Wounds: Basic Principles of Surgical Asepsis

Question 1

You are assisting in a surgical procedure and are preparing the sterile field. A new nurse takes out a package of gauze from her pocket and hands it to you. Why would you not take this gauze from the new nurse?

Answer 1

• all obeject in a sterile field must be sterile
  -> never assume that an item a sterile

Question 2

When preparing a sterile field, you notice that the packing surrounding a sterile scaple is slightly open and dirty. Upon further inpection, you notice that the outer package is wet. You alert the surgeon and they tell you that it is fine to use because they need to rush to perform surgery. Is it okay to use this instrument? Why or why not?

Answer 2

• No, it is not appropriate to use this intrument.
• all packages must be:
  -> unopened
  -> clean
  -> dry

Question 3

While setting up a sterile field, your ungloved hand accidentally brushed against a sterile intrument. Is the instrument still considered sterile?

Answer 3

• no, sterile objects become unsterile when tocuhed by unsterile objects

Question 4

While in a sterile field, you noticed that an instrument was moved ever so slightly to the left. You don’t remember anyone moving or touching the instrument. How do you proceed in this scenario?

Answer 4

• if your questioning the sterility of an item, consider it contaminated.

when in doubt, throw it out

Question 5

When handling sterile materials it is best to use sterile ____ and ____ to maintain sterility.

Answer 5

sterile golves and forceps

Question 6

While in a sterile environment, abby calls karen while she is by the door. Karen turns around to answer to her and turns back and realizes everyone is staring at her and shaking their heads. Why is everyone upset with karen?

Answer 6

• dont turn your back to a sterile field
  -> sterile items out of sight are considered CONTAMINATED

Question 7

While in a sterile enviornment, karen accidentally drops her scapel. She instictively reaches below her waist to attempt to catch the scalpel. The surgeon proceeds to cuss her out and says, how could you be so DUMMMMMMMMB!!!! Why is the surgeon so upset with karen?

Answer 7

• anything below the waist is considered unsterile

Question 8

When in a sterile setting, karen decides to raise the table next to her to a more appropriate working height. She does so by reaching underneath the table and pulling the table up. Again…. everyone looks are her with utter dismay and disaapointment. What did karen do this time?

Answer 8

• Only the surface of the table is considered sterile
• Karen reach underneath the table
  -> contaminating herself

Question 9

Abby is preparing a sterile field with Josh. Josh keeps complaining about how hot it is and decides to turn on a nearby fan. Abby gets mad at Josh and smacks him across the head. What did Josh do wrong.?

Answer 9

Josh turned on a fan in a sterile environment.

• Microorganisms are airborne
  -> moving air bring microorganisms

Question 10

Abby and Karen are in a sterile field together. Abby is wearing a mask, while Karen decides that she does not need one. While doing the porcedure, Karen keeps talking and getting her hot, STANKYYY ARSEEE breath all over the place. What should Abby do in this scenario?

Answer 10

• Abby needs to control the air by putting a mask on karen and telling her to be quiet.

Question 11

Abby and Josh are preparing a sterile field in an room with high traffic out the door. Josh takes initiatie and places a note outside the door that reads, “KEEP OUT: sterile enviornment in progress”. Why did Josh do this?

Answer 11

• Josh did this to minimize traffic and to ensure that the door stays closed

Question 12

While performing a procedure, Karen is constantly reaching over the sterile field and keeps moving all the instruments all over the place. What changes should Karen make to reduce the risk of contamination?

Answer 12

• stop reaching over ther sterile field
• decrease movement of sterile object

Question 13

When opening a new package of sterile gloves, you should open the first fold ________ from you.

Answer 13

away

Question 14

Why wound surgery need to be done as quickly as possible?

Answer 14

• sterile objects can become unsterile by prolonged exposure to air

Question 15

When preparing for a sterile procedure, Josh does his 10 seconds hand hygiene regimen. What is he correct technique that he should be using?

Answer 15

• Josh should use sterile technique (surgical handwash)
  -> wash from clean to dirty

Question 16

How should Abby hold her sterile dry forceps?

Answer 16

• hold them to keep the tips up

Question 17

Josh thinks that the proper technique on holding his wet forceps is to keep the tips facing upwards. Why is Josh wrong?

Answer 17

• Josh needs to hold the tip downward = allow unsterile fluid drips off the tip

Question 18

Josh is preparing a sterile field on a wet table. He decides to place a sterile paper barrier on the table surface and place his sterile equipment on top of it. What is Josh doing wrong? What should Josh know?

Answer 18

• Josh should use a waterprrof barrier under a sterile field.
• Josh should know that moisture passing thru a sterile object draws microorganisms from unterile surfaces to the sterile surface

Question 19

During a dressing change, josh accidently splashed antiseptic solution onto the sterile field. Why is this a problem?

Answer 19

• splashing makes a sterile field unsterile

Question 20

Jessica is preparing a sterile field and places her instruments on the one inch border on the edge of the drape. Are her instruments still consdiered sterile? Why or Why not? How could Jessica avoid occuring this mistake in the future?

Answer 20

• NO, her instrument is not sterile. The one inch margin at the end of an opoen drape is considered nonssterile/contaminated.
• jessica should place all her instruments in the center of the sterile field and place everything within one inch of the inside margin edge.

Question 21

When providing wound care, Josh uses surgical gloves to remove the old dressing. After removing the dressing, Josh removed his gloves and donns a new pair of clean gloves. With his clean gloves, Josh decides to clean the wound. What did Josh do wrong? How could he improve his wound care technique?

Answer 21

MISTAKES:

• Josh wore sterile gloves to remove old dressing
• Josh used clean gloves to clean the wound and apply new dressings.

IMPROVEMENT:

• Josh should use clean gloves to remove old dressing
• Josh should use sterile gloves to clean the wound and apply new dressings

Question 22

Jessica recently applied an antiseptic onto a patient’s skin and now claims that she has sterilized the area. Why is Jessica wrong? What is an important detail that Jessica should know about the sterility of skin?

Answer 22

• Antiseptics only make skin clean, not sterile
• Skin can never be sterile

Question 23

When holding sterile objects, you should use ____ ____ or ____.

Answer 23

sterile applicators; forceps

Question 24

Karen, a new nurse, is working in the OR and accidentally brushes her sleeve on the sterile field. No one else in the operating room noticed Karen’s mistake. What should Karen do?

Answer 24

• Karen should be honest and verbaize that she contaminated the sterile field.