PREPARATION OF THE SURGERY TEAM AND STERILISATION/ASEPSIS Flashcards
What is sepsis?
– Invasion of the body by pathogenic microorganisms or their toxins
What is Asepsis?
Absence of the microorganisms that cause infections
What is antiseptics?
Chemical that inhibits/prevents the growth of microbes on living tissue
What is disinfectant?
Chemical that inhibits/prevents the growth of microbes on inanimate objects
What is Aseptic techniques? and how is it implemented?
Activities performed before, during and after surgery designed to
minimise the introduction of microbes into living tissue
- Set up sterile field in which surgery can be safely performed
- Isolate operating site from surrounding unsterile area
- Prevent contamination of surgical site and sterile field
What is sterilisation?
Techniques used to eradicate allmicro-organisms
What are the most important techniques to preventing infection to the patient?
Aseptic and sterile techniques are the most important
practices to prevent infection in the patient
Who is involved in aseptic techniques?
Un-scrubbed personnel
* Non sterile
* Circulator
* Scout
* Theatre tech/nurse
* Anaesthetist
Scrubbed personnel
* Sterile
* Veterinarian
* Scrub assistant
If you are an unsterile personnel, what are important techniques you have to be aware of when performing aseptic techniques?
- DO NOT lean over sterile field
- DO NOT walk between sterile trolleys and operating
tables - DO NOT touch inner
surface of sterile packs - DO NOT turn your back
on sterile field - DO avoid contact with scrubbed personnel
- DO handle sterile packs with care
- Excessive handling/dropping/humidity can force bacteria
into packs - DO keep sterile field dry
- If moisture is allowed, bacteria can migrate
- DO open sterile drape/gown carefully
- When opening, do not flip it out, it may stir up dust or touch a
non-sterile object - If in doubt about the sterility of an item, always discard it
If you are an sterile personnel, what are four important techniques you have to be aware of when performing aseptic techniques?
Always drape patient from near to far
Drape surface of the animal and table
Drape the surgicalsite
Drape the top of the instrument trolley / table
* Proper attire in the surgical theatre
* Surgical hand scrub
* Gowning and gloving
* Aseptic techniques
* Theatre cleaning
What scrub solutions are used?
- chlorhexidine 4%
- iodine 7.5%
What is the aim of the surgical scrub?
Removes as many micro-organisms as possible from
hands, nails, arms by mechanical washing and antiseptic
contact time
What is brushless scrub?
can be used instead of washing, highly concentrated alcohols mixed with antiseptics, iodine or chlorhexidine
no water needed
Removes bacteria from hands by killing it rather than
scrubbing it off
* The rub should start with the fingers and proceed to the
hands and continue up the arms to 5cm above the elbow
Is the back of a gown sterile?
no, never sterile
what is the purpose of gloving?
The purpose is to create barrier between sterile and
non-sterile areas
* Cover the surgical teams’ skin to prevent it from
contaminating patient
* Open on surface away from other sterile supplies so
that surgeon doesn’t contaminate them with any drips of
water
where are nonsterile areas?
Neckline, shoulders, sleeve cuff, gown back
If contamination has occured, what steps are taken to fix it?
take immediate action
change glovers, gowns, instruments
may need to consider prophylactic antibiotics
how do you ensure theatre cleanliness?
- cleaning - removal of soil and organic materials with detergent
remove all instruments and take to instrument cleaning area
clean and disinfect tables, positioning aids, monitoring leads
- disinfection - Destruction of micro-organisms by use of disinfection
(virucidal, bactericidal)
PLAN YOUR DAY
* Do the clean surgeries first, then
clean-contaminated, then dirty
procedures last
HOW DO YOU PREVENT MICROBIAL INVASION
Surgeon/Veterinary Staff
* Surgical attire, personal hygiene, aseptic techniques
Housekeeping
* All surfaces in theatre to be wiped down with alcohol/disinfectant
* Decrease traffic flow through theatre and prep area
Surgical Equipment
* Surgical instruments should be scrubbed thoroughly and cleaned
* Use correct sterilisation cycles for instruments/kits
Patient
* Clip appropriate margins for surgical site
* Surgical Scrub for patient
How do you clean surgical equipment?
scrubbed thoroughly
ultrasonic cleaner
wrapped properly with autoclavable paper - indicator strips/tape
correct sterilisation cycle for instruments
handle autoclaved equipment carefully
Tissues entering the body cavity, vascular systems and non intact MM, require CRITICAL cleaning - using appropriate processing methods, what is the aim of cleaning and what are the methods?
- High heat sterilisation
- Steam sterilisation
Objects will be sterile (free of all micro organisms
including bacterial spores)
Tissues entering that contact (indirectly or directly) with intact MM or non intact skin require require SEMI - CRITICAL cleaning - using appropriate processing methods, what is the aim of cleaning and what are the methods?
- High level disinfection
- Thermal disinfection
- Chemical disinfection
- Objects will be free of all micro organisms, with the
exception of high numbers of bacterial spores
Tissues entering that contact intact skin require but not MM require non critical cleaning - using appropriate processing methods, what is the aim of cleaning and what are the methods?
- Low level disinfection
- Cleaning (manual or mechanical)
objects will be clean
What is the instrument and equipment processing order?
- Pre-soak in distilled water and instrument cleaning
solution - Manual clean & rinse in distilled water
- Ultrasonic cleaning & rinse in distilled water
- Inspect
- Lubricate to prolong life
- Dry
- Wrap
- Sterilise
- Store
What is involved in manual cleaning?
- Use enzymatic cleaner and distilled water
- All items must be thoroughly cleaned
- Use a fine brush to clean each surface of the instrument
- Brushing action same direction as instrument teeth
- Any grease, oil, organic matter etc must be removed
Why is distilled water rinse prefered over tap water?
High in minerals - Leaves residue
on instruments
* Can cause permanent damage and
shorten instrument life
* Can interfere with cleaning agents
What is in surgicial packs?
General Instruments
Swabs
Hand towels
Bowls
Sterile indicators
what are considerations to be made when preparing a surgical pack?
Ensure hinged/jointed instruments are unlocked
Keep packs as small as practical to ensure thorough steam
penetration
Don’t pack too tightly or steam can’t penetrate
Don’t pack too loosely as pack may fall apart
Sterile indicators
Label kits
