Surgical Asepsis and Infection Prevention

Question 1

Definition of asepsis

Answer 1

Refers to absence of pathogenic organism (bacteria, fungi, virus, cysts, protozoa)

Question 2

Definition of surgical asepsis

Answer 2

Aseptic technique which exclude all pathogenic micro-organism that can cause infection

Question 3

What is the the purpose/goal of asepsis procedure

Answer 3

It is to optimise primary wound healing, prevent surgical infection and minimise the length of recovery from surgery

Question 4

Where are the sterile fields?

Answer 4

Site of incision that has been prepared for the use of sterile supplies, furniture covered with sterile drapes and personnel attired in sterile garb

Question 5

Why the need for asepsis?

Answer 5

To prevent contamination of surgical wound and to create and maintain a sterile field that is isolated from surrounding unsterile area.

Question 6

Reason for aseptic practices/ technique?

Answer 6

The prevention of microbial contamination of living tissue and sterile material by removal, exclusion or destruction of micro organism

Question 7

What is surgical conscience?

Answer 7

It is an inner commitment to adhere strictly to aseptic practice, report any break in aspetic practice, and correct any violation - whether or not anyone else is present or observes the violation

Question 8

When to practice surgical aspesis?

Answer 8

Used in procedure when entry is made into a normally sterile body part

Question 9

What are the 4 sources of contamination?

Answer 9

1. Preoperative patient prepration
2. Principle of surgical asepsis
3. Preparation of healthcare professional personnel
4. Surgical environment traffic

Question 10

Where are the colonising flora usually found?

Answer 10

It is mostly found in body region rich in sebaceous gland: scalp, forehead, axillae, and front of the chest

estminated 4k to 10k contaminated particles are shed

Question 11

Skin preparation (preoperative patient preparation)

Answer 11

1. prep bathing using antimicrobial soap for patient
2. General: iodine with or without alcohol
3. Contraindication for alcohol solution such as facial area, ear, nose, and open wound
4. Skin prep with dual agent solution (iodine with another antiseptic solution such as chlorhexidine gluconate)

Question 12

How to do surgical skin preparation?

Answer 12

1. Hair removal
2. Antimicrobial prep agent
3. Direction of clean to dirty
4. Heaviest bioburden cleansed last

Question 13

Types of antiseptic solution

Answer 13

1. Cetrimide 1%
2. Povidone iodine 1-10%
3. chlorhexidine 0.5% with 70%
4. Chlorhexidine 1:2000
5. Methylated spirit

Question 14

Principles of surgical aspesis

Answer 14

In preparation of invasive procedure
in preparation of sterile team
creation and maintenance of sterile field
disinfection and sterilization

Question 15

AORN recommended practice #1

Answer 15

All items used in the sterie procedure must be sterile

Question 16

AORN recommended practice #2

Answer 16

Items or areas doubtful of sterility are considered unsterile.

Question 17

AORN recommended practice #3

Answer 17

Items introduced into the sterile field should be opened, dispensed and transferred by method that maintain and integrity

Question 18

AORN recommended practice #4

Answer 18

Gowns are considered sterile from front chest to level of sterile field and above elbow to the cuff of the sleeves

Question 19

AORN recommended practice #5

Answer 19

Tables are only sterile at table level

Question 20

AORN recommended practice #6

Answer 20

Edges and sides are considered unsterile

Question 21

AORN recommended practice #7

Answer 21

Sterile person only touch sterile item/area

Unsterile person only touch unsterile item/area

Question 22

AORN recommended practice #8

Answer 22

Edge of wrapper that enclose sterile content are considered unsterile

Question 23

AORN recommended practice #9

Answer 23

Sterile drapes are used to establish a sterile field

Question 24

AORN recommended practice #10

Answer 24

Sterile field is prepared as close as possible to the time of use, constantly maintained and monitored.

Question 25

AORN recommended practice #11

Answer 25

Unsterile person avoid reaching over sterile field

Sterile person avoid leaning over an unsterile area

Question 26

AORN recommended practice #12

Answer 26

Sterile person keep well within the sterile area

Unsterile person avoid sterile area

Question 27

What is the proper surgical attire?

Answer 27

2 piece pantsuit, disposable cap, footwear

Question 28

What is the purpose of hand scrubbing?

Answer 28

Remove dirt, skin oil and transient microoganism from nails, hands and forearms. * Use prescribed amount of time or number of stroke and friction for effective cleansing

Question 29

What is the purpose of gowning?

Answer 29

To prevent microorganism on the clothings from being transferred to the patient’s surgical wound. A wrap-around gown may be used for better coverage of the back but the back of the gown is neve considered steriel

Question 30

What is the purpose of gloving?

Answer 30

Provide a bacterial barrier between the patient and health care worker. Decrease the risk of exogenous organism which result in surgical wound infection

Question 31

Surgical environment and traffic

Answer 31

Inanimate and animate object, traffic pattern, air current and movement, number of personnel, housekeeping practice, clean and soiled activities