Surgery Exam 1 - Principles Of Surgical Asepsis

Front 1

What is Asepsis?

Back 1

Prevention of microbial contamination of living tissues or sterile materials by excluding, removing or killing micro-organisms including pathogens and spores.

Front 2

What is Aseptic technique?

Back 2

Refers to a procedure that is performed under sterile conditions to prevent nosocomial infections. It breaks the cycle of infection which limits the patient's exposure to a number of microorganisms that is not detrimental.

Front 3

What is the Cycle of Infection?

Back 3

Pathogenic microorganism --> reservoir or source --> portal of exit --> method of transmission --> portal of entry (surgical wound) --> susceptible host --> (keeps circling)

Front 4

Why do we need surgical asepsis?

Back 4

The act of surgery robs a patient of a protective barrier (skin) against infection or disease. Whenever the skin is disrupted, microorganisms have the opportunity to invade tissue and proliferate. Therefore, it is a must to practice surgical asepsis during a surgery.

Front 5

What is a pathogen?

Back 5

Microorganisms that cause infection or disease in humans and animals.

Front 6

What is an infection?

Back 6

It is the multiplication of an infectious agent within the body tissues that results in cellular injury.

Front 7

What is a nosocomial infection?

Back 7

An infection that is the result of treatment in a hospital. Considered nosocomial if appears in 48 hours or more in the hospital or within 30 days of discharge.

Front 8

Source of Organisms?

Back 8

Exogenous: operating room environment (air), surgical instruments, and surgical team.

Endogenous: Patient's resident flora = MOST IMPORTANT SOURCE

Front 9

What is the most common form of nosocomial infection?

Back 9

Surgical Site Infection (SSI)

Front 10

Describe surgical site infections.

Back 10

Purulent discharge

Signs of inflammation (redness, swelling, heat, pain, loss of function)

Isolation of microorganisms from wound.

Front 11

What are the clinical significances of SSI?

Back 11

Can lead to increased morbidity and possibly mortality.

Can progress to Systemic Inflammatory Response Syndrome (SIRS)

Very costly to treat.

Front 12

Surgical asepsis involves proper preparation of what?

Back 12

1. Facilities and environment
2. Surgical site
3. Surgical team
4. Surgical equiment

Front 13

Why must surgical personnel wear proper attire?

Back 13

Provides a barrier between sources of contamination - the patient and personnel

Front 14

Where must hands be for surgical asepsis and why?

Back 14

Hands are clasped in front of body above waist (may not be folded into axillary region)

The axillary region of the gown is not considered sterile.

Front 15

Where are gowns considered sterile?

Back 15

Mid chest to waist and from gloved hand to 2 inches above elbow.

Object held below a person's waist is considered contaminated.

Can't see what is touched. The back of the gown is not considered sterile.

Front 16

Why must surgical team members remain within the sterile area?

Back 16

To minimize contamination.

Cross contamination: The transfer of an infection directly from one person to another or indirectly from one person to a second person.

Front 17

Why can't you talk, sneeze, laugh or cough over a sterile field or objects?

Back 17

To minimize the moist droplets laden with bacteria from these sources.

Front 18

Why are sterile tables only sterile at table height?

Back 18

Items hanging over the table edges are considered non-sterile because they are out of the surgeon's vision.

Front 19

What is used to create a sterile field?

Back 19

Sterile drapes. Drapes should be waterproof. Should not be moved or rearranged once positioned.

Front 20

Why must equipment used during surgery be sterilized?

Back 20

To prevent a source of contamination.

Front 21

Why must all items within a sterile field be sterile?

Back 21

Contamination can occur from perforated wrappers or from strike-through from moisture transport.

Front 22

How should items be introduced onto the sterile field?

Back 22

Open, dispensed, and transferred by methods that maintain sterility. The edges of sterile containers are not considered sterile once package is opened and once a fluid cap has been removed, it cannot be replaced on the bottle.

Front 23

If a sterile object touches the sealing edges of the pouch that holds it during opening, it is considered contaminated. Why?

Back 23

Once opened, sealed edges of the pouches are not sterile.

Front 24

Why should non-scrubbed personnel not reach over the sterile fields?

Back 24

To prevent the contamination from dust, lint, exfoliated skin or other vehicles of bacteria that may fall on the sterile field.

Front 25

Why should a sterile field be maintained and monitored constantly?

Back 25

Diligent observation is an important part of infection control and must be exercised by all members of surgical team.

Front 26

How should scrubbed team members stand and why?

Back 26

Should always face each other and the sterile field at all times. Never turn your back on a sterile tray or leave it unattended. This prevents contamination from the backside of the team member which is normally considered non sterile.

Front 27

How much movement should occur for surgical asepsis?

Back 27

Movement in the operating room by all personnel is kept to a minimum except when needed to prevent cross contamination from turbulent air flow.

Front 28

How should personnel moving within or around a sterile field do so?

Back 28

When scrubbed personnel change positions, they should maintain a safe distance and pass each other back-to-back or front-to-front.

Front 29

Who should handle sterile items and why?

Back 29

Scrubbed personal handle only sterile items. (Non-scrubbed personnel handle only non-sterile items). This prevents cross contamination.

Front 30

If the sterility of an item is questioned, what should you do?

Back 30

Consider it contaminated. A sterile object becomes contaminated by prolonged exposure to air. This is to prevent cross contamination.

Front 31

A sterile object or field becomes contaminated by capillary action when a sterile surface comes in contact with a wet contaminated surface. Why?

Back 31

Moisture carries bacteria from a non-sterile surface to a sterile surface (strike-through).

Front 32

Why should surgical team remain seated until the surgery has been completed if they began the surgery seated?

Back 32

The surgical field is sterile only from table height to the chest; movement from sitting to standing during surgery may increase cross contamination.

Front 33

What are the main portals of exit from human reservoirs for the cycle of infection?

Back 33

Hands, mouth, nose and secretions.

Front 34

What are the methods of transmission for cycle of infection?

Back 34

1. Direct contact by hands to animal, animal to animal, object or person or animal
2. Airborne
3. Water droplets
4. Vectors

Front 35

What can the portals of entry be for cycle of infection?

Back 35

1. Mouth - GI tract
2. Nostrils - Respiratory tract
3. Break in skin

Front 36

What 3 main factors determine whether a pathogen is successful in establishing an infection?

Back 36

1. Susceptibility of host
2. Amount of pathogen
3. Presence of all elements of the infection cycle

Front 37

Aseptic technique is a process designed to break the infection cycle. It includes....?

Back 37

1. Practices that reduce the number of organisms by interrupting the cycle at the level of causative agent and reservoir.
a. Use of antiseptic soap (hand washing and patient skin preparation.
b. Disinfectants on objects
c. Sterilization of instruments/drapes

2. Practices that interrupt transmission at the level of portal of exit and entry
a. Gloves, gowns, mask, surgical drapes