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23 Cards in this Set
- Front
- Back
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Zone 1. Unrestricted |
Person may enter in street clothes. -entrance - family waiting area - personnel locker room/restroom |
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Zone 2: semi-restricted |
Person dresses in scrub attire with hair and shoe covers - all areas, except surgical (operating) room |
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Zone 3: restricted |
Person wearing scrub attire, hair covered, shoes covered, and mask. -operating room |
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Surgical procedure |
- door closed - only those involved are present - minimize traffic in and out of the room - “being scrubbed/scrubbed in” - those directly involved with the surgical procedure(invasive/operation site) and dressed in sterile attire - Surgeon - surgical assistant - physician, nurse, technician |
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being scrubbed/scrubbed in |
- those directly involved with the surgical procedure(invasive/operation site) and dressed in sterile attire |
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Surgical asepsis |
complete removal of microorganisms and their spores (reproductive unit) from the surface of any object • Invasive procedure • Major or minor • Parenteral medication (other than mouth or rectum) • Invasive imaging • Urinary catherization • Tracheostomy care • Dressing changes • Must be observed any time there is a break or penetration of skin or protective membrane. |
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Dress and behavior protocol |
1. Closed and comfortable shoes 2. Meticulous personal hygiene 3. Jewelry and artificial nails prohibited 4. Body piercing prohibited 5. Fitted scrub attire (not loose and tucked in) 6. All hair must be covered 7. Shoe covers (optional) 8. Wash arms or wear scrub jacket when leaving environment 9. Wear mask in designated areas |
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Mask protocol |
Mask protects • The patient from droplets expelled by personnel • The health care worker from pathogenic microorganisms 1. Cover nose and mouth with no gaps 2. Do not cross tie 3. Single use |
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Surgical environment |
Sterile material, equipment, and supplies must be packaged and stored in a particular manner considered “safe” to be used • Break in sterile protocol increases the chance of patient getting an infection (touching non-sterile items while wearing sterile attire) • Health care personnel needs to be familiar in opening sterile packages and donning sterile attire |
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Common causes of contamination: |
• Contaminated instruments • Contaminated gloves • Wet or damp sterile field • Poor ventilation |
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Surgical team (O. R) |
Surgeon- the primary physician who plans and performs the surgical procedure • Surgical assistant- secondary surgeon or surgical resident. May have several • Scrub nurse or technician- dressed in sterile attire. Sets up the sterile field for operation, assists the surgeons(s) by presenting sterile instruments and equipment needed for the procedure • Anesthesiologist- a physician specializing in anesthesia • Nurse anesthetist- specialized nurse who administers anesthesia and monitors the patient under supervision of the anesthesiologist • Circulating nurse- oversees the safety of the patient and maintains the surgical environment |
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People not sterilized during procedure |
• Anesthesiologist- a physician specializing in anesthesia • Nurse anesthetist- specialized nurse who administers anesthesia and monitors the patient under supervision of the anesthesiologist • Circulating nurse- oversees the safety of the patient and maintains the surgical environment |
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People sterilized during procedure |
Surgeon. Surgical assistant. And scrub nurse or technician |
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Radiologic technologist |
Present at the request of the surgeon to perfect imaging procedure. Wears non sterile clothes surgical attire |
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Scout image |
Preliminar image taken by radiographer. Test run. |
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Sterile |
• Notice non-sterile personnel is assisting sterile personnel so they don’t contaminate themselves • Sterile habitus: • The “scrub” is considered a sterile person • The parts of a surgical gown considered sterile are the sleeves (except for the axillary area and cuffs) and the front of the gown from table level to a few inches below the neck opening • A sterile person should keep his hands in sight and at waist level or above • Only the table top is sterile. Anything that hangs off the edge is not sterile |
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The radiographer and the O. R. |
Aware of protecting not only self, but everyone in the surgical suite • Radiation • Sterile field • Keep x-ray equipment clean and dust-free 1. Radiographic machines must be cleaned with disinfectant solution 2. Sterile technique must be followed and maintained at all times 3. Place IR prior to patient being draped. Take scout images when possible 4. If radiographs are required during procedure, hand IR to an awaiting scrub/tech into a sterile bag 5. If radiographer places the IR himself, care and caution must be taken so as not to contaminate the field or scrub personnel. May require assistance in positioning the IR underneath the sterile drape 6. Assure the “scrubbed” personnel are wearing lead protection. Have the remainder step away from the radiation source or behind a protective barrier 7. When hands are necessary in holding a body part under direct radiation exposure, make sure surgeon wears leaded sterile gloves 8. Pregnant personnel should not be in the suite during radiation exposure 9. Radiation badge should be worn outside the lead apron, collar level 10. Make sure all surgical instruments are removed from the radiographic field and that the incision site is properly draped |
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Sterilization and Disinfection |
• Sterilization isn't complete until spores are completely removed • Method depends on item being sterilized • Identifiers located on inside and outside of packages • Other items and surfaces that cannot be sterilized are disinfected • Floors, tables, counters, walls, equipment • Solutions used for skin preparation is called antiseptic |
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Spaulding System |
• Disinfectants are categorized by their disinfecting ability 1. High-level 2. Intermediate level 3. Low-level • Items to be sterilized or disinfected are classified based on the risk of infection on the patient (Spaulding Classification System) 1. Critical 2. Semi-critical 3. Non-critical |
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Physical disinfectant methods |
• Boiling • Spores survive even at very high temperatures • Sodium carbonate (cuts boiling time in half) • Ultraviolet rays |
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Sterilization |
• Methods of sterilization • Steam under pressure • Items are double-wrapped and autoclaved. Autoclaves sterilize by gravity displacement and dynamic air removal (pressure cooker) • Operates above 270o F • Chemical sterilization • Antimicrobial and sporicidal gas agent • Low-temperature sterilization (54-60 degrees Celsius) 129-140o F • Ethylene oxide • Used for items that cannot withstand moisture and high temperatures • Must be cleaned and dried immediately |
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Betadine scrubbing (povidone iodine ) |
- circular motion - inside to outside - no retracing - discard sponge |
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Chlorhexidine |
-found in mouthwash to kill germs - no particular pattern - retracing allowed - 6-10” diameter - alcohol |
