GROUP-1-REPORTNCM-112-SKILLS.docx

**SURGICAL HAND ASEPSIS** **OVERVIEW AND DEFINITION** **Asepsis** - **Surgical asepsis ("sterile technique")** - The inadvertent transfer of microorganisms such as bacteria to a patient\'s wound site during surgery can result in a wound infection that is commonly called a *surgical site...

**SURGICAL HAND ASEPSIS** **OVERVIEW AND DEFINITION** **Asepsis** - **Surgical asepsis ("sterile technique")** - The inadvertent transfer of microorganisms such as bacteria to a patient\'s wound site during surgery can result in a wound infection that is commonly called a *surgical site infection (SSI).* There are many different points in the care pathway where prevention of SSIs can take place. This includes antiseptic cleansing of the hands for those who are operating on the patient. **Surgical Hand Asepsis** - Nurses working in operating rooms perform surgical hand antisepsis prior to donning sterile gowns and gloves before participating in surgical and invasive procedures, to decrease and suppress the growth of skin microorganisms in case of glove perforations. **PURPOSE** 1. 2. 3. 4. In surgical asepsis an area or object is considered contaminated if touched by any object that is not sterile. It demands the highest level of aseptic technique and requires that all areas be kept free of infectious microorganisms. **EQUIPMENT** - - - - - - - **PROCEDURE** 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a. b. c. d. e. f. g. h. **DONNING & DOFFING, GLOVING** **OVERVIEW AND DEFINITION** The process of putting on and taking off personal protection equipment (PPE) are referred to as donning and doffing, respectively. These words are frequently used in the healthcare industry as well as other fields where wearing protective gear is necessary to avoid contamination or exposure to hazardous materials by workers. ***Donning*** means to *put on* and *use PPE* properly to achieve the intended protection and minimize the risk of exposure. ***Doffing*** means *removing PPE* in a way that avoids self-contamination. **PURPOSE** - **ASSESSMENT** - *Rationale:* This will determine which equipment is required. **PLANNING** - - - **IMPLEMENTATION** - *Rationale*: By removing or securing loose items, healthcare workers can maintain the integrity of their PPE and reduce the risk of exposure to harmful substances. 1. 2. 3. - - - *Rationale*: Overlapping securely covers the uniform at the back. Waist ties keep the gown from falling away from the body which can cause inadvertent soiling of the uniform. 4. - - - *Rationale:* To ensure a secure and effective fit that maximizes protection against airborne contaminants. - *Rationale:* With the edge of the mask under the glasses, clouding of the glasses is less likely to occur. - *Rationale*: To be effective, a mask must cover both the nose and the mouth, because air moves in and out of both. - *Rationale*: A secure fit prevents both the escape and the inhalation of microorganisms around the edges of the mask and the fogging of eyeglasses. - *Rationale*: A mask should be used only once because it becomes ineffective when moist from exhaled breath. - *Rationale:* To ensure safety and hygiene, a used mask should be either discarded appropriately if disposable or stored in a clean, designated container if it will be reused. 5. 6. - - - 7. 8. *Rationale*: Contact with microorganisms may occur while removing PPE. 9. 10. - *Rationale*: The top part of the gown may be soiled, for example, if you have been holding an infant with a respiratory infection. - - 11. - - *Rationale*: This prevents the top part of the mask from falling onto the chest. - *Rationale*: The front of the mask through which the nurse has been breathing is contaminated. - - **GLOVING (Open Method)** Gloving serves as a critical sterile barrier that minimizes the risk of contamination between the surgeon and the patient. It is performed following the thorough scrubbing and drying of the surgeon\'s hands. **PURPOSE** - **ASSESSMENT** - *Rationale:* This will determine which equipment is required. **PLANNING** - **IMPLEMENTATION** - *Rationale*: Any moisture on the surface could contaminate the gloves. - - - *Rationale*: The inner surfaces, which are next to the sterile gloves will remain sterile. - - *Rationale*: The hands are not sterile. By touching - *Rationale*: If the thumb is kept against the palm, it is less likely to contaminate the outside of the glove. - *Rationale*: Attempting to further unfold the cuff is likely to contaminate the glove. 6\. Put the second glove on the non-dominant hand. - **OXYGEN ADMINISTRATION** **OVERVIEW AND DEFINITION** **Oxygen** - - **Oxygen Administration** - **GENERAL PURPOSES:** - - - - **OXYGEN DELIVERY SYSTEM** Separated into 2 categories**:** 1. - - - 2. - - - **Low-Flow Systems** **Cannula** - a. b. ***a. Plain Nasal Cannula*** - - - ***b.Reservoir Nasal Cannula*** - - - - - - **Face Mask** - - - - - a. b. c. d. **a.Simple Face Mask** - **b. Partial Rebreather Mask** - c\. **Non Rebreather Mask** - d\. **Venturi Mask** - **Specific Considerations for the Patient with COPD Receiving Oxygen Therapy** - - - - **Complications of Oxygen Administration** - - - **Safety Precautions during Administration of Oxygen** - - - - - - **References:** Berman, A. (2021). Kozier and Erb‟s Fundamentals of Nursing: Concepts, Processes and Practice. Hinkle, J.L., & Cheevr, K. H. (2018). Brunner and Suddarth‟s Textbook of Medical-Surgical Nursing. 14th edition Osmosis - Medical and surgical asepsis: Clinical skills notes - Osmosis Video Library. (n.d.). Osmosis. [https://www.osmosis.org/learn/Medical\_and\_surgical\_asepsis:\_Clinical\_skills\_notes] Reyes, M.J., (2020). Hand Washing -- Surgical Technique. ASU-BSN Checklist Tanner, J., Dumville, J. C., Norman, G., & Fortnam, M. (2016). Surgical hand antisepsis to reduce surgical site infection. The Cochrane Library, 2016(1). https://doi.org/10.1002/14651858.cd004288.pub3 Mun Global. (January 20, 2020). Donning and doffing personal protective equipment. Retrieved from https://munglobal.com.au/resources/knowledge-base/personal-protectiveequipment/donning-and-doffing-personal-protective-equipment