Theatre Practice Flashcards
Define sepsis
Presence of pathogens or their toxic products in blood/tissues of patient
Define asepsis
Freedom from infection
Define surgical site infection
Infection in wound post surgical intervention
Define antisepsis
Prevention of sepsis by destruction or inhibition
Define disinfection
Removal of microorganisms but not spores
Define disinfectant
Agent that destroys microorganisms
Define virulence
Severity of disease
What are roles of nurses in theatre pre-op?
Infection control Cleaning Preparing personnel Preparing equipment Preparing patient, consent, anaesthesia, monitoring, surgical site
What are roles of nurses intraoperatively?
Infection control Communication to other staff Scrub nurse Circulating surgical nurse Medications Monitoring
What is the role of a scrub nurse in theatre?
Hold instruments
Hold patient
Suturing
Counting needles and swabs
What is a circulating nurses role?
Manages nursing care in theatre
What are roles of nurses post-operatively?
Recover patient Nursing care Medication Cleaning and maintaining equipment Deep cleaning theatre Discharging
What are sources of surgical site infections?
Animal- endogenous or exogenous
Personnel
Theatre space and environment
Equipment, instruments and consumables
Define sterilisation
Complete removal of microorganisms
How can theatres be made more suitable which may help to reduce risk of infection?
Layout- isolated (one entry/exit) so no through traffic, easy to clean
Materials used easy to clean
Operating light easily accessible
Power points accessible
Reduced aircon, doors, windows etc- blow air increasing infection risk
Minimal storage
Health and safety followed
Cleaning protocols- daily damp dust, monthly deep clean
Well maintained
State the different methods of heat sterilisation
Autoclaving- vertical, horizontal, vacuum assisted
Dry heat- hot air oven, high vacuum oven, convection oven
Describe how vacuum assisted autoclave sterilises
Steam penetration and pressure sterilises and the load is then dried
What are the conditions for vacuum assisted autoclave at 121 degrees C? (pressure/PSI, pressure/kg/cm2, time/min)
Pressure/PSI- 15
Pressure/kg/cm2- 1.2
Time/min- 15
What are the conditions for vacuum assisted autoclave at 126 degrees C? (pressure/PSI, pressure/kg/cm2, time/min)
Pressure/PSI- 20
Pressure/kg/cm2- 1.4
Time/min- 10
What are the conditions for vacuum assisted autoclave at 134 degrees C? (pressure/PSI, pressure/kg/cm2, time/min)
Pressure/PSI- 30
Pressure/kg/cm2- 2
Time/min- 3.5
What needs considering to ensure autoclaving is effective at sterilising?
Correct loading and packing
Machine well maintained
Monitored efficacy
List methods of monitoring efficacy of autoclaving and state how they work
TST strips- colour change when inside of packing reaches correct temperature and pressure for correct time
Bowie dick indicator tape- dark brown stripes at 121 degrees but can only show outside temperature
Brownes tubes- colour change from orange to green
Spore tests- spore impregnated paper autoclaved in packing then incubated to see if were killed
List methods of cold sterilisation
Ethylene oxide
Chemical solutions
Gamma radiation (industrial)
When is cold sterilisation used?
When materials would melt
What are some advantages and disadvantages of ethylene oxide sterilisation?
Advantages- highly penetrative and effective, good for equipment that would be easily damaged
Disadvantages- toxic gas produced, takes long time
How does ethylene oxide sterilisation work?
Gas reacts and undergoes alkylation which alters cell membrane proteins shapes causing the membrane to be destroyed and the organism to die
What are the characteristics of ethylene oxide?
Colourless, flammable gas
Boils at 10.5 degrees
Sterilises at 20 degrees
What can’t be sterilised by ethylene oxide and why can so many things be sterilised by it?
Food, drugs, liquid, gels, powders
Non corrosive
What are the regulations surrounding use of ethylene oxide?
Exposure limits
Annual monitoring
Operator training
What are dangers associated with ethylene oxide and exposure to it?
General- toxic, explosive
Acute exposure- eye, skin and respiratory tract irritation, headache, nausea
Chronic exposure- cancer, reproductive effects
What are the routes of exposure to ethylene oxide and what should you do if you are exposed?
Inhalation, skin contact, eye contact
Wash area for 15 minutes, leave room if inhalational
What makes the process of ethylene oxide safe despite its risks?
Small amount of gas used
Sterilised inside liner bag
Users are always trained
How is equipment prepared for ethylene oxide streilisation?
Disassembled
Washed
Dried without heat
Wrapped in paper, cloth or permeable plastic
Describe how you use an ethylene oxide steriliser
Wrap in bag with dosimeter and ampoule
Secure around purge bobbin with velcro strap
Remove air
Break ampoule
Close door, select cycle and leave to run
Open and remove contents