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Principles Of Surgery > Principles of Surgical Asepsis > Flashcards

Principles of Surgical Asepsis Flashcards

1
Q

What is antisepsis?

A

Antisepsis – Destruction of most microorganisms on animate (living) objects
• Antiseptics are used to kill most microorganisms during patient skin prep and surgical scrubbing
• Remember skin is not sterile

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2
Q

What are antiseptics?

A

inorganic chemical compounds that combat sepsis by inhibiting the growth of microorganisms without necessarily killing them. Used primarily on skin to stop the growth of resident flora.

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3
Q

What is asepsis?

A

Absence of pathogenic microbes in living tissue that cause disease
• PREVENT wound contamination by destroying organisms before they enter the wound

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4
Q

What is Aseptic technique?

A

Aseptic technique- Principles employed to minimize degree of contamination of a surgical wound.

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5
Q

What is a barrier?

A

A material used to reduce or inhibit the migration or transmission of microorganisms in the environment: personal attire, gowns, furniture, and patient drapes, equipment, and supply packaging, and ventilating filters

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6
Q

What does it mean to be contaminated?

A

Carrying or infected by microorganisms

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7
Q

What is cross contamination?

A

Transmission of microorganisms from patient to patient or from inanimate object to patient.

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8
Q

What is decontamination?

A

Cleaning and disinfecting or sterilizing processes carried out to make contaminated items safe to handle.

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9
Q

What is sterility?

A

Sterility – Absence of all forms of microbial life
• Only inanimate objects

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10
Q

What is the most important thing to remember about asepsis in a hospital setting?

A

Complete absence of microorganisms cannot be reached in a hospital environment but using aseptic techniques will help control pathogens and decrease risk of infection

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11
Q

What is the purpose of aseptic and sterile technique?

A

• Decrease infection rate
• Minimize sources of contamination
• Block transmission of microorganisms
• Reduce patients’ risk of exposure to
microorganisms that cannot be
removed

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12
Q

What are animal sources of contamination?

A
  • Skin
  • Hair
  • Nasopharynx; Oral Cavity
  • Ear Pinnae
  • Vulva, Prepuce, Anus
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13
Q

What are inanimate sources of contamination?

A
  • Fomites & Air
  • Hair clipper
  • Scrubs
  • Hospital structures
  • Walls
  • Floors
  • Furniture
  • Equipment
  • Lights
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14
Q

What are airborne sources of contamination? How can you limit contamination?

A
  • 1 cubic foot of air contains thousands of particles
  • This can increase in longer procedures to more than 1 million
  • Decrease foot traffic in sx room (staff, other patients, pet owners)
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15
Q

What is the primary aerial bacterial source? How many microbes shed from skin per minute?

A
  • PRIMARY AERIAL BACTERIAL SOURCE = YOU THE SURGEON
  • 3,000-50,000 MICROBES SHED FROM SKIN /MIN/PERSON
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16
Q

W hat should we do to reduce Pathogenic Microorganisms

A
  • Regular hand washing
  • Use of non sterile/ sterile gloves when working with sources of pathogens/ high risk patients ( patients with infection/ wounds) ect.
  • Cleaning / disposal of equipment between patients
  • Proper equipment storage
  • Scheduled cleaning of hospital surfaces/ soiled laundry.
  • Minimizing unnecessary traffic.
  • Proper maintenance of heating, ventilation and AC units.
  • Isolation of patients with known pathogenic microorganisms.
17
Q

What are methods of preparation surgeons use to be aseptic in a procedure?

A
  • Surgeon Preparation:
  • Surgical Scrubbing
  • Drying of hands
  • Gowning
  • Gloving
18
Q

What are methods of preparation are used on patients to be aseptic in a procedure?

A
  • Patient Preparation:
  • Surgical site preparation
  • Hair removal
  • Skin preparation
  • Draping
19
Q

What other preparation should be completed to keep procedures as aseptic as possible?

A
  • Instrument Sterilization
  • Sterile technique
  • Maintaining a safe environment in the OR
20
Q

What should a surgeon be wearing?

A

Surgeon Attire
• Lab Coat
• Surgical scrubs
• Surgery Cap
• Face Mask
• Shoe covers

21
Q

What is the benefit of scrubbing prior to surgery? How has it changed over time?

A
  • Removes dirt and oil
  • Reduces transient bacterial population

• Depression of skin’s resident bacterial population
• Bacteria isolated in skin
Over time we have moved away from using scrub brushes and moved towards alcohol rubs and decreased scrubbing time.

22
Q

How do you scrub in? What should you remove?

A

• Remove all jewelry and put on surgery cap, surgery
mask, and booties

• Nail polish??

  • Fake nails???
  • Make way to sink and open new scrub brush
  • Basic hand wash
  • Clean fingernails
  • Scrub
  • Anatomic timed method

• Counted brush stroke method

23
Q

Why has scrubbing changed?

A

• Until recently surgical hand asepsis included scrubbing hands and arms with a brush • Studies have shown scrubbing leads to skin damage and increased bacterial counts

• Scrubbing with a brush removes epidermal layers, increases bacterial cell shedding,
increases microbial counts, and changes microbial flora

• Vigorous scrubbing is no longer recommended

24
Q

How do you scrub in with Avagard alcohol based scrub?

A
  • Remove all jewelry
  • Basic hand wash
  • Clean fingernails
  • Apply hand antiseptic
  • 3 pump application
25
Q

How do you dry your hands aseptically?

A
  • Pick up sterile towel from pack on table
  • Unfold towel and hold lengthwise
  • Use one end of towel to dry 1 hand/arm
  • Bring dry hand to opposite end of towel and repeat step 3
  • Drop towel into trash or on the ground
26
Q

What is important about remaining sterile after scrubbing?

A

DONT LET HANDS DROP BELOW WAIST

27
Q

What are the pros and cons of reusable cloth gowns?

A

Pros: Cheap, easily found

Cons: Fabric is instantly permeable to bacteria when wet ( allows strike through). With each washing fabric pores widen decreasing effectiveness.

28
Q

What are the pros of disposable gowns?

A
  • Non-woven material
  • Made from fibers instead of yarn/cotton

• You will glove up before tying waist

  • Not being washed so harder to break down.
  • Breathable material
29
Q

Things to remember when you are using disposable gowns?

A

• Gown ties on the side • Assistant ties the neck/collar but YOU tie
waist
• “twirl”

30
Q

What is important about sterile surgical gloves? What do they need to have/ how should they be handled to keep as sterile of a procedure as possible?

A
  • Gloves should have inner surfaces lubricated with adherent coating of hydrogel
  • This is what makes them slide onto hands nicely
  • Ideally gloves should not be dropped onto the opened gown pack before scrubbing and shouldn’t be placed onto sterile field until surgeon’s hands have been dried
31
Q

How do you glove with a closed technique? What does this technique ensure?

A
  • Closed Technique
  • Most common for surgery

• Ensures hand never comes in contact with the outside of the gown or glove

32
Q

What is open gloving?

A
33
Q

What is assisted gloving? Which hand should be gloved first?

A
  • To glove another team member
  • Scrub person always gloves the other person’s right hand first
34
Q

What is not sterile in the surgery suite?

A
  • Body parts:
  • Back
  • Neck
  • Shoulders
  • Axillae
  • Anything below waist
  • Keep hands between wait and axillae
  • Anything below table height

• Wet gowns or drapes

• Anything under drapes/patient
Shown in green in the image

35
Q

What is the goal and purpose of draping? What are the kind of drapes?

A

• Eliminates the passage of microorganisms between nonsterile and sterile areas

  • Minimizes skin exposure
  • Decreases risk of contamination
  • Maintains sterile field around surgery site
  • Types of drapes
  • Reusable: Huck towels , Fenestrated cloth
  • Disposable: Paper, plastic, or combination
36
Q

What kind of instrument sterilization are there?

A
  • Process that removes microorganisms from medical instruments
  • Steam
  • Chemical
  • Plasma
  • Peracetic acid
  • Ionizing radiation
  • Cold chemical sterilization
37
Q

What are the principles of sterile technique?

A
  • Principles:
  • Only use sterile items in the sterile field
  • Sterile scrubbed personnel are gowned and gloved
  • Sterile personnel operate within a sterile field
  • Sterile drapes are used to create a sterile field
  • All items used in a sterile field must be sterile
  • All items introduced onto a sterile field should be opened, dispensed, and transferred by methods that maintain sterility and integrity
  • Sterile fields are areas that are set up for procedures and are free from microorganisms
  • Usually, a tray covered with a sterile towel

• A sterile field should be maintained and monitored constantly

• Surgical staff should be trained to recognize when they have broken
technique and should know what to do next

38
Q
A

Principles Of Surgery (14 decks)

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