Scrubbing, Gowning, and Gloving

Question 1

Principles of Aseptic Technique

12

Answer 1

1. Only sterile items are used within the sterile field
2. Sterile persons are gowned and gloved
3. Tables are sterile only at table level
4. Sterile persons touch only sterile items or areas
5. Unsterile persons avoid reaching over the sterile field
6. The edges of anything that encloses sterile contents are considered unsterile
7. The sterile field is created as close as possible to the time of use
8. Sterile areas are continuously kept in view
9. Sterile persons keep well within the sterile area
10. Sterile persons keep contact with sterile areas to a minimum
11. Unsterile persons avoid sterile areas
12. Destruction of the integrity of microbial barriers results in contamination

Question 2

Only Sterile Items Are Used Within A Sterile Field
Discard any contaminated items such as?
7

Answer 2

1. If a sterile package is found in a contaminated area.
2. If uncertain about the actual timing or operation of the sterilizer.
3. If an unsterile person comes into close contact with a sterile table.
4. If a sterile table or unwrapped sterile items are not under constant supervision.
5. If the integrity of the packaging material is not intact.
6. If a sterile package wrapped in a material other than plastic or another moisture-resistant barrier becomes damp or wet.
7. If a sterile package wrapped in a pervious woven material drops on the floor or other areas of questionable cleanliness

Question 3

Sterile Persons are Gowned and Gloved

Observed gowning practices:
1. Self-gowning and gloving should be done from a separate sterile surface to avoid what?

2. The stockinette cuffs of the gown are enclosed beneath sterile gloves. The stockinette is absorbent and retains moisture. Why is this a problem?
3. Sterile persons keep their hands in sight at all times and at or above what level? 2
4. Hands are kept away from the face, and the elbows are kept close to the _____?
5. The back of the gown is considered what?
6. The gown is considered sterile only to the highest level of what?

Answer 3

1. dripping water onto sterile supplies or a sterile table.
2. and doesn’t provide a microbial border
3. waist level or the level of the sterile field.
4. sides.
5. contaminated.
6. the sterile tables.

Question 4

Tables Are Sterile Only At The Table Level
1. What part of the table is considered sterile?

2. Anything falling or extending over the table edge, such as a piece of suture, is what?
3. When unfolding a sterile drape, what part is unsterile?

Answer 4

1. Only the top of a sterile, draped table is considered sterile. The edges and sides of the drape extending below table level are considered unsterile.
2. Anything falling or extending over the table edge, such as a piece of suture, is unsterile.
3. When unfolding a sterile drape, the part that drops below the table surface is not brought back up to table level.

Question 5

Sterile Persons Touch Only Sterile Items or Areas
1. Sterile team members maintain contact with the sterile field by means of what?

2. The who does not directly contact the sterile field?
3. What does the circulator do?

Answer 5

1. sterile gowns and gloves.
2. unsterile circulator
3. Supplies are brought to sterile team members by the circulator, who opens the wrappers on sterile packages.

Question 6

Unsterile Persons Avoid Reaching Over the Sterile Field
1. The unsterile circulator never reaches where?

2. The circulator holds only the what over the basin when pouring solution into a sterile basin in order to avoid reaching over the sterile area?
3. The scrub person sets basins or glasses to be filled where?

Answer 6

1. over a sterile field to transfer sterile items.
2. lip of the bottle
3. at the edge of the sterile table.

Question 7

Edges of Anything That Encloses Sterile Contents Are Considered Unsterile

1. The inside of a wrapper is considered sterile to within ___ inch of the edges.
2. The circulator opens top flap _________ self.
3. Then turns the sides _______?
4. The ends of the flaps are secured in the hand so they do not dangle loosely. The last flap is pulled toward the person opening the package, thereby exposing the package contents where?

Answer 7

1. 1
2. away from
3. under.
4. away from the unsterile hand.

Question 8

Edges of Anything That Encloses Sterile Contents Are Considered Unsterile (Con’t)

1. How should you list contents from packages?
2. The flaps on peel-open packages should be opened how?

Answer 8

1. Sterile persons lift contents from packages by reaching down and lifting them straight up, holding their elbows high.
2. The flaps on peel-open packages should be pulled back, not torn, to expose the sterile contents. The contents should not be permitted to slide over the edges.

Question 9

After a sterile bottle is opened, the contents are managed how?

Answer 9

either used or discarded. The cap cannot be replaced without contaminating the pouring edges.

Question 10

The Sterile Field Is Created As Close As Possible to the Time of Use
1. Sterile tables are set up when?

2. It is virtually impossible to uncover a table of sterile contents without what?
3. Can you cover sterible tables for later use?
   - why?

Answer 10

1. just prior to the surgical procedure.
2. contamination.
3. Covering sterile tables for later use is not recommended.
   - A covered table is not under observation at all times.

Question 11

Sterile Areas Are Continuously Kept in View
1. Sterile persons face what?

2. Someone must remain in the room at all times. Why?
3. An unguarded sterile field is considered what?

Answer 11

1. Sterile areas
2. maintain vigilance when sterile packs are opened in a room or a sterile field is set up.
3. Sterility cannot by ensured without direct observation. An unguarded sterile field should be considered contaminated.

Question 12

Sterile Persons Keep Well Within the Sterile Area
1. Sterile persons stand back at a safe distance from operating bed when what?

2. Sterile persons pass each other back to back at a _____ degree turn.
3. Sterile persons act how to an unsterile person or area when passing?
4. How do sterile people pass a sterile area?

Answer 12

1. draping the patient.
2. 360-
3. turn their backs
4. Sterile persons face a sterile area to pass it.

Question 13

Sterile Persons Keep Well Within the Sterile Area
1. Sterile persons ask an unsterile individual do what rather than risk contamination?

2. Movement within and around a sterile area is kept to a minimum to avoid what?

Answer 13

1. to step aside

2. contamination of sterile items or persons.

Question 14

Sterile Persons Keep Contact With Sterile Areas to a Minimum

2 things to remember not to do when sterile in a sterile area?

Answer 14

1. Sterile persons do not lean on sterile tables or on the draped patient.
2. Sitting or leaning against an unsterile surface is a break in technique.

Question 15

Unsterile Persons Avoid Sterile Areas
1. Unsterile persons maintain a distance of at least how far from any area of the sterile field?

2. Unsterile persons do what when passing a sterile area to be sure they do not touch it?
3. Unsterile persons never walk between where?
4. The ________ restricts to a minimum all activity near the sterile field?

Answer 15

1. 1 foot
2. face and observe
3. two sterile areas.
4. circulator

Question 16

Destruction of the Integrity of Microbial Barriers Results in Contamination
1. Sterile packages are laid on ____ surfaces only.

2. If a sterile package wrapped in absorbent material becomes damp or wet, it is what?
3. The package is considered unsterile if any part of it comes in contact with what?
4. Drapes are placed where?

Answer 16

1. dry
2. discarded.
3. moisture.
4. on a dry field.

Question 17

Destruction of the Integrity of Microbial Barriers Results in Contamination
1. If solutions soak through a sterile drape to an unsterile area, the wet area managed how?

2. Sterile items are stored in what?
3. Sterile packages are handled with what?

Answer 17

1. is covered with impervious sterile drapes or towels.
2. clean, dry areas.
3. clean, dry hands.

Question 18

1. What is the surgical scrub?

2. When is skin considered sterile?

Answer 18

1. process of removing as many microorganisms as possible from the hands and arms by mechanical washing and chemical antisepsis before participating in a surgical procedure.
2. Despite the mechanical action and the chemical antimicrobial component of the scrub process, skin is never sterile.

Question 19

1. All surgical scrubs are ____ minutes in length.

2. All are performed using a what? 2

Answer 19

1. 5
2. • surgical scrub brush and
   • an antimicrobial soap solution.

Question 20

Surgical Scrub Procedure

Answer 20

1. Wet the hands and forearms
2. Apply antiseptic agent from the dispenser to the hands.
3. Wash the hands and arms thoroughly to 2 inches above the elbows, several times. Rinse thoroughly under running water with the hands upward, allowing water to drip from the flexed elbows.
4. Take a sterile brush or sponge (from a package or dispenser) and apply an antiseptic agent ( if it is not impregnated in the brush). Scrub each individual finger, including the nails, and the hands, a half minute for each hand.
5. Hold the brush in one hand and both hands under running water, and clean under the fingernails with a disposable plastic nail cleaner. Discard the cleaner after use.
6. Again scrub each individual finger, including the nails and the hands with the brush, half a minute for each hand.
7. The final rinse: Be sure to keep both arms in the upright position (careful not to touch the faucet!) so that all water flows off the elbows and not back down to the freshly scrubbed hands. Bring arm through the water once, starting with the fingers, then pull the arm straight out. Do not let water run down to hands, must drip off elbows
8. Rinse the hands and brush, and discard the brush.
9. Reapply the antimicrobial agent and wash the hands and arms, applying friction to the elbows, for 3 minutes. Interlace the fingers to clean between them.
10. Rinse the hands and arms as described in the previous slide.

Question 21

Drying the hands and the arms?

4

Answer 21

1. Reach down to the opened sterile package containing the gown, and pick up the towel. Be careful not to drip water onto the pack. Be sure no one is within arm’s reach.
2. Open the towel full-length, holding one end away from the nonsterile scrub attire. Bend slightly forward.
3. Dry both hands thoroughly but independently. To dry one arm, hold the towel in the opposite hand and, using the oscillating motion of the arm, draw the towel up to the elbow.
4. Carefully reverse the towel, still holding it away from the body. Dry the opposite arm on the unused end of the towel.

Question 22

Gowning and Gloving Technique?

6

Answer 22

1. Reach down to the sterile package and lift the folded gown directly upward.
2. Step back away from the table into an unobstructed area to provide a wide margin of safety while gowning.
3. Holding the folded gown, carefully locate the neckline.
4. Holding the inside front of the gown just below the neckline with both hands, let the gown unfold, keeping the inside of the gown toward the body. Do not touch the outside of the gown with bare hands.
5. Holding the hands at shoulder level, slip both arms into the armholes simultaneously.
6. The circulator brings the gown over the shoulders by reaching inside to the shoulder and arm seams. The gown is pulled on, leaving the cuffs of the sleeves extended over the hands. The back of the gown is securely tied or fastened at the neck and waist, touch the outside of the gown at the line of ties or fasteners in the back only.

Question 23

Gloving by the Closed Glove Technique

Answer 23

1. Using the right hand and keeping it within the cuff of the sleeve, pick up the left glove from the inner wrap of the glove package by grasping the folded cuff.
2. Extend the left forearm with the palm upward. Place the palm of the glove against the palm of the left hand, grasping in the left hand the top edge of the cuff, above the palm. In correct position, glove fingers are pointing toward you and the thumb of the glove is down
3. Grasp the back of the cuff in the left hand and turn it over the end of the left sleeve and hand. The cuff of the glove is now over the stockinette cuff of the gown, with the hand still inside the sleeve.
4. Grasp the top of the left glove and underlying gown sleeve with the covered right hand. Pull the glove on over the extended right fingers until it completely covers the stockinette cuff.
5. Glove the right hand in the same manner, reversing hands. Use the gloved left hand to pull on the right glove.