Asepsis/ sterility

Question 1

Definition of asepsis

Answer 1

absence of pathogenic microorganism (within hospital environment)

Question 2

Definition of sterility

Answer 2

absence of all living organism & spores in or on inanimate items

Question 3

Definition of contaminated

Answer 3

carrying microorganism

Question 4

Aseptic technique

Answer 4

rules/ protocol to prevent pathogenic organisms from gaining access & establish in surgical wound

Question 5

Goal for aseptic technique

Answer 5

pathogen control & reduction of risk

Question 6

Source of contaminants

Answer 6

Animal: secretion, nasopharynx, oropharynx
inanimate source: fomite, airborne

Question 7

Methods of transmission

Answer 7

• contact
• droplets
• airborne

Question 8

What is the most likely source of transmission of contaminants in surgery room?

Answer 8

personnel

Question 9

What are resident bacteria?

Answer 9

normal flora on the patient

Question 10

What are transient bacteria

Answer 10

• gain access to surgical site from within the operating room
• inanimated source
• animated source

Question 11

Clean procedure

Answer 11

• do not enter organsystem
• no break in aseptic technique
• ex: overiohysterectomy, total hip replacement

Question 12

What is clean-contaminated procedure?

Answer 12

• enters organ system
• minor break in aseptic technique
• ex: enterotomy, gastrotomy, lung lobectomy

Question 13

What is contaminated procedure

Answer 13

• oral/ anal surgical procedure
• infected bile/ urine
• all traumatic wounds
• major break in aseptic technique

Question 14

What is dirty procedure?

Answer 14

gross contamination or infection external trauma or perforation of a hollow viscus

Question 15

components of aseptic technique

Answer 15

• isolate patients with infectious disease
• use PPE
• clean facilities & instruments between patients
• regular deep cleaning of environment
• minimize traffic
• washing hands

Question 16

Components of sterile technique in the OR

Answer 16

Facilities & equipments
- cleaning & disinfection
- sterilization of the surgical pack
Patients
- preop clipping & scrubbing
Personnel
- maintaining sterility

Question 17

What are disinfectants?

Answer 17

germicidal chemical substance that kill microorganism on inanimate

Question 18

What to do when preparing the surgical instruments & packs

Answer 18

• sterilized in surgical packs
• marked with an expiration or sterilization date
• store appropriately

Question 19

What clipper blade should we use for surgically prepping the patient?

Answer 19

40 blade

Question 20

What is the intended incision landmark?

Answer 20

xiphoid to pubis

Question 21

where are the drapes placed during abdominal surgery?

Answer 21

• cranial to xiphoid
• caudal to pubis
• mammary gland

Question 22

What are the margins to clip?

Answer 22

• extend onto thorax
• caudal to pubis
• flank folds

Question 23

Goals of the rough scrub

Answer 23

• remove organic debris
• reduce the numbers of pathogenic organisms

Question 24

What should surgical antiseptics ideally be like?

Answer 24

• kill wide spectrum
• hypoallergenic
• no cutaneous absorption
• strong residual activity

Question 25

What does isopropyl alcohol do?

Answer 25

- rapidly denatures cell wall protein, DNA, RNA - widely effective against most microorganisms - good immediate action - no residual action

Question 26

Shortcomings of using isopropyl alcohol

Answer 26

Highly irritating: corneas, wounds, mucous membrane

Question 27

Chlorhexidine

Answer 27

- disrupt cell membrane, precipitate cell components - activity - excellent residual activity - common

Question 28

What is chlorhexidine effective against?

Answer 28

gram +. gram - , fungi - less active against Mycobacteria

Question 29

Why does chlorhexidine have long residual activity?

Answer 29

binds to keratin

Question 30

Shortcoming of chlorhexidine

Answer 30

neurotoxin, toxic to cornea & eye

Question 31

What is chlorhexidine used for commonly?

Answer 31

- 4% pre-surgical scrub - 0.05% for mucous membranes & open wound

Question 32

Function of povidone-iodine

Answer 32

iodinates, oxidizes cell component molecules

Question 33

characteristics of Povidone-iodine

Answer 33

- widely effective against most microorganism - activity reduced by organic debris - good residual activity

Question 34

Short-coming of povidone-iodine

Answer 34

- skin irritation - thyroid dysfunction over time

Question 35

What is the goal for preputial wash

Answer 35

remove exudate and reduce bacterial load

Question 36

What is preputial wash?

Answer 36

- 2-minute flush - chlorhexidine 0.05% more effective - chlorhexidine cause less preputial irritation

Question 37

What to do for patient preparation in the OR

Answer 37

final prep

Question 38

Goal for sterile/ final prep

Answer 38

eliminate bacteria acquired during patient tranfer and new bacteria from patient pores/follicles

Question 39

What does normal hand washing with soap

Answer 39

- will remove transient bacteria - will not remove resident bacteria

Question 40

What does mechanical scrubbing action and antimicrobial detergent

Answer 40

- will remove transient bacteria - will remove resident bacteria

Question 41

How long does it take to do surgical scrubbing

Answer 41

5 minute