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Chapter 11: Surgical Asepsis Flashcards

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1
Q

a device that provides steam sterilization under pressure, the most commonly used sterilization method

A

Autoclave

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2
Q

temporary molecule, portion of a molecule, or atom with unpaired electron (s) in its outer shell

A

Free radical

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3
Q

the awareness of sterile technique and the responsibility for notifying those in charge whenever contamination occurs

A

sterile conscience

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4
Q

is a microorganism-free area prepared for the use of sterile supplies and equipment

A

sterile field

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5
Q

is the complete destruction of all organisms and spores from equipment used for patient care or procedures

A

sterilization

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6
Q

is the process of creating and maintaining an area that is completely free of pathogens

A

surgical asepsis

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7
Q

a specific method of using a brush and antimicrobial soap to reduce the number of organisms on the hands and forearms and decrease the rate of microbial growth in the following hours

A

surgical hand scrub

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8
Q

an alternative to the conventional surgical hand scrub that involves the use of a non-antimicrobial soap, followed by drying the skin and applying a surgical alcohol- based skin rub

A

surgical hand rub

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9
Q

FOUR METHODS OF STERILIZATION

A
  • CHEMICAL
  • AUTOCLAVING (STEAM)
  • GAS
  • GAS PLASMA
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10
Q

THE IMMERSION AND SOAKING OF CLEAN OBJECTS IN A
BATH OF GERMICIDAL SOLUTION FOLLOWED BY A STERILE
WATER RINSE
* NOT RECOMMENDED FOR SURGICAL ASEPSIS
* ONE OF THE LESS SATISFACTORY METHODS BECAUSE CONTROL
OF EFFECTIVENESS FACTORS (TIME, SOLUTION STRENGTH AND
TEMPERATURE, AND CONTAMINATION DETECTION) IS DIFFICULT

A

CHEMICAL STERILIZATION

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11
Q

IS A DEVICE THAT PROVIDES STEAM
STERILIZATION UNDER PRESSURE.
- Is an controlled environment

A

AUTOCLAVE

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12
Q
  • THE MOST COMMONLY USED STERILIZATION METHOD
  • QUICKEST AND MOST CONVENIENT MEANS FOR ITEMS THAT
    CAN WITHSTAND HEAT AND MOISTURE
A

AUTOCLAVING

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13
Q

METHOD THAT USES A MIXTURE OF GASES HEATED TO 135°F
(57°C)

A

CONVENTIONAL GAS STERILIZATION

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13
Q
  • USED FOR ITEMS THAT CANNOT BE AUTOCLAVED
  • ELECTRICAL, PLASTIC, RUBBER ITEMS, AND OPTICAL WARE
  • TELEPHONES, STETHOSCOPES, BLOOD-PRESSURE CUFFS, AND
    OTHER EQUIPMENT USED IN ISOLATION ROOMS
A

CONVENTIONAL GAS STERILIZATION

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14
Q

WHAT ARE SOME DRAWBACKS FOR CONVENTIONAL GAS STERILIZATION

A

*GASES USED ARE POISONOUS.
* MUST BE DISSIPATED BY AERATION IN A CONTROLLED
ENVIRONMENT.
* PROCESS IS TIME-CONSUMING.

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15
Q

SAFER THAN CONVENTIONAL GAS STERILIZATION
NO TOXIC BY-PRODUCTS (primarily oxygen and water)

A

GAS PLASMA TECHNOLOGY

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15
Q

ABLE TO STERILIZE HEAT/MOISTURE-SENSITIVE ITEMS IN
GREATER VOLUME
* MORE COST-EFFECTIVE THAN CONVENTIONAL GAS
* CANNOT COMPLETELY REPLACE GAS BECAUSE IT IS NOT
EFFECTIVE ON ITEMS WITH LONG, NARROW LUMINA
* CANNOT BE USED ON CELLULOSE ITEMS (LINENS, ETC.)
- cleaned wrapped instruments
- kills both microorganisms and spores
- stripping atoms of electrons
- sterilize endoscopes, fiberoptic devices, microsurgical instruments, and powered instruments
- hydrogen peroxide

A

GAS PLASMA TECHNOLOGY

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15
Q

STERILITY INDICATORS

A
  • CHEMICAL INDICATORS THAT CHANGE COLOR WHEN
    STERILIZATION HAS OCCURRED
  • USED TO IDENTIFY WHETHER A PACK HAS BEEN STERILIZED
  • PLACED INSIDE AND OUTSIDE THE PACK TO SHOW THAT THE
    GAS, HEAT, STEAM, OR GAS PLASMA HAS PENETRATED TO
    ALL SURFACES
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16
Q

THE TAPE THAT SEALS THIS
PACK WAS ORIGINALLY A PLAIN,
LIGHT COLOR. THE STRIPES
APPEARED ON THE TAPE WHEN
CONDITIONS FOR STERILITY
WERE ACHIEVED.

A

STERILITY INDICATORS

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17
Q

DEFINED AS A MICROORGANISM-FREE AREA PREPARED FOR
THE USE OF STERILE SUPPLIES AND EQUIPMENT

A

STERILE FIELD

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18
Q

STEPS TO ESTABLISH A STERILE FIELD

A

*PLACE THE PACK ON A CLEAN SURFACE WITHIN REACH OF
THE PHYSICIAN.
* JUST BEFORE THE PROCEDURE BEGINS, BREAK THE SEAL
AND OPEN THE PACK.
* UNFOLD THE FIRST CORNER AWAY FROM YOU; THEN
UNFOLD THE TWO SIDES.
* PULL THE FRONT FOLD DOWN TOWARD YOU AND DROP
IT.
* DO NOT TOUCH THE INNER SURFACE.
* THE INNER WRAP, IF THERE IS ONE, IS OPENED IN THE
SAME MANNER.
* YOU HAVE NOW ESTABLISHED A STERILE FIELD.

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19
Q

SURGICAL ASEPSIS:
STANDARD PRINCIPLES

A

-ANY STERILE OBJECT OR FIELD TOUCHED BY AN UNSTERILE OBJECT OR
PERSON BECOMES CONTAMINATED.
- NEVER REACH ACROSS A STERILE FIELD.
- ORGANISMS MAY FALL FROM YOUR ARM INTO THE FIELD.
- INCREASES THE RISK OF BRUSHING THE AREA WITH
-YOUR UNIFORM
IF YOU SUSPECT AN ITEM IS CONTAMINATED, DISCARD IT.
- INCLUDES DAMP ITEMS, ITEMS WITH BROKEN SEAL, AND ITEMS ON WHICH
THE INDICATOR TAPE HAS NOT ASSUMED THE CORRECT COLOR
- DO NOT PASS BETWEEN THE PHYSICIAN AND THE STERILE FIELD.
- NEVER LEAVE A STERILE AREA UNATTENDED.
- NO ONE WOULD KNOW IF FIELD WERE CONTAMINATED.
- A 1-INCH BORDER AT THE PERIMETER OF THE STERILE FIELD IS
CONSIDERED A “BUFFER ZONE” AND IS TREATED AS IF IT WERE
CONTAMINATED

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20
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 1 to 5

A
  • OBTAIN A “SKIN-PREP SET” AND A BOTTLE OF ANTISEPTIC
    FOR PAINTING THE SKIN. THE PREPARATION SET INCLUDES A
    BASIN, LIQUID SOAP SUCH AS PHISODERM, GAUZE
    SPONGES, RAZOR, TOWEL, FORCEPS, AND MEDICINE CUP.
  • PERFORM HAND HYGIENE.
  • PLACE THE PATIENT IN A COMFORTABLE POSITION AND
    ENSURE PRIVACY.
  • EXPLAIN WHAT IS TO BE DONE.
  • EXPOSE AN AREA SLIGHTLY LARGER THAN THE
    PREPARATION SITE, KEEPING THE PATIENT AS COMPLETELY
    COVERED AS POSSIBLE TO PROVIDE COMFORT AND
    MODESTY.
  • Start in the middle and work your way out
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21
Q

SKIN PREPARATION FOR
STERILE PROCEDURES
steps 6 to 10

A

NOTE: IF HAIR REMOVAL IS NOT ORDERED, OMIT STEPS 6 AND
7.
6. IF HAIR REMOVAL IS ORDERED, USE A DRY RAZOR TO SHAVE
A SMALL AREA AT A TIME. HOLD THE SKIN TAUT WITH ONE
HAND AND SHAVE WITH SHORT, FIRM STROKES IN THE
DIRECTION OF HAIR GROWTH. THE SAME CONCEPT APPLIES
IF USING AN ELECTRIC RAZOR.
7. WIPE THE AREA WITH A STERILE GAUZE SPONGE WETTED
WITH ALCOHOL, REMOVING ALL THE HAIR.
8. PERFORM HAND HYGIENE AND DON STERILE GLOVES.
9. POUR A LITTLE OF THE ANTISEPTIC INTO A WASTE
CONTAINER TO CLEANSE THE LIP OF THE BOTTLE.
10. FILL THE MEDICINE CUP WITH ANTISEPTIC.

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22
SKIN PREPARATION FOR STERILE PROCEDURES steps 11-15
11. GRASP SEVERAL GAUZE SPONGES WITH THE FORCEPS AND DIP THEM INTO THE ANTISEPTIC. 12. PAINT THE SKIN WITH THE ANTISEPTIC, STARTING IN THE CENTER OF THE AREA AND WORKING OUTWARD IN A CIRCULAR PATTERN. DO NOT SCRUB HARSHLY, BUT REMEMBER THAT FRICTION IS MORE EFFECTIVE THAN SOAP IN CLEANSING THE SKIN. DISCARD THE SPONGE. 13. ALLOW THE SKIN TO DRY. 14. REPEAT STEPS 12 AND 13. 15. OPEN THE PACK CONTAINING THE STERILE DRAPE OR STERILE TOWELS. THE PHYSICIAN, WEARING STERILE GLOVES, WILL DRAPE THE AREA SURROUNDING THE PREPARED SITE.
23
SURGICAL HAND SCRUB steps 1-6
1. WEAR SURGICAL ATTIRE AND APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT. 2. USING FOOT OR KNEE LEVER, ADJUST WATER FLOW AND TEMPERATURE. 3. WET YOUR HANDS. ADD A FEW DROPS OF ANTIMICROBIAL SOAP AND MORE WATER AS NEEDED TO MAKE A LATHER. 4. WASH YOUR HANDS AND FOREARMS THOROUGHLY. USE ONE BRUSH AND SOAP TO CLEAN YOUR HANDS AND NAILS, AND CLEAN UNDER YOUR NAILS WITH THE NAIL CLEANER UNDER RUNNING WATER. 5. RINSE YOUR HANDS AND ARMS THOROUGHLY, KEEPING YOUR HANDS HIGHER THAN YOUR ELBOWS. TAKE CARE TO AVOID SPLASHING YOUR SCRUB CLOTHES BECAUSE THE DAMPNESS MAY LATER MOISTEN YOUR STERILE GOWN, CAUSING CONTAMINATION. 6. USING THE SECOND BRUSH AND MORE SOAP, THE ACTUAL SCRUB BEGINS. THE PRESCRIBED NUMBER OF BRUSH STROKES IS USUALLY 15 STROKES TO THE NAILS OF EACH HAND AND 10 STROKES TO EACH AREA OF THE SKIN, WHICH USUALLY TAKES ABOUT 5 MINUTES.
24
SURGICAL HAND SCRUB steps 7-13
THE FINGERS AND HANDS SHOULD BE VISUALIZED AS HAVING FOUR SIDES, AND EACH SIDE MUST BE EFFECTIVELY SCRUBBED. STARTING WITH THE FINGERNAILS, SCRUB THEM VIGOROUSLY, HOLDING THE BRUSH PERPENDICULAR TO THEM. THEN SCRUB ALL SIDES OF EACH FINGER AND THE PALMS AND BACKS OF THE HANDS. DIVIDE EACH FOREARM INTO THIRDS AND USE A CIRCULAR MOTION TO SCRUB EACH SIDE OF THE FOREARMS AND ELBOWS, UP TO 2 INCHES ABOVE THE ELBOWS. KEEP YOUR HANDS ABOVE YOUR ELBOWS WHILE SCRUBBING AND ADD SMALL AMOUNTS OF WATER AS NEEDED TO MAINTAIN A GOOD LATHER. WHEN SCRUBBING IS COMPLETED, DISCARD THE BRUSH. RINSE YOUR HANDS AND ARMS THOROUGHLY FROM FINGERTIPS TO ELBOWS IN ONE MOTION, ALLOWING THE WATER TO DRAIN OFF AT THE ELBOWS. TURN OFF THE WATER WITH THE FOOT OR KNEE CONTROL. KEEPING YOUR HANDS ABOVE THE ELBOWS AND AWAY FROM YOUR BODY, ENTER THE SURGICAL SUITE BY BACKING THROUGH THE DOOR. TO DRY, GRASP THE CORNER OF A STERILE TOWEL AND STEP BACK FROM THE FIELD, ALLOWING THE TOWEL TO FALL OPEN. BEND FORWARD AT THE WAIST AND HOLD YOUR ARMS AWAY FROM YOUR BODY AND ABOVE YOUR WAIST. DRY YOUR HANDS AND THEN YOUR ARMS THOROUGHLY, ROTATING THE TOWEL AS REQUIRED. TAKE CARE NOT TO CONTAMINATE THE STERILE FIELD, THE TOWEL, OR YOUR HANDS. YOU ARE NOW READY TO DON A STERILE GOWN AND GLOVES.
25
SURGICAL SCRUB: ALCOHOL-BASED HANDRUB METHOD steps 1-7
WEAR SURGICAL ATTIRE AND APPROPRIATE PERSONAL PROTECTIVE EQUIPMENT. USING FOOT OR KNEE LEVER, ADJUST WATER FLOW AND TEMPERATURE. WET HANDS AND ARMS AND LATHER WITH APPROVED NONANTIMICROBIAL AGENT. CLEAN FINGERNAILS UNDER RUNNING WATER USING DISPOSABLE NAIL CLEANER; DISCARD NAIL CLEANER. RINSE HANDS AND ARMS UNDER RUNNING WATER. DRY HANDS AND ARMS USING A PAPER TOWEL. DISPENSE OF THE MANUFACTURER’S RECOMMENDED AMOUNT OF ALCOHOL-BASED HAND RUB INTO THE PALM OF ONE HAND. DO NOT USE WATER WITH THE HAND PREP.
26
SURGICAL SCRUB: ALCOHOL-BASED HANDRUB METHOD steps 8-13
DIP THE FINGERTIPS OF THE OPPOSITE HAND INTO THE HAND PREP AND WORK IT UNDER THE NAILS. SPREAD THE REMAINING HAND PREP EVENLY OVER THE HAND AND FOREARM TO JUST ABOVE THE ELBOW, COVERING ALL SURFACES. USING ADDITIONAL HAND PREP, REPEAT STEPS 7–9 WITH THE OTHER ARM. REPEAT STEPS 7–10, IF RECOMMENDED. TO FACILITATE DRYING, CONTINUE RUBBING ANTISEPTIC HAND PREP INTO HANDS UNTIL DRY. KEEP SCRUBBED HANDS AND ARMS IN VIEW AND AVOID CONTAMINATION; ALLOW TO AIR DRY COMPLETELY BEFORE DONNING A STERILE GOWN AND GLOVES.
27
STERILE GOWNING WITH CLOSED GLOVING TECHNIQUE
ASSISTANT OPENS GLOVES AND STERILE GOWN PACK. LIFT FOLDED STERILE GOWN, AND STEP BACK FROM TABLE. ALLOW GOWN TO UNFOLD WITH INSIDE OF GOWN TOWARD YOU. INSERT ARMS INTO SLEEVES. DO NOT ALLOW HANDS TO PROTRUDE THROUGH CUFFS. ASSISTANT FASTENS GOWN AT NECKLINE. WITH DOMINANT HAND REMAINING INSIDE SLEEVE, PICK UP GLOVE FOR NONDOMINANT HAND. INSERT NONDOMINANT HAND INTO GLOVE. STRETCH CUFF OF GLOVE OVER CUFF OF GOWN. WITH NONDOMINANT HAND, PICK UP SECOND GLOVE. STRETCH CUFF OF GLOVE OVER CUFF OF GOWN. CLOSED GLOVING IS COMPLETE. SEPARATE WAIST TIE FROM GOWN AND PASS TIE WITH TAB TO ASSISTANT. TURN IN A CIRCLE TO WRAP TIE AROUND YOUR WAIST. A SHARP TUG ON TIE WILL SEPARATE IT FROM THE CONTAMINATED TAB, ALLOWING YOU TO FASTEN THE TIE WITHOUT CONTAMINATING GOWN.
28
OPEN GLOVING TECHNIQUE
PERFORM HAND HYGIENE. OBTAIN GLOVES, AND CHECK FOR CORRECT SIZE. OPEN OUTER WRAP TO REMOVE FOLDED INNER WRAP. EXPOSE GLOVES WITH OPEN ENDS FACING YOU. OPEN INNER WRAP COMPLETELY, TAKING CARE NOT TO CONTAMINATE GLOVES OR WRAP IMMEDIATELY SURROUNDING GLOVES. WITH ONE HAND, GRIP CUFF FOLD OF GLOVE FOR OPPOSITE HAND. PUT ON FIRST GLOVE, TOUCHING ONLY INNER SURFACE OF FOLDED CUFF. USING GLOVED HAND, GRASP SECOND GLOVE UNDER CUFF. INSERT HAND INTO SECOND GLOVE. PUT ON SECOND GLOVE, AND UNFOLD CUFF. INSERT FINGERS UNDER CUFF OF FIRST GLOVE, AND UNFOLD CUFF. GLOVING COMPLETE. KEEP HANDS IN FRONT OF BODY AND AT SAFE DISTANCE FROM UNIFORM TO AVOID CONTAMINATION.
29
DRESSING REMOVAL
PERFORM HAND HYGIENE AND DON GLOVES. INFORM THE PATIENT OF WHAT YOU ARE ABOUT TO DO. USE CARE IN REMOVING THE DRESSING TO PREVENT CROSS-CONTAMINATING THE WOUND AND YOURSELF. REMOVE THE DRESSING GENTLY TO AVOID HURTING THE PATIENT. PLACE THE SOILED DRESSING IN A PLASTIC BAG AND SEAL IT BEFORE ADDING IT TO THE BIOHAZARD CONTAINER. REMOVE YOUR GLOVES FOLLOWING THE SAME PROCEDURE USED WITH ISOLATION TECHNIQUES. PERFORM HAND HYGIENE
30
SUPPLIES NEEDED FOR A STERILE DRESSING
PREPARE SUPPLIES: STERILE GLOVES STERILE DRAPE STERILE GAUZE TAPE NORMAL SALINE
31
APPLYING A STERILE DRESSING
TELL THE PATIENT WHAT YOU PLAN TO DO. PERFORM HAND HYGIENE. TEAR SEVERAL STRIPS OF TAPE TO A CONVENIENT LENGTH. OPEN THE STERILE DRAPE PACK, PLACING THE DRAPE NEAR THE PATIENT. PARTIALLY OPEN THE DRAPE BY PULLING FROM THE CORNERS. THIS CREATES A SMALL STERILE FIELD FOR YOUR OTHER STERILE ITEMS. OPEN THE DRESSING PACKAGE AND ADD THE STERILE DRESSING TO YOUR STERILE FIELD. IF YOU WILL NEED TO CLEANSE AROUND THE WOUND, DROP STERILE GAUZE SPONGES INTO YOUR FIELD FOR THIS PURPOSE. TO MOISTEN THE GAUZE SPONGES, OPEN A SMALL VIAL OF STERILE NORMAL SALINE SOLUTION. RECHECK THE LABEL AND POUR A SMALL AMOUNT OF THE SALINE OVER THE SPONGES. DO NOT ALLOW LIQUID TO SOAK THROUGH TO THE STERILE TOWEL. CHECK THE LABEL FOR THE THIRD TIME BEFORE DISCARDING THE VIAL. DON STERILE GLOVES USING THE OPEN METHOD DESCRIBED FOR STERILE GLOVING. USE THE MOIST SPONGES TO CLEAN GENTLY AROUND THE WOUND. ALLOW THE AREA TO DRY COMPLETELY. APPLY THE DRESSING OVER THE WOUND, AND SECURE IT IN PLACE WITH TAPE. COVER THE PATIENT. DISPOSE OF ANY WASTE. REMOVE YOUR GLOVES. PERFORM HAND HYGIENE
32
temporary molecule, portion of a molecule, or atom with unpaired electron(s) in its outer shell.
free radical
33
refers to an awareness of sterile technique and the responsibility for telling the person in charge whenever you contaminate a field or observe its contamination by someone else.
sterile conscience
34
Is the complete destruction of all organisms and spores from equipment used for patient care or procedures.
sterilization
35
Process of creating and maintaining an area that is completely free of pathogens.
surgical asepsis
36
is necessary when the radiographer is asked to assist with a sterile procedure by working within a sterile field.
surgical hand scrub
37
product that provides a very high level of disinfection that persists for a prolonged period of time.
surgical hand rub-
38
what should the degree be to kill off organisms
240-270 degrees F
39
When scrubbing where do you start
start from the middle and make your way out
40
how should you pass someone when sterile
Back to back or front to front
41
what part of the gown is considered dirty
back of the gown
42
mixed with water 1 to 10 ratio
bleach 1 part bleach 10 parts water
43
how should you hold your hand
hold your hands together above your waist (below your waist is considered dirty)
44
what is another way to disinfect that has not been mentioned in other steps
boiling something for 12 minutes
45
methods of reducing pathogenic microorganisms in the environment and intervening in the process by which microorganisms are spread
medical asepsis
46
What is the disadvantage of chemical sterilization?
Very easily contaminated only kills microorganisms does not kill pores
47
What is the temperature used for autoclaving, making it an effective method in killing off microorganisms?
250 to 275 degrees F or (121 to 135 degrees C)
48
outside of gloves is considered what?
sterile
49
inside of gloves is considered what?
unsterile
49
What is the other name for nosocomial infection
hospital acquired infection
50
number one hospital acquired infection?
UTI
50
It can effectively sterilize endoscopes, fiberoptic devices, microsurgical instruments, and powered instruments
gas plasma technology
51
advantage is greater safety for central sterile supply department workers because there are no toxic fumes, by-products, or residues - compact mobile unit low temperature hydrogen peroxide
Gas plasma technology
52
cannot sterilize instruments that have long, narrow lumina and not used for powders, liquids, or any cellulose maters: paper, cotton, or linen
gas plasma technology
53
Most hospitals use what kind of identify to determine a pack has been sterilized
chemical indicators
54
Hospitals use what to ensure all forms of microbial life are destroyed during the sterilization process
biological indicators (BIs)
55
Suppliers of commerical sterile use what to destroy microorganisms?
cobalt 60 or an electron beam
56
Packages are considered sterile when:
- they are clean, dry, and have not been opened or punctured - their expiration date has not been exceeded - their sterility indicators have changed to a predetermined color, confirming sterilization
57
If a procedure must be postponed what do you do with tray?
- do not open tray if is already open - cover it immediately with a sterile drape or discard it
58
are often used to achieve high-level disinfection of devices that come in contact with the mucous membranes, such as flexible fiberoptic endoscopes. High-level disinfection can be accomplished in less than an hour and is effective at destroying microorganisms, but will not kill spores.
chemical sterilization
58

Patient Care ll (mine) (5 decks)

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