Chapter 5 Flashcards
Practice that helps reduce the number & spread of microorganisms
Medical asepsis
Complete removal of microorganisms and their spores from the surface of an object
Surgical asepsis
Absolute killing of all life forms
Reduces the probability of acquiring an infection to zero
Sterilization
Most frequently used method of sterilization
Heat
Which is much more effective and rapid at killing than dry heat
Involves using steam under pressure
Quickest, most convenient & most commonly used method
Moist heat
Device used to sterilize using moist heat
Autoclave
Oven with a higher temperature
Dry heat
As many microorganisms as possible are eliminated from surfaces by physical or chemical means
Disinfection
Which are not destroyed by disinfection
Spores
Which Objects or surfaces that cannot be sterilized
Tables, floors, walls, equipment
When the skin is disinfected
Antiseptics
Disinfection Categorized as:
High level/Intermediate level/Low level (iodine, Betadine, Hydrogen peroxide …)
Items to be sterilized or disinfected are
Critical, Semicritical & noncritical
Based on risk of infection for the patient
Surgical asepsis refers to the removal of:
Microorganisms and their spores
What is the autoclave method of sterilization?
Steam under pressure/moist steam
Procedures require use of sterile technique
Monogram/Audiogram
Purpose of surgical zones
Help to decrease infections
Must practice @ all times in sterile environment
3 zones
Street clothing
Entrance to surgery department
Zone 1 or Unrestricted
Scrub clothing with hair & shoe covers
Hallways of the surgery department
Zone 2 or Semi-restricted
Attire scrub attire
Hair, shoe coverings & a mask
Zone 3 or Restricted
Who needs a mask?
All member who is entering the surgical suite
Must remain on while in the surgical suite.
How to wear a mask?
It must cover the nose and mouth without gapping.
Ties (behind head) must not cross as this may create venting
Worn for one procedure and then discarded.
Mask Consider
Highly contaminated
Good for 15 minutes.
Never place the mask around your neck for reuse.
When removing, handle mask by the ties only Discard mask in a trash receptacle.
If you are wearing a mask for a surgical procedure that has just finished and you are about to head to another surgical room for another procedure, should you wear the same mask?
NO
Equipment & Supplies
Must be packaged in a particular manner to be considered “safe” for use.
Stored in a particular manner to protect from contamination
Equipment remains in surgical area
Imaging equipment must be clean
With a disinfectant solution prior to entering the surgical suite. (clean @ room only)
Door of Surgical Suite
Kept closed during the procedure
Allow only who involved with the procedure
NO Traffic in and out
NO Conversation except physician
If the sterility of an object is questionable?
It is not sterile
Sterile people movement
Not lean on table/wall
Must pass another back to back
Keep hands above waist & front chest
Sterile field
Created just before use.
Ends @ the level of the tabletop or @ the waist of the sterile person’s gown (not corner)
NON-Sterile field
Edges of a draped sterile table
Anything that falls below the tabletop
Sterile gown
From the waist to the shoulders in front
Sleeves from 2” above the elbow to the cuffs
(Not include the cuff, but to the cuff/glove cover cuff)
Glow will cover cuff
Cuffs collect moisture - (non-sterile)
If a sterile pack becomes dampened or wet?
Non-sterile
When pouring a sterile solution (betadine)
Lid face upward & Not touch the inside of the lid or the lip of the flask.
Pour a small amount of solution out before the remainder is poured into the sterile container. (6 inches above)
The sterile container is placed at the edge of the sterile field by the sterile person.
If two people in sterile attire should need to pass one another, in what manner should this be done?
Back to back
What portions of the gown are considered to be sterile?
2” to cuff above the elbow
Waist to shoulder front
Which may be used for packaging items.
Cloth, nonwoven fabrics, paper or plastic
Who must be able to penetrate the material for packaging items?
Sterilizing agent
How to wrap sterile items?
Must be covered completely by the wrapper & securely fastened with tape or a heat seal.
Wrapper must be strong enough to remain damage free.
Wrapper must allow opening and removing of item without contamination.
Wrapper must be impermeable to dust, microbes, and moisture and must be able to maintain the sterility of contents until opened.
Storage Guidelines
All sterile items are stored in the same place, separate from non-sterile items.
A sterile package must have an expiration date.
If no date on package
consider it non-sterile.
Before open a sterile items
Check the sterilization date to avoid exceeding shelf life
If sterilized in hospital and wrapped in cloth or paper
Considered sterile for 30 days if in a closed cabinet.
If sterile on an open shelf
Considered sterile for 21 days.
If sealed in a plastic bag immediately after sterilization
Considered sterile for 6 to 12 months
seal must not be broken
If commercially packaged
Considered sterile until seal is broken or package is damaged or until expiration date has passed.
Most items commercially packaged are wrapped in paper or plastic or both.
How does one open a sterile tray?(Creating a Sterile Field)
Place item in the center of a table with the sealed end pointing towards you.
Open first flap away from you.
Open the side flaps.
Right hand to open the right flap and left hand to open the left flap (wrap and pinch)
Pull open and lay flat on the surface
Open the last flap and drop it towards your body (sterile field)
How does one open a sterile pack?
Grasp the ends of the wrapper and pull apart. (needle)
Gently flip the object onto the sterile field being careful not to contaminate the field or
or hold the contents forward for a sterile person to grasp.
Never cut packs open or pierce with a sharp object.
Before entering NICU room
Remove all jewelry, including watches
Obtain scrub brush kit
Wet hands and forearms to approximately 2 inches from your elbows
Hands are held up to allow water to drain downward towards elbow
Cleanest to dirtiest area
Purpose of Surgical Scrub
To remove as many microorganisms as possible from the skin of your hands and lower arms.
“Open method” OF Sterile Gloving
Open the glove wrapper and expose the gloves.
Glove the dominant hand first.
Pick up the right glove (if right handed) with the left hand at the folded cuff (inside portion) and slide the right hand into the glove leaving the cuff down.
Do not touch the outside surface of the glove
When opening a sterile tray, the first corner of the wrap is opened in which direction?
Away from you
When examining a sterile package that is going to be used for a procedure, what should be examined first?
Expiration date/not damage and broken
Which method of putting on gloves should be used when placing gloves on over a sterile gown?
Close method if have glove and gown
If not have glove and gown
Open method
Skin Preparation
Before an invasive procedure is started
Remove oil, dirt, and as many microorganisms as possible
Reduce the potential for infection
Allergy to antiseptic or sterile gloves
Do not allow the solution (betadine (something to clean dirt of skin) to drain off the area being prepped and collect under the patient (don’t put too much betadine on pt)
Surgical Team
Surgeon Surgical assistant Anesthesiologist or nurse anesthetist Circulating nurse Scrub nurse or surgical technician
Another surgeon or surgical resident
Surgical assistant
Oversees the safety of the patient and maintains surgical environment
Circulating nurse
Scrub nurse or surgical technician
Sets up sterile field
Assists surgeon
Imaging in the OR
Place IR before draping the patient for a procedure.
If IR must be placed after the procedure has been started
you must pass the IR to the scrub nurse who will receive it in a sterile plastic bag and places according to your directions.
During imaging
All personnel remaining in the room must have radiation protection apparel or step behind a lead lined screen.
IR within a sterile field
Sterile plastic cover with only the outer surface sterile
How to handling the IR to sterile surgical?
Sterile surgical personnel holds plastic cover open and technologist carefully slides the IR into the cover
Surgical personnel places the IR based upon the technologist’s directions
