Flashcards in 1-21-2016 Reading Material Deck (54):
the absence of pathogenic organisms that cause infection
Define surgical conscience.
the commitment of the surgical personnel to adhere strictly to aseptic technique and report and address/correct any break in aseptic technique
How is asepsis maintained in the surgical area?
by practicing aseptic and sterile techniques
What portion of the gown is considered to be the sterile field?
the scrubbed personnel's gowns from the chest to the level of the sterile field, the sleeves two inches above the elbow to the top of the edge of the cuff
What portion of the gown is not considered to be part of the sterile field?
the neckline, shoulders, and cuffed portion of the gown sleeves, the back of the gown, the cuffs of the gown
Define strike through.
occurs when liquids soak through a drape from a sterile area to an unsterile area and vice versa
How should a sterile field be monitored?
a sterile field should be monitored continuously and never left unattended
How are sterile supplies opened?
unwrapping the flap farthest away first, the sides next and the nearest flap last
How should sterile supplies be inspected for sterility?
make sure there are no tears or holes in the outer package and that the items ave gone though the proper sterilization by checking the sterile indicators
What are the duties of the circulating nurse?
open packs, runner for the surgical team
Why should surgical attire not be worn outside of the surgery area?
microorganisms could be transferred to the scrub suit
Why should head covers be worn in the surgical area?
to prevent bacteria, dandruff, and 0ther contaminants from falling onto the scrub suits or into the surgical environment
When should a mask be worn in the surgery room?
when open sterile supplies or scrubbed personnel are present
When should shoe covers be changed, if they are worn?
if they become torn, wet or soiled, and when personnel reenter the surgical area
What should be done with jewelry?
all jewelry and watches should be removed
How should fingernails be kept?
fingernails should be shorter then the end o the finger, natural and free of polish
Define surgical hand scrub.
the process of removing as many microorganisms as possible from nails hands and arms by mechanical washing and chemical antisepsis before a person participates in a surgical procedure
Can skin be made sterile?
What does the scrub procedure consist of?
mechanical removal of bacteria and debris and chemical antimicrobial/antiseptic skin cleansing agents
What characteristics are desirable for a surgical scrub product?
FDA compliant, broad spectrum of activity, fast acting and effective, non irritating, and with persistent effects and cumulative activity
What should the technician do in preparation for scrubbing?
remove all rings, watches and jewelry, remove all pens, nametags and other items from scrub top pockets
When preforming a surgical hand scrub, how many times should each surface of the hand and skin be scrubbed?
Describe the surgical hand scrub process.
- wash the hands and arms within 2 inches of the elbow using antimicrobial scrub
-apply antimicrobial scrub to wet hands and forearms
-brush each surface of the first hand ten times moving from fingertips -> 3 sides of fingers -> palm of hand -> back of hand -> four sides of arm
- follow same process on second arm
- rinse beginning at the fingertips keeping the hands above the elbows
- repeat until manufacturer contact time requirements are met
What needs to take place after the surgical hand scrub?
hands and arms need to be thoroughly dried with a sterile towel
How should gowns and gloves be opened?
on a dry flat surface away from other sterile supplies so that dripping water will not contaminate them
How should the hands be dried using the sterile towel?
use one end of the towel to gently rub the fingers hands and arms in that order of the first hand, rubbing circumferential beginning at the wrist and moving to the elbow, then follow the same process with the other end of the towel on the other arm
What should you do with the towel after drying your hands?
drop it on the floor without allowing your hands to drop below waist level
How should the gown be put on?
lift the folded gown out of the package, hold the gown by the neckline and allow it to unfold, slide both arms into the sleeves by reaching and extending both arms at the same time, the circulating nurse will assist in fastening and tying the gown
Where should the hands be during the gowning process?
inside the sleeves, the arms being held above the waist
What are the three methods of gloving?
closed gloving, open gloving, and assisted gloving
What is the advantage of the closed gloving technique?
closed gloving provides assurance against contamination because no skin is exposed in the process
Describe the closed gloving technique.
with the left hand pick up the right glove by the folded cuff
extend the right hand still within the cuff with the palm facing upward
place the palm of the glove palm down against the palm of the hand with the thumb and fingers of the glove facing the body
through the gown cuff grasp the back of the glove cuff with the right hand
with the left hand pull and lift the cuff up and over the gown cuff and the right hand
with the left hand grasp both the top of the right cuff and the gown cuff and pul toward the elbow while pushing the hand through the gown cuff and into the glove
glove the left hand using the same technique
When is the open gloving method used?
when one glove becomes contaminated in surgery and an assistant is not available to perform assisted surgical gloving
Define assisted gloving.
when a sterile team member helps another scrubbed in team member glove
What happens if gown becomes contaminated during surgery?
it must be removed
What are the duties of the surgical nurse?
maintaining sterility and assisting the surgeon
What are the duties of the surgical assistant?
accepting sterile packs and equipment from the circulating nurse, properly passing instruments to the surgeon, maintaining the instrument table, and insuring the working order of instrumentation throughout the procedure
What tool is used to load a scalpel blade onto a scalpel handle?
a needle driver
How are ring handled instruments passed to the surgeon?
they are held with the box lock between the thumb and index finger and the shaft of the instrument stabilized by the remaining fingers of the passing hand
How should instruments without ring handles be passed to the surgeon?
similar to the ring handled instrument technique but with the tips facing the floor
What is one of the most important guidelines of surgical assisting?
moist tissue is happy tissue
Why is it important to avoid wiping or rubbing gauze sponges directly on tissue?
it irritates the tissue and promotes the formation of adhesions
Why should bleeding tissue be blotted rather then wiped?
wiping may wipe away blood that has already clotted
What is the purpose of the instrument count?
to document how many instruments are present at the outset of a procedure
What is the purpose of the sponge count?
to document the initial quantity of sponges before any have been used
What must be performed at the end of each surgical procedure?
a second instrument count and a second sponge count
If an instrument or sponge is missing, must what be done?
it must be found
If a sponge cannot be found inside or outside of the patient, what must be done?
the incident must be documented in the patient's medical record
What are the foundation principals regarding draping?
the edges where hands hold drapes should be folded over to protect sterile gloves from being contaminated by the patient's skin or hair, a sterile person must never reach across a nonsterile field, personnel placing drapes must be careful not to contaminate gown sleeves or the front of the gown
What order should the ground towels be placed?
closest to the person draping, the opposite side (after walking to the other side of the table), then the cranial drape
Which side of the drape faces the patient?
the light side
How are the drapes secured?
with nonpenetrating towel clamps
When may a surgical assistant be involved with drug administration?
if the drug in question must be applied directly to the surgical site