Surgical Asepsis Flashcards
Donning Sterile Gloving Steps
Open Outside package
push in half
Open with middle borders
Thumb of glove is always lateral
Dont let flap go back on sterile field
Stand in front of the glove putting on
1) Grab the cuff of the glove and hold down the border at the bottom = slide hand in
2) Cuff under the glove
- Hitchhiker’s thumb
- Fixed fingers
- Pull from inside the hand for snugness
Sterile Field Steps
Clean surface with gloves
Wash hands
Flap towards you
Open away from you (only touch inch border)
Open 4x4 like banana and toss onto sterile field
Don on sterile gloves
Always above waist height
https://www.webmd.com/allergies/latex-allergies
Common Latex Products
Gloves (dishwashing)/Balloons/Condoms/Erasers
Bandages (Adhesives)
Therapy bands
Pacifiers/ Baby Bottle Nipples
Red rubber catheters/Elastic/ Rubber Bands
Blood Pressure cuffs
Stethoscope tubing
Tourniquets
Vial stoppers/Spandex
https://www.webmd.com/allergies/latex-allergies
Cross Reactive Foods: High (4)
Banana
Avocado
Chestnut
Kiwi
https://www.webmd.com/allergies/latex-allergies
Cross Reactive Foods: Moderate (7)
Apple
Carrot
Celery
Papaya
Potato
Tomato
Melons
https://www.webmd.com/allergies/latex-allergies
Cross Reactive Foods: Low/Undetermined (33)
Pear. Mango, Sweet Pepper, Peach, Rye, Cayenne Pepper, Plum, Wheat, Shellfish, Cherry, Hazelnut, Sunflower seed, Pineapple, Walnut, Citrus fruits, strawberry, soybean, coconut, fig, peanut, check pea, grape, buckwheat, castor bean, apricot, dill, lychee, passion fruit, oregano, zucchini, nectarine, sage, perisimmon
Modified sterile
sterile equipment but regular exam gloves
Medical asepsis
- Practice
- Technique
- Through
clean technique
practices to confine or limit the growth of contamination or spread
through CHG, alcohol
Clean technique
use of clean hand hygiene or exam gloves, clean supplies
What are the different types of technique levels used for most invasive to least invasive procedures?
Sterile technique
Modified
Clean
Cornerstone of Asepsis
-know dirty, clean, sterile
NEVER OVERLAP
Surgical asepsis
sterile technique through steam, gas, radiation, chemicals
technique - only sterile gloves and supplies
Asepsis
state of being free from disease-causing contaminants or microorganisms
Aseptic technique
using practices and procedures to prevent contamination
Where are microorganisms?
air, water, food, clothes
Microorganisms spread by
touching someone infected
touching belongings/linens of contaminated person
sneezing/coughing
handling/consuming contaminated food, meds, water
What percentage of alcohol-based solutions for routine hand cleaning
60
What hygiene do you use for visibly soiled hands?
antimicrobial soap and water
What disease requires soap and water?
Clostridium difficile
5 moments for hand hygiene
- before touching a pt
- before clean/septic technique
- after body fluid exposure/risk
- after touching a pt
- after touching a pt surroundings
Standard Precautions
1) practices used when coming into contact with any patient’s blood or body fluids
2) Principles designed to minimize exposure and transmission of microorganisms
3) Consider every patient a potential infection risk
Standard Precaution Infection Control
Hand hygiene
Use of PPE (gloves, gowns, masks, eyewear)
Sharps safety
Respiratory hygiene
Safe injection practices
Sterile instruments and devices
Cornerstones of Medical Asepsis
Know what is dirty
Know what is clean
Know what is sterile
Keep these conditions separate
Medical Asepsis uses
alcohol, chlorhexidine, hydrogen peroxide
Surgical Asepsis uses
steam, gas, radiation, chemicals
Medical Asepsis practices
to confine or limit the growth of contamination or spread
Sterile Technique
strict use of sterile gloves and supplies
Clean technique
use of clean hands via hand hygiene or exam gloves, clean supplies
Principles of Surgical Asepsis
1) Only sterile to sterile
2) one-inch border contaminated
3) Time Management
- Sterile items expire
- stored on clean, dry surfaces
4)Avoid talking, coughing, sneezing, reaching across a sterile field or object
5) Never walk away or turn back on the sterile field
6) at or above waist level
7) Avoid spilling any solution on a cloth or paper used as a field for sterile setup
10) sterile field always in sight
11) Consider an object contaminated if you have any doubt of a break in sterility
12) If you see someone contaminate a sterile field or object, make it known
13) personal nurse hygiene
- keep fingernails short & clean
- No Polish or Artificial Nails
- Avoid wearing jewelry that dangles
- Keep long hair pulled back & No stray strands
Elements of Surgical Asepsis
1) Wash hands first - gather supplies & determine if assistance is needed
2) Supplies are packaged in a clean wrapper, But the inside is sterile
3) Handle sterile equipment only with sterile gloves
Adding Sterile Items
1) Sterile items may be “flipped” on to the sterile field if it does not touch the outer 1” border
2) Items added to a sterile field demand strict awareness
Sterile transfer
Sterile fluids are only viable for
24 hours after opening
Principles of Adding Sterile Fluids
1) Remove the bottle cap and place face up on the surface
2) Hold the bottle with a label in the palm of your hand so the solution does not run-down label
3) “Lip” small amount then pour the required amount of sterile solution into the available receptacle
4) Pour solution onto the dressing or site without the bottle making contact
When cleaning off a pt’s bedside table, what do you use to clean the table?
Clorox wipes
Gloves
Allow to dry
Preparing for a sterile procedure - Nurse’s Role
Determine allergy status to latex or antiseptic used
Assess pain level & readiness before starting – ALWAYS
Position patient, bed, etc.**
Initiate sterile consciousness
Perform hand hygiene
Gather sterile items
Check expiration date and assess package integrity
Place bedside table where the sterile field is always in sight
Ensure workspace is flat & waist level
Clean and ensure the surface is dry
Hand Hygiene
If in doubt,
throw it out
Opening a Sterile Field
Remove Outer Package
Take 1st flap facing you & fold back/away*
Open each side flap
Bring the last flap toward you
Do Not cross over Sterile Field at any time when opening flaps*
Items are typically packed/arranged in order of use
Remove Outer Package
Take 1st flap facing you & fold *
Open each side flap
Bring last flap towards you
Do Not cross over Sterile Field at any time when opening flaps*
Apply serile gloves then proceed
Items are typically packed/arranged in order of use
Sterile Gloving
Select correct size
Check for latex sensitivity
Determine package integrity
Medical hand hygiene
Place package on a clean, dry flat surface
Open package without contamination
During sterile gloving hands always remain at __________ level and in sight
waist
Glove Removal
Grasp outside of gloved hand, palmer side, with other gloved hand (glove to glove)
Pull glove off, turning inside out
Place dirty glove just removed tightly into palm of remaining gloved hand
Place finger of bare hand inside CUFF of other glove (skin to skin). Peel off, inside out over dirty glove and discard both
With sterile gloves, what can you touch
sterile field except for an inch of border
Doffing Sterile Glove Steps
Wad up the 1st glove into the 2nd hand
Next skin to skin, dispose of gloves
