Lecture 4: Prep of surgeon, surgical team and surgical facilities

Question 1

What are the clean surgical facilities

Answer 1

ORs, scrub sink areas, sterile supply rooms

Question 2

what are the mixed surgical facilities

Answer 2

hallways between OR, and other areas, storage areas, utility rooms

Question 3

what are the contaminated surgical facilities

Answer 3

anesthesia and prep rooms, dressing/locker rooms, offices

Question 4

most bacteria in OR is shed from __ and __ by __

Answer 4

skin and hair by personnel

Question 5

where do you clip and vacuum patients

Answer 5

in contaminated area only- do not clip in OR

Question 6

what should temp and humidity be for preparation room

Answer 6

temp: 62-68 F, humidity of 50% or less to reduce bacterial growth

Question 7

what is the single most important environmental factor to prevent SSI

Answer 7

proper air handling

Question 8

air should flow from __ to __

Answer 8

OR to corridors

Question 9

shedding of bacteria from hair shown to increase __

Answer 9

SSI

Question 10

what is function of surgical masks

Answer 10

contain droplets of microorganisms from mouth and nasopharynx

Question 11

where should you face when sneezing, talking or coughing

Answer 11

sterile field- sides are not secured/sealed to face

Question 12

when are glove perforations increased risk

Answer 12

1. Non-dominant hand
2. Non-soft tissue surgeries (ortho)
3. Longer than 60 minutes

Question 13

why is scrubbing with a brush no longer recommended

Answer 13

Results in skin damage, increased bacterial load/shedding, changes in microbial flora

Question 14

what should you do prior to surgical scrub

Answer 14

wash hands with non-medicated soap and completely dry

Question 15

what are the most common medicated scrub soaps

Answer 15

1. Chlorhexidine gluconate
2. Providing iodine
3. Hexachlorophene

Question 16

what are the most common alcohol based surgical scrubs

Answer 16

1. Triseptin
2. Avagard
3. Purell
4. Endure 450

Question 17

What is the MOA of medicated soap: chlorhexidine gluconate

Answer 17

disrupts bacterial cell wall and precipitates cell proteins

Question 18

chlorhexidine gluconate is __spectrum

Answer 18

broad

Question 19

what is MOA of medicated soap: iodophors/ povidone iodine

Answer 19

cell wall penetration, oxidation, replaces microbial contents with free iodine

Question 20

Is providone iodine broad or narrow spectrum

Answer 20

broad

Question 21

which is inactivated by organic material: chlorhexidine gluconate or povidone iodine

Answer 21

povidone iodine

Question 22

povidone iodine requires minimum of __minutes of skin contact

Answer 22

2

Question 23

which may be irritating to skin: chlorhexidine gluconate or povidone iodine

Answer 23

povidone iodine

Question 24

what is MOA of alcohol based scrubs

Answer 24

protein denaturation, lysis, and metabolic lysis

Question 25

Are alcohol based scrubs broad or narrow spectrum

Answer 25

broad

Question 26

why are alcohol scrubs considered superior vs medicated soaps

Answer 26

1. Higher antibacterial efficacy 2. Rapid reduction in resident skin flora 3. Repeat use for 1 week associated with lower # of bacteria 4. Cost effective

Question 27

T or f: front and back side of your gown are sterile

Answer 27

false- only front side