29 terms

Surgical Asepsis

What is Surgical asepsis?
INcludes procedures used to eliminate all microorganisms. Also known as sterile technique. Demands the highest level of aseptic technique. ******Contamination occurs with touching of any object that is not sterile!!!!
Surgical asepsis
What is the purpose of ______? To prevent transfer of microorganisms in order to prevent infection.
Medical asepsis
Decreases number of micoorganisms and uses clean technique.
Surgical asepsis
Eliminates all micoorganisms and uses sterile technique.
When should surgical asepsis be used?
In OR, Labor and Delievery. At the bedside, for Catherization, IV, wound care, and pick line. Any procedure with intentional perforation of pt's skin. When skin integrity is broken due to trama, incisions and burns. During insertion of catherters or instruments into sterile body cavities.
Surgical asepsis-OR
Apply mask, protective eyewaer, cap. Surgical hand scrub. Sterile gown, gloves.
Surgical asepsis-bedside
Wash hands, sterile gloves and mask as needed.
Patient preparation
Teach about the procedure. Avoid sudden movements. Do not touch sterile area. Avoid talking, sneezing, or coughing over sterile area. May need to pre-medicate.
Principles of surgical asepsis
Failure to follow results in infection. Nosocomial or health-care associated infections (HAIs). 2 million HAIs yearly in US. $45 billion in costs.
A sterile object
________ remains sterile only when touched by another sterile object: Sterile + Sterile =Sterile. Sterile + Clean= Contaiminated. Sterile + Contaminated= Contaminated. Sterile + Not sure= Contaminated. Sterile object does not change color when contaminated! May look untounched.
Only sterile objects
______ may be placed on a sterile feild. All sterile packages must be: Clean, dry, intact, have labels or proof of sterilty and expiration.
A sterile object or feild
______ out of range of vision or an object held below the waist is contaminated. Sterile field must be in view at all times.
A sterile object
_______ becomes contaminated by prolonged exposure to air. Avoid excessive movements. Avoid talking, sneezing, or coughing. Minimize traffic. minimize reaching over table.
When sterile surface
________ come in contact with a wet, contaminated surface, the sterile object or field becomes contaminated by capillary action. Any spill is contamination unless it is on a sterile surface that mositure cannot penetrate.
Fluid flows
_______ in the direction of gavity, Surgical scrub: hold hands above elbows. Hold wet instruments with tip down.
The edges
______ of a sterile field or container are considered to be contaminated. You have a 1" border about the sterile field that is consitered to be contaimnated.
____ cannot be sterilized and is considered contaminated.
______, alertness, and honesty are necessary to maintain surgical asepsis. Contaminated objects will NOT look different. Microes cannot be seen.
Sterilize and disinfect
How do we ______? 1) Moist heat: steam under pressure-autoclave. 2) Chemical sterilants. 3) Gas: Ethylene Oxide (very toxic to humans) 4) Boiling water 5)Radiation
Neuman's Varibles: Physiological, Psychological, developmental, sociocultural, and spiritual.
Assess the physiological conditions that require use of surgical asepsis? Catherization. Identify physiological factors that may disrupt a sterile procedure, Refuse to take shower before surgery, cognitive status, and having to go to the bathroom during the procedure.
Assess _____ state/coping. Clients often experience anxiety/fear with any procedure-particularly if no previous experience. Explain what you are doing!!!!!
How does the client's _____ stage influence his/her reaction to the use of surgical asepsis? Teen worried about body image after procedure is done. Elderly congnitive status or may want their child to be with them.
How does the client's ____ background influence the use of surgical asepsis? The only way to know about ones culture is to ask them to explain it. Only reason to change or break cultural rituals is if will harm the pt.
Assess spiritual beilfs/practices. Does the use of surgical asepsis impact these? Want to pray before procedure, would like it at a certan time of the day so it doesnt interfer with prayer. If in doubt always ask.
Nursing diagnoses
1) Risk for infection 2) Impaired skin intergrity 3) Risk for impaired skin integrity 4) Fear/anixety related to procedure 5) Knowledge about procdure.
What factors can disrupt sterile procedure? Pain (pre-medicate if needed), Lack of knowledge, Movement, Anxiety, Full bladder (make sure they void before starting), Forgetting equipment (everybody does this but students are famous for it!)
Sterile technique. Collect supplies (bring extra!) Establish sterile field. Open sterile supplies, add to field. Do sterile gloves. Maintain principles of surgical asepsis.
Document pt response to procedure. Assess pt perceptions of how infection spreads. Assess pt outcomes. Monitor for signs of infection. Observe all surgical sites for redness, swelling, discharge, pain. Go back and asses, how they did and pain meds after procedure.