Revision 1, work organization, asepsis Flashcards
Areas of different restriction level (examples, requirements)
RESTRICTED AREA
- Operating rooms
- Sterile supply rooms
- Scrub sink area
Requirements:
1. Scrub suit
2. Hair covering
3. Mask
4. Clean shoes/shoe coverings
- Food and drink not permitted
Areas of different restriction level (examples, requirements)
SEMIRESTRICTED AREA
- Hallways between operating rooms
- Instrument and supply processing area
- Storage areas
- Utility rooms
- Nurse’s workstation
Requirements:
1. Scrub suit
2. Hair covering
3. Mask
4. Clean shoes/shoe coverings
- Food and drink not permitted
Areas of different restriction level (examples, requirements)
UNRESTRICTED AREA
- Central control point monitoring the entrance into the restricted area
- Anesthesia and preparation rooms
- Dressing rooms
- Lounges
- Offices
Requirements:
1. Scrub suit
- Patients clipped and vacuumed here
- Initial surgery preparation
- Soiled linen and trash kept in an unrestricted area
- Doors between areas should be kept always closed
Traffic patterns between areas; surgery planning (order in which they should be carried out)
- Unrestricted area → Semirestricted area → restricted area → unrestricted area
- Operating rooms limited to essential personnel and equipment
- Traffic in and out rooms minimized → movement of airborne contaminants reduced
- Positive air pressure (air flows from cleanest to least clean area) (high → low air
pressure) - Movement of contaminated and sterile equipment separated
Different rooms in the surgical department, their objectives and requirements
Operating room/theatre
Requirements
- Large enough for equipment and personnel
- Only necessary equipment (suction, access to medical gases etc.)
- Soft, white light with regulated intensity, no heating effect, 260°
rotation - Adjustable surgical table (also warming if possible)
- Ventilation, optimal airflow
- 17-20°C and <50% humidity
- Easily cleanable surfaces (resistant to corrosive effect)
Different rooms in the surgical department, their objectives and requirements
Scrub sink area
- Centrally located
- Ideally motion-sensitive
- Only for scrubbing hands
- Never to clean equipment/dispose of body fluids
- Antiseptic soap, scrub brushes, fingernail cleaners
Different rooms in the surgical department, their objectives and requirements
Gowning and gloving area
- Separate from the scrub sink area
- May be inside the operating room or just outside
Different rooms in the surgical department, their objectives and requirements
Nurse’s workstation (also instrument processing
- Centrally located in the surgical area
- Cleaning, sterilization of instruments
- Surgery log, surgery (anesthesia) protocols
- Autoclave, refrigerator, blanket warmer, formalin containers etc.
- Should be divided into two separate areas to prevent cross-contamination
Different rooms in the surgical department, their objectives and requirements
Storage
- Everything used in surgery, but unnecessary for the current procedure
- Can be combined with nurse’s workstation
Different rooms in the surgical department, their objectives and requirements
Anesthesia and patient preparation room
- Necessary equipment and drugs organized
- Transportable crash cart advisable
- 17-20°C and <50% humidity
Different rooms in the surgical department, their objectives and requirements
Minor (septic) procedures operating room
- A separate room adjacent to the anesthesia preparation area
- Minor contaminated surgical procedures
Equipment:
1. Operating table
2. Spotlight
3. Gas, suction lines
4. Suture material, instrument packs
5. Antiseptic preparation materials
Different rooms in the surgical department, their objectives and requirements
Patient recovery room
- Oxygen supply
- Warming possibilities
- Monitoring
- 21-25°C
General rules of aseptic technique
- Surgical team members remain within the sterile area
- Talking and movement by all personnel is kept to a minimum
- Nonscrubbed personnel touch only nonsterile items and do not reach over sterile areas
- Drapes should be moisture proof
- If the surgical team begins the surgery seated → should remain seated until it has been completed
- Gowns are considered sterile only from mid-chest to waist and from gloved hand to 5 cm above the elbow
- Items of questionable sterility are considered contaminated
Levels of sterility and disinfection (with examples)
Cricital
- Equipment/material entering the body beneath the skin or mucous
membranes require sterilization and are handled using sterile technique - E.g. suture materials, intravenous catheters
Levels of sterility and disinfection (with examples)
Semicritical
- Equipment coming into contact with skin/MM without penetration must be cleaned and disinfected
- E.g. endotracheal tubes
