Unit 6: Surgical asepsis, medical asepsis, wound healing, and wound care Flashcards
Microorganisms
Microscopic organisms; bacteria, fungus, viruses.
Pathogens
microorganisms that can cause infection; can be present on both living organisms and inanimate objects.
These microorganisms aren’t pathogenic, UNLESS they get into a place where they don’t belong
Asepsis
the absence of pathogenic (disease-causing) microorganisms
Aseptic technique
practices used during patient care that prevent microbial contamination; includes clean technique (medical asepsis) and sterile technique (surgical asepsis).
Stem from the fields of microbiology and epidemiology
Sterile
free from ALL microorganisms, not just pathogens
Contamination
the introduction of infectious material on normally clean or sterile sites
Surgical asepsis
Sterile technique
The absence of all microorganisms (including pathogens) from an area, piece of equipment, or supplies
The use of a sterile field
Much more rigid technique than medical asepsis / clean technique
When and where is surgical asepsis used
Operating Room, Labour & Birth, Ambulatory Care, Endoscopy, any unit for sterile procedures
Whenever you need to handle sterile equipment, instruments, or supplies
During procedures involving broken skin (burns, open wounds, decubitus ulcers, surgical incisions, drain sites, IV sites, etc)
During procedures in which you enter a sterile body cavity / system:
- Nasotracheal or orotracheal suctioning
- Inserting a urinary catheter
During procedures that require intentional perforation of the patient’s skin:
- Insertion of an intravenous (IV) line
- Insertion of a central venous access device (CVAD)
- Injections (SC, IM, ID)
Principles of surgical asepsis
- All items used within a sterile field must be sterile
- A sterile barrier that has been permeated by punctures, tears, or moisture must be considered contaminated
- Once a sterile package is opened, a 2.5cm (1 inch) border around the edges is considered unsterile
- Tables draped as part of a sterile field are considered sterile only at table level
- If there is any question or doubt about the sterility of an item, the item is considered to be unsterile
- Sterile contacting sterile equals sterile; sterile contacting unsterile equals unsterile
- Movement around and in the sterile field must not compromise or contaminate the sterile field
- A sterile object or field out of the range of vision or an object held below waist level is contaminated
- A sterile object or field becomes contaminated by prolonged exposure to air; stay organized and complete any procedure as soon as possible
What factors affect wound healing?
Location, severity, extent of injury, and tissue
The presence of wound can impact:
Comfort and pain Risk for infection Circulation (r/t bleeding) Nutritional requirements Mobility Body image
Serous
Clear, watery plasma
Sanguineous
Bright red, indicates fresh bleeding
Purpose of drain
drain accumulated wound drainage to promote wound healing
Care of drains: Considerations
Sterile procedure
Open plug or port, drain into measuring container
Clean plug and port with antiseptic swab
Re-establish vacuum and close
Care of drains: Assess
- drain site (for colour, edema, dressing)
- drainage (type, amount in mLs)
- patency of tubing
Care of drains: Actions
- Cleanse drain site, working from insertion site to surrounding skin (clean to dirty)
- Apply new drain dressing
Purpose of C & S of Wound
- Find out if microorganisms are present in the wound and what they are (culture)
- Find out which antimicrobial medication(s) the microorganisms are susceptible to (sensitivity)
Performing C & S of wound
- Often done by swab
- Wound must be cleansed prior to avoid contamination
- Only viable tissue can be swabbed
- Swab 1cm², rotating with pressure
- Place swab in medium in tube and send to lab
Guidelines for Suture and staples removal
- Usually done 14 days after surgery
- Sterile procedure
- Administer analgesics 30 minutes prior
- Cleanse wound prior to removal
- Remove every other interrupted suture or staple, observing for incision separation (Steri-strips can be used to reinforce)
Documentation of dressing change
- Chronological (in the order that you did it)
- Removal of old dressing & wound assessment
- What you did
- How the patient tolerated it
- Any other interventions performed
- Safety
