Week 13: Infection Control Practices and Assisting with Minor Surgery

Mole or cyst removal supplies needed:

• local anesthetic

• scalpel

• suture supplies

Mole or cyst removal MA role:

• obtain detailed history/change in mole

• obtain family history/cancer

• specimen to be sent to lab for evaluation

• instruct patient to monitor wound, return if infection occurs, follow up suture removal, if needed

Toenail removal/Ingrown toenail supplies needed:

• local anesthetic

• sterile scissors, forceps, hemostats

• bandaging materials

Toenail removal/Ingrown toenail MA role:

• notify patient - will experience discomfort

• patient to soak area in warm water to facilitate healing

• assist provider

• bandage wound

Cryosurgery supplies needed:

liquid nitrogen

Cryosurgery MA role:

• provide patient support and instructions

• discomfort as tissue warms

• assist with procedure

Electrosurgery/Electrocauterization

electrical current sent through tissue to stop bleeding, destroy polyps, or break scar tissue

Electrosurgery/Electrocauterization supplies needed:

electrocautery unit

Electrosurgery/Electrocauterization MA role:

provide patient care and wound care

Colposcopy/hysteroscopy

uses instrument to inspect vaginal area, cervix, and uterus

Colposcopy/hysteroscopy supplies needed

• exam table

• colposcope/hysteroscope

  • biopsy forceps

Colposcopy/hysteroscopy MA role:

• patient into lithotomy position

• notify patient of discomfort

• provide patient instructions

• assist provider

• prepare specimens for transport

Suture and Staple Removal Prior to Removal:

• inspect wound for healing, draining, or infection

• If crusting - need to be soaked before removal of staples or sutures

Suture and Staple Removal supplies needed:

• suture removal tool

• scissors

• forceps

• wound care supplies

• gauze

• steri-strips

Suture and Staple Removal MA role:

• Note the number of sutures or staples that were used to close the wound to ensure the same number are removed

• stop procedure if gaping of the wound occurs

• when removing sutures, cut close to the knot and pull with forceps by grabbing the knot and pulling toward the wound

• apply wound care and educate patient on care and procures to avoid infection

Laceration

is a jagged, open wound in the skin that can extend down into the underlying

Puncture wound

• deep wound caused by a sharp object

• may require TDAP injection if by metal object

Cleaning a Wound

• thoroughly clean with soap and water

• irrigate with sterile saline solution or sterile water

• Debridement - removal of debris or dead tissue from the wound; helps to expose healthy tissue and promote healing

Cutting and dissecting instruments

• scalpels

• scissors

Grasping and clamping

• forceps

• hemostats

• towel clamps

suturing instruments

• needles

• needle holders

• sutures

• syringes

• instrument packs

Surgical Asepsis

• Removal of ALL microorganisms, including spores:

  • Must be used during invasive procedures

  • When penetrating skin or mucous membranes

Sterile supplies and surgical techniques are used:

• sterile gloves

• sterile gowns

• sterile drapes

• sterile scrub

• set up a sterile field

Surgical asepsis starts with:

• sanitizing and disinfecting instruments

  • cleaning and scrubbing with germicidal soap and water

  • allow instruments to dry

• Sterilization

  • done by autoclaving

  • pressurized steam

The Autoclave

items must be wrapped and labeled:

• porous fabric, paper, or plastic

• sterile pack - instruments used together

• label with non-toxic marker

  • identity of items inside wrapping

  • person completing the procedure

  • expiration date

Surgical scrub

• removes more microorganisms than routine handwashing

• different than aseptic hand washing

  • a sterile scrub brush is used instead of a nail brush

  • both hands are kept above the elbows

  • sterile towels are used instead of paper towels

  • sterile gloves are put on immediately after the hands are dried

Sterile gloves

• don’t sterile gloves after performing a surgical scrub

• only touch the items in the sterile field

  • if a glove is damages, consider anything touched by that glove to be contaminated

Setting Up for a Procedure

• Avoid contamination of sterilized items or sterile field

• 1” around sterile field is considered non-sterile

Basic principles for maintaining a sterile field include:

• open packages so they can easily drop onto sterile field

• sterile liquids should be poured from the side of the sterile field; do not let liquid leak on to the field

• Do not leave a sterile field unattended

• medication vials should be cleaned with alcohol prior to holding with two hands for the provider to inject with a needle

Preoperative Procedures:

• Obtain consent

  • written

  • informed

• Answer patient questions

• Preparing the Patient

  • gown, position and drape the patients

• Surgical skin preparation

  • remove hair if needed clean the area with circular movements inside to out

  • apply antiseptic

During Procedures:

• handling instruments

  • arrange them according to use

  • pass them to the physician

• other duties

  • swab fluids from a wound

  • retract edges of a wound

  • cut sutures

Postoperative Procedures:

• immediate postoperative care

  • administer medications as directed

  • monitor vital signs

  • watch for adverse reactions

  • document all observations

  • wound dressing - steril

  • bandaging the wound

  • set up follow-up appointment

  • educate patient on wound care and signs of infection

Surgical Room Cleanup

• place reusable instruments in a disinfectant soak

• dispose of waste and sharps appropriately

• disinfect the counters, exam table, and trays

• disinfect small pieces of nonsurgical equipments