Asepsis and Operating Room Personnel

Asepsis make environment clean for surgery

Do we expect surgical environment to be aseptic or sterile?

Aseptic

What is the term that describes pathogenic microorganisms removed or not present?

Sterile

What is the term that describes all living microorganisms to be removed, including spores?

Makes area surgically clean, not sterile, and having restricted access to surgery areas to maintain asepsis

What does it mean to have asepsis in the surgery room?

1) Commitment of surgical personnel to adhere to strict aseptic technique, 2) Any break in aseptic technique immediately reported, addressed, corrected! 3) Anything less may increase infection risk to patient.

What are three things you note about surgical conscience?

Any are covered with sterile barrier such as person, table, table cover, patient, gown, and drape)

What is a sterile field?

1) Scrubbed surgical personnel work in a sterile field, 2) it should not be left unattended, 3) to be monitored continuously

What are three important things to know about the sterile field?

Chest to level of sterile field and two inches above sleeve elbow to edge of cuff

What are considered sterile parts of a surgical gown?

1) Neckline, 2) Shoulder, 3) Top of Cuff, 4) Lower portion of gown, 5) Back of gown

What are considered unsterile parts of the surgical gown?

Sterilized drapes

What are used to establish sterile field in patient?

Barriers

What prevents microorganisms from passing between sterile and nonsterile areas?

1) Entire animal, 2) Surgery Table, 3) surgery equipment that is part of sterile field

What should the drape all cover?

Liquid/fluid soaks through drape from sterile to unsterile area

What is strike-through?

1) No holes/tears in outer package, 2) Sterile indicator reads appropriately, 3) Seal is secure on package, 4) Package not worn, 5) No expiration date if above criteria is met

What are things to inspect for on items for sterility?

Unwrap furthest flap 1st, then sides, nearest flap last

What is the order you should unwrap packs to maintain sterility and integrity?

Discard cap and unused fluid

After a fluid bottle is opened, what should be discarded due to contamination?

Face to face or back to back

What are the two ways scrubbed personnel much change positions around sterile field a safe distance apart?

Endogenous

What type of contamination is from the patient itself, such as skin or an underlying infection?

Exogenous

What type of contamination is from the surgical tema and/or sugical environment?

1) Freshly laundered scrub suits, 2) Head Covers, 3) Masks, 4) Clean Shoes/ Shoe Covers

What are four things to help reduce shedding of micoorganisms?

Scrub top should be short-sleeved, fit snug to body, tucked into pants

What is best practice for wearing of scrub tops?

All hair on head and facial hair covered, and a bouffant is preferred over skull cap

Proper head covers need to cover what?

1) Worn over mouth and nose, 2) Changed Frequently, 3) Conform to face, 4) Do not turn head or bend over when needing to sneeze or cough

What are four distinct factors when wearing a mask?

1) Comfortable, clean 2) No open toes/ open heels, 3) Shoe covers are option

What are three distinct factors about footwear?

No jewelry, fingernails should be short, clean, healthy with no polish or artificial nails?

What are important factors about hands during surgery?

Surgical hand scrub

What is the process of removing microorganisms from the nails, hands, and arms using mechanical and chemical antisepsis?

Mechanical part

Which part of the surgical hand scrub is the removal of bacteria and debris via friction to remove dirt, oil, etc that is loosely attached to the skin?

Chemical part

Which part of the surgical hand scrub inactivates or inhibits growth of microorganisms on skin, and in hair follicles, sebaceous glands, and sweat glands?

Timed or Stroke count

What are the two methods of scrubbing?

5 minutes

How long should scrubbing take if it is performed correctly?

1) FDA compliant, 2) Broad spectrum of activity, 3) Fast acting/ effective, 4) Non Irritating, 5) Persistent effects and cumulative activity

What are five ideal characteristics wanted in types of scrub solutions?

Antimicrobial scrub agents and Alcohol-based hand rub

What are two types of scrub solutions?

1) Closed, 2) Open, 3) Assisted

What are three methods of Gloving?

Closed Gloving

What type of golving is when no bare skin is exposed, hands within cuffs of gown, and uses palm to palm, thumb to thumb, and fingers of glove face elbow?

Open Gloving

What type of gloving is used when one glove become contaminated, must be replace, and sometimes no gown is needed?

Assisted Gloving

What type of gloving involves another sterile team member that helps another scrubbed in team member, the cuff of gown no pulled over hand, and is the bes method to re-glove?

Maintaining Sterility and Assisting surgeon

What are the responsibilities of sugical technician?

1) Avoid Locking knee joints while assisting, 2) Eat before scrubbing-in, 3) Slowly shift weight from leg to leg, 4) Flex toes

What are some tips for assisting during surgery?