infection
clean
sanitize
disinfect
check expiration date
check clean and dry
ensure sterile drape is sterile
if package is opened or wet then it is
unsterile
opening sterile packages/trays: which way do you place package on surface
top flap opens away from you
can you reach over sterile package/tray to open flaps
no
use right hand on right side and left hand on left side
if your shirt sleeve touches inner surface of sterile package is it still a sterile package
no
rest sterile package on your hand and pull first flap away from you
are only sterile items used in sterile field
yes
sterile items can be added to sterile tray after it has been opened
drop contents on field
6 inches and at an angle
sterile solution bottles are only sterile where
inside
once sterile bottle is set down it isn’t sterile anymore
check name, concentration and expiration date 3 times
use immediately once opened
show bottle and name to person performing exam
setting up sterile tray
top side down
do not pour over label
hold 6 inches over bowl
no splashing
can contaminate if not done properly
sterile solution bottles
biopsys, hip injections, arthography
procedures using sterile techniques
removes debris and transient microorganisms from hands and nails
reduce resident microbial count to minimal
inhibit rapid rebound growth of microorganisms
purpose of surgical scrubbing
numbered stroke
timed scrub (happy bday song)
2 methods of surgical scrubbing
use scrub brush, antiseptic soap and nail cleaners
remove jewelry and watches
wash hands and arms with antiseptic soap
clean subungual
scrub for 3 minutes
scrub arms to 3 inches above elbow
repeat for other hand/arm
blot/rotate from wrist to elbow, don’t revisit area
guidelines for surgical scrubbing
12 inches from sterile area
grasp gown on folded edges
no objects near
shake gently
raise arms up and put in sleeves
have someone else tie
sterile gowning self
closed—hands in gown
open—hands out of gown (radiology dept more)
2 ways to put arms/hands in sleeves of sterile gown by self
gloving performed after gowning
use closed method or open method
sterile gloving self
fingers covered by gown and pick up gloves
right handed…use left hand to pick up glove
place glove on hand with palm down and fingers facing you
fingers grasp bottom of cuff and assistant hand pulls glove over hand to be gloved
closed method (hands in gown)
opposite hand picks up glove
careful not to touch outside surface of glove
dominant hand gets gloved first
sterile glove hand picks up the other glove by reaching under cuff
sterile glove on first must touch only the outer surface and sterile surfaces
open method (hands out of gown)
sterile person picks up gown
outside facing sterile person
circular person (non-sterile) fastens it
pullcuff over hands careful not to touch sterile gloves to hands
gowning another
if in doubt consider it unsterile
field must be watched continuously
set up for procedure close to time of procedure
below waist and table is unsterile
arms and front of gown are sterile
sterile people pass each other back-to-back
unsterile people don’t reach above or over sterile field
if wet then package unsterile but can redrape
gloves kept in sight and above waist level
principles of sterile technique
done for upper airway obstructions
sterile technique used
patient communicates with yes/no, hand signals, sign language
treat with Maslows hierarchy of needs
tracheostomies
do not touch unless using sterile technique
nurse or respiratory therapist suctions
use ambu-bag if you suction (5-10 breaths)
test catheter
insert until resistence met then withdraw 1 cm
apply suction intermittently while withdrawing in rotating motion
never suction longer than 15 seconds
asses using auscultation
tracheostomies
internal body sounds heard with stethoscope
listen for clear breath sounds
auscultation
used for atelectasis (collapsedlung), pneumothorax, thoracotomy, open heart surgery
tube into pleural cavity to remove fluid, blood, air
chest tubes
collection chamber
water seal chamber to prevent air from entering chest
2nd water chamber to control amount of suction
lower than patients chest
report if drainage is excessive (100cc per hour) or fluid color changes
chest tube drainage system
aseptic (sterile) technique used
used for emptying bladder, relieve retention, irrigate bladder, put drugs in, measure urine output, incontinence
urinary catheters
measured in french unit (outer diameter)
range from 8-18
catheters
foley (balloon, fill with sterile H2o)
straight
indwelling (remains in place)
types of urinary catheters
plastic (short term)
latex (2-3 weeks)
polyvinyl (4-6 weeks)
silicone (2-3 months)
types of catheters based upon duration
collection bag below bladder (prevent reflux and infection)
don’t drag bag on floor
cut opening to drain sterile water before trying to remove (clamp/reclamp)
don’t entangle
urinary catheters things to watch for
lithotomy position (supine, knees bent, genitalia exposed)
sterile drape under female
sterile drape under penis male
test balloon with sterile water
lubricate tip
expose the urinary meatus with non-dominant hand (no longer sterile)
clean urinary meatus with forceps, cotton balls, antiseptic
insert .5 inches women
insert 6-8 inches men
fill balloon when in place
urinary catheter insertion
use gloves
wash hands
provide privacy
get consent
basin under valve
cut tip of balloon valve, drain
remove
get help if resistence when removed
removing urinary catheter
radiography of urethra and bladder before, during and after voiding
voiding cystourethrograms
suprapubic (closed drainage system above pubis; obgyn surgeries)
condom (males; incontinence)
other types of catheters
regulates heart rate
prevents bradycardia (decreased heart rate)
involve an electrode to send impulses to contract heart
use subclavian vein
placed underneath skin on left side of patients pectoral fascia
pacemakers
radiographer runs fluroscopy while physician positions guidewire
guidewire provides path for introducer sheath and pacing lead
use subclavian vein
lead is advanced to right atrium
sheath withdrawn and lead placed atapex of right ventricle
use C-arm
sterile technique
pacemaker inserting technique
area between patient drape and instrument table
sterile corridor
snap cover (most common)
shower curtain approach
stop gap approach
3 approaches to maintain sterile field
cannot do mri if patient has this
pacemaker
injecting contrast into joint to be imaged
sterile technique for injection
done in radiology dept prior to MRI
arthograms
