Podcast
Questions and Answers
What should be done with items that are dropped on the floor during a surgical procedure?
What should be done with items that are dropped on the floor during a surgical procedure?
- Store them for later use
- Put them back in a sterile pack
- Clean and reuse them
- Consider them contaminated (correct)
How should sterile personnel pass each other to maintain the sterile field?
How should sterile personnel pass each other to maintain the sterile field?
- Crossing paths at an angle
- Side by side
- Turning to the side
- Facing each other or back to back (correct)
Which of the following is considered unsterile?
Which of the following is considered unsterile?
- The table level of a sterile setup
- The sleeves of a sterile gown
- The front of a sterile gown below the neck
- The edges of a sterile instrument enclosure (correct)
Which action is NOT recommended when dealing with liquids during a surgical procedure?
Which action is NOT recommended when dealing with liquids during a surgical procedure?
What should be done with all opened supplies if a surgical case is canceled?
What should be done with all opened supplies if a surgical case is canceled?
How should circulating persons interact with the sterile field?
How should circulating persons interact with the sterile field?
Under what condition can a sterile barrier be considered contaminated?
Under what condition can a sterile barrier be considered contaminated?
What is the primary cause of surgical site infections?
What is the primary cause of surgical site infections?
What is the purpose of scheduling a case at the end of the day in a specific room?
What is the purpose of scheduling a case at the end of the day in a specific room?
Which classification describes a non-infected wound with no signs of inflammation?
Which classification describes a non-infected wound with no signs of inflammation?
What should be ensured after an OR surgery before the room can be used again?
What should be ensured after an OR surgery before the room can be used again?
Which of the following surgeries is an example of a Clean Contaminated Wound (Class II)?
Which of the following surgeries is an example of a Clean Contaminated Wound (Class II)?
Why are surgical masks worn during patient transfer at the end of the day?
Why are surgical masks worn during patient transfer at the end of the day?
What is a major characteristic of Clean Wounds (Class I)?
What is a major characteristic of Clean Wounds (Class I)?
Which of the following surgeries is not classified as a Clean Wound (Class I)?
Which of the following surgeries is not classified as a Clean Wound (Class I)?
What is the main implication of proper wound classification?
What is the main implication of proper wound classification?
What is the primary purpose of the operating room environment in surgical procedures?
What is the primary purpose of the operating room environment in surgical procedures?
How often should air exchange occur in the operating room?
How often should air exchange occur in the operating room?
Which factor is NOT a component of maintaining a sterile field during surgery?
Which factor is NOT a component of maintaining a sterile field during surgery?
What should be done if there is uncertainty about the sterility of an item?
What should be done if there is uncertainty about the sterility of an item?
What is the acceptable temperature range for the operating room?
What is the acceptable temperature range for the operating room?
Which infection requires airborne precautions?
Which infection requires airborne precautions?
Which of the following statements about peel packs is correct?
Which of the following statements about peel packs is correct?
What additional attire is necessary for infections requiring droplet precautions?
What additional attire is necessary for infections requiring droplet precautions?
To minimize the risk of surgical site infections (SSIs), which practice is essential for OR personnel?
To minimize the risk of surgical site infections (SSIs), which practice is essential for OR personnel?
What practice should be followed after surgery in the operating room?
What practice should be followed after surgery in the operating room?
What should be assessed for package integrity before using surgical items?
What should be assessed for package integrity before using surgical items?
Which of the following infections requires contact precautions?
Which of the following infections requires contact precautions?
What is a standard procedure for managing a patient with tuberculosis?
What is a standard procedure for managing a patient with tuberculosis?
In the context of croup, what type of precautions are necessary?
In the context of croup, what type of precautions are necessary?
Which viral infections mentioned require droplet precautions?
Which viral infections mentioned require droplet precautions?
What is important to ensure in the operating room after a patient with an infection has been treated?
What is important to ensure in the operating room after a patient with an infection has been treated?
What characterizes primary intention in wound healing?
What characterizes primary intention in wound healing?
Which type of wound is classified as a Class IV wound?
Which type of wound is classified as a Class IV wound?
What is a feature of secondary intention in wound healing?
What is a feature of secondary intention in wound healing?
When is third intention also known as delayed primary closure applicable?
When is third intention also known as delayed primary closure applicable?
What indicates a Class III contaminated wound?
What indicates a Class III contaminated wound?
Which of the following scenarios is least likely to result in extensive scar tissue?
Which of the following scenarios is least likely to result in extensive scar tissue?
What does 'major breaks in aseptic technique' refer to?
What does 'major breaks in aseptic technique' refer to?
Which method is primarily used for healing infected or perforated wounds?
Which method is primarily used for healing infected or perforated wounds?
Study Notes
Surgical Asepsis and Infection Control
- The operating room (OR) is designed to prevent contamination and maintain the integrity of surgical supplies.
- Adherence to aseptic standards is crucial to minimize the risk of surgical site infections (SSIs) and achieve optimal patient outcomes.
Aseptic Environment
- Keep OR doors closed to limit exposure to contaminants.
- Maintain positive pressure air exchange, typically 20 exchanges per hour.
- Temperature must be between 20-23°C, with humidity between 30-60%.
- Minimize traffic in and out of the OR.
Establishing the Sterile Field
- Ensure surfaces are dry and dust-free before unpacking sterile items.
- Use impermeable drapes to establish a sterile barrier.
- Sterile working surfaces are only considered sterile at table level.
Sterile Setup Practices
- Open items only when needed; assess package integrity before use.
- Observe expiry dates on sterile items and handle peel packs carefully.
- Avoid flipping supplies; consider any items dropped or damaged as contaminated.
- Maintain a sterile boundary by ensuring sterile personnel communicate and navigate without contaminating the sterile field.
- Discard opened supplies if a case is canceled while the patient is present.
Maintaining the Sterile Field
- Unattended sterile setups are at risk and should be monitored continuously.
- Any sterile barrier that becomes compromised is considered contaminated.
- Sterile gowns are only sterile from 2 inches below the neckline to table level; backs and edges are unsterile.
- Movements must be controlled to avoid contaminating the sterile area.
Microbiology and Infection Prevention
- Microorganisms including bacteria, fungi, and viruses can cause surgical site infections.
- MRSA and C. difficile are common pathogens associated with surgical infections.
- Implement additional precautions based on transmission routes: contact, droplet, and airborne.
Wound Classifications
-
Clean Wounds (Class I): Non-infected with no inflammation.
- Examples include hernia repair and total joint replacements.
-
Clean Contaminated Wounds (Class II): Entered respiratory, alimentary, or genitourinary tracts without infection.
- Examples include bowel surgeries and cholecystectomies.
-
Contaminated Wounds (Class III): Open fresh wounds or those with major breaks in aseptic technique.
- Examples include penetrating trauma or bowel perforations.
-
Dirty/Infected Wounds (Class IV): Pre-existing infections or wounds with gross contamination.
- Examples include abscess drainage.
Wound Healing Processes
- Primary Intention: Quick closure of an aseptic wound, with minimal drainage.
- Secondary Intention: Healing through granulation with the wound left open, requiring cleaning and packing.
- Third Intention: Delayed closure of a wound that may require debridement and secondary sutures after several days.
Best Practices for Infection Control
- Follow ORNAC standards for comprehensive infection prevention.
- Utilize terminal cleaning protocols after surgery to ensure a sterile environment for the next procedure.
- Schedule higher-risk cases at the end of the day and allow ample time for air exchange before the next surgery.
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Description
Test your knowledge on surgical asepsis and infection control as outlined in Alexander’s Care of the Patient in Surgery and ORNAC Standards. This quiz will cover key concepts regarding the operating room environment and best practices for preventing infections. Enhance your understanding and ensure you are prepared for surgical settings.
