Infection control: Surgical Asepsis Flashcards

1
Q

What is the key principle regarding sterile objects in surgical asepsis?

A
  • A sterile object remains sterile only when touched by another sterile object
  • This guides how nurses place and handle sterile objects
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2
Q

What happens when sterile objects touch sterile objects?

A
  • They remain sterile
  • Examples: Sterile gloves, forceps used on sterile field
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3
Q

What happens when a sterile object touches a clean (non-sterile) object?

A
  • The sterile object becomes contaminated
  • Example: Sterile syringe tip touching clean disposable glove
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4
Q

What is the objective of surgical asepsis or aseptic technique?

A
  • Prevent microorganisms from being introduced to a susceptible site
  • Prevent transmission of microorganisms to other patients or staff
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5
Q

What should be done to prepare for a sterile procedure?

A
  • Gather all required supplies
  • Ensure a clear and dry field
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6
Q

How should movement around a sterile field be done?

A
  • In a manner that does not contaminate the sterile field
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7
Q

When should sterile fields be prepared?

A
  • As close to time of use as possible to minimize environmental contamination
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8
Q

What should be minimized in a sterile field?

A
  • Conversation to reduce contamination from respiratory droplets
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9
Q

What should be done prior to setting up a sterile field?

A
  • Perform hand hygiene
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10
Q

How should the sterile barrier be checked?

A
  • Ensure it is intact with no punctures or moisture damage
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11
Q

ow should questionable sterility be handled?

A
  • The item must be considered unsterile
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12
Q

How should sterile packs be opened?

A
  • Carefully to prevent contamination of contents
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13
Q

What is required for items in a sterile field?

A
  • All items must be sterile
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14
Q

What area is considered unsterile once a package is opened?

A
  • A 2.5 cm border around the edges
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15
Q

How should solutions be poured into sterile receptacles?

A
  • Slowly to avoid splashing and contamination
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16
Q

When is an object considered no longer sterile?

A
  • If below waist level or out of vision range
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17
Q

Why should sterile gloves be worn?

A
  • Prevent introducing microorganisms to site
  • Protect wearer from body fluids
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18
Q

What happens when a sterile object touches a contaminated object?

A
  • The sterile object becomes contaminated
  • Example: Touching a sterile object with an ungloved hand
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19
Q

How should questionable sterile objects be handled?

A
  • Considered contaminated and discarded
  • Example: Torn/broken packaging, even if object appears untouched
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20
Q

What can be placed on a sterile field?

A
  • Only properly sterilized objects
  • Stored in clean, dry areas with intact packaging
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21
Q

When is a sterile object or field considered contaminated?

A
  • Out of nurse’s vision range
  • Held below waist level
  • Unattended and could be accidentally touched
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22
Q

How does prolonged air exposure contaminate sterile objects/fields?

A
  • Air currents from movements can carry microorganisms
  • Talking/coughing/sneezing over sterile area
  • Reaching over sterile area
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23
Q

How does contact with a wet, contaminated surface affect sterility?

A
  • Sterile object/field becomes contaminated by capillary action
  • If moisture seeps through sterile packaging, object is contaminated
  • Wet sterile packages must be discarded or re-sterilized
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24
Q

How can spills contaminate a sterile field?

A
  • Any spill can contaminate unless field rests on moisture-proof sterile surface
  • Example: Spill in sterile catheter tray container won’t contaminate contents
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25
When is a sterile object at risk of gravity contamination?
* If gravity causes a contaminated liquid to flow over object's surface * Hands held above elbows during scrub to prevent this
26
What areas of a sterile field are considered contaminated?
* 2.5 cm border around edges where field touches unsterile surface * Open container edges exposed to air * Sterile objects must avoid touching these areas
27
What should be done before starting a sterile procedure?
* Have extra supplies available in case of accidental contamination
28
Why should each step be explained before the procedure?
* To ensure patient can cooperate fully
29
What should be done if an object becomes contaminated during the procedure?
* Discard the contaminated object immediately
30
What protective equipment may nurses wear for sterile procedures on a general nursing unit?
- Surgical mask - Eyewear (if risk of fluid/blood splashing) - No cap required
31
For sterile surgical procedures, what is the proper order for donning protective equipment?
- Apply clean cap covering all hair first - Then put on surgical mask - Then put on eyewear
32
How should the surgical mask fit?
- Snugly around face and nose - To prevent droplet nuclei contamination
33
When should a surgical mask be changed?
- If it becomes moist, as moisture promotes microorganism spread
34
How should protective eyewear fit?
- Snugly around forehead and face - To fully protect eyes
35
When is eyewear needed?
- For procedures with risk of body fluid splashing into eyes
36
What should be removed first before taking off mask, eyewear and cap?
- Remove gloves first - To prevent contamination of hair, neck and face
37
How should a used mask be removed and discarded?
- Untie mask, hold by ties and discard with cap - Do not wear hanging from neck after removal
38
What should be done after removing all protective equipment?
- Perform hand hygiene
39
How are sterile items packaged?
- In paper or plastic containers impervious to microorganisms when dry and intact - Some reusable supplies wrapped in permeable paper/linen for steam autoclaving
40
How are sterile items stored?
- In clean, enclosed storage cabinets - Separated from non-sterile equipment
41
What indicates an item has been sterilized?
- Chemical tapes that change color during sterilization process - If tapes don't change color, item is not sterile
42
When should a sterile item not be used?
- If packaging integrity is compromised
43
How do facilities indicate expiration of sterile items?
- "Event-related expiration" with date processed and lot number - "Date-related expiration" with expiration date applied
44
What should be done before opening sterile packages?
- Perform thorough hand hygiene - Inspect supplies for package integrity and sterility indicators
45
Where should sterile packages be opened?
- On a cleaned work area above waist level - Not in confined spaces where dirty objects could fall on them
46
How should commercially packaged sterile items be opened?
- Hold item in one hand, pull away paper/plastic cover with other hand - Take care to keep inner contents sterile before use
47
What are the steps to open facility-packaged sterile items?
- Place item flat in center of work surface - Remove sterilization tape/seal - Grasp and open outer flap away from body, arm outstretched - Open side flaps one at a time, allowing to lie flat - Stand away and open innermost flap, letting it fall flat - Use inner package surface as sterile field, avoiding 2.5cm border
48
How can a sterile package be closed if not for immediate use?
- Touch only outside wrapper surface - Reverse order of opening - Do not touch inner contents or reach over field
49
How should a small sterile item be opened when held?
- Hold package in non-dominant hand - Use dominant hand to carefully open side/top flaps away from item - Open so item can be handed to person with sterile gloves or transferred
50
What is a sterile field?
- An area free of microorganisms - Prepared to receive sterile items - Created using inner sterile wrapper surface, sterile drape, or dressing tray
51
How are sterile items added to the field?
- Carefully placed directly on field - Transferred using sterile forceps - Any contact with 2.5cm border requires discarding item
52
What precautions are taken when wearing sterile gloves on the field?
- Can touch entire drape area - Sterile items must be handed over by assistant - Gloves cannot touch wrappers of sterile items
53
hat parts of a bottle containing sterile solution are considered sterile?
- Inside of the bottle - Inside of the bottle cap
54
How should the bottle cap be handled after removal?
- Held in hand or placed sterile side up on clean surface - Never rested on sterile surface to avoid contamination
55
What should be checked before pouring the solution?
- Check label to ensure it is the correct solution
56
How should the bottle be held when pouring?
- Hold with label in palm to prevent wetting/fading - Keep bottle edge away from receiving container edge/inside
57
How should the solution be poured?
- Pour slowly to avoid splashing sterile field - Hold bottle outside edge of sterile field
58
How many times can solution be poured from container?
- Pour solution from container once only - Discard remaining fluids after procedure
59
Why must nurses decontaminate their hands when working in operating rooms?
- To decrease and suppress growth of skin microorganisms - In case glove tears during procedure
60
What areas should be scrubbed during surgical hand antisepsis?
- Scrub from fingertips to elbows with antiseptic soap
61
What products can be used for surgical hand antisepsis?
- Antimicrobial surgical scrub agent intended for surgical hand antisepsis - Alcohol-based antiseptic surgical hand rub with persistent/cumulative activity
62
How long should a traditional surgical scrub last?
- 3-5 minutes to allow adequate contact time - Follow manufacturer's instructions and facility policy
63
What should be removed for maximum bacteria elimination?
- All jewelry including watches - Keep nails clean and short
64
What should not be worn on fingernails?
- Artificial nails or enhancements as they harbor more bacteria - Nail polish as it conceals soil and chipped polish increases bacterial load
65
Who should be excluded from the surgical team?
- Nurses with active skin infections, open lesions/cuts - Nurses with respiratory infections
66
What are sterile gloves used for?
- An additional barrier to bacterial transfer - Used by nurses for procedures like dressing changes and catheter insertions
67
What is open gloving?
- Technique used by nurses on general nursing units - For procedures like dressing changes and catheter insertions
68
What is closed gloving?
- Performed after applying sterile gown in operating room - Used for surgical procedures
69
How is the sterile drape opened?
- Place pack on surface and open as shown in Figure 34.4 - Ensures sterility of packaged drape
70
How is the sterile drape lifted?
- Use fingertips of one hand on 2.5cm unsterile border - Gently lift and unfold without touching objects
71
How is the drape positioned on surface?
- Hold adjacent corners up and away from body - First lay bottom half, then top half over surface
72
What is the purpose of laying drape this way?
- Prevents reaching over sterile field - Creates flat sterile work surface
73
How should the sterile drape be positioned on the work surface?
- First lay bottom half of drape over work surface - Then place top half of drape over work surface last
74
How should sterile items be opened?
- Open according to package directions - Hold outer wrapper in non-dominant hand
75
How should wrapper be removed?
- Carefully peel onto non-dominant hand - Do not shake item onto sterile field
76
How should item be placed on field?
- Place at an angle, not holding arm over field - Prevents contaminating sterile surface
77
Why dispose of outer wrapper?
- Prevents accidental contamination of sterile field
78
Why use sterile technique?
- Prevents transmission of infection to patient