Chapter 1. Infection Control Show
Sterile procedures are required before and during specific patient care activities to maintain an area free from microorganisms and to prevent infection. Performing a surgical hand scrub, applying sterile gloves, and preparing a sterile field are ways to prevent and minimize infection during surgeries or invasive procedures. Surgical Hand ScrubSkin is a major source of microorganisms and a major source of contamination in the OR setting (CDC, 2010). Since skin cannot be sterilized, members of the surgical team must wear sterile gloves. The purpose of the surgical hand scrub is to significantly reduce the number of skin bacteria found on the hands and arms of the OR staff (Kennedy, 2013). A surgical hand scrub is an antiseptic surgical scrub or antiseptic hand rub that is performed prior to donning surgical attire (Perry et al., 2014) and lasts two to five minutes, depending on the product used and hospital policy. Studies have shown that skin bacteria rapidly multiply under surgical gloves if hands are not washed with an antimicrobial soap, whereas a surgical hand scrub will inhibit growth of bacteria under gloved hands (Kennedy, 2013). Types of surgical hand scrubsSurgical hand scrub techniques and supplies to clean hands will vary among health care agencies. Most protocols will require a microbial soap-and-water, three- to five-minute hand scrub procedure. Some agencies may use an approved waterless hand scrub product. See Checklist 11 for the steps to follow when scrubbing with medicated soap. Checklist 11: Surgical Hand Scrub with Medicated Soap
Applying Sterile GlovesSterile gloves are gloves that are free from all microorganisms. They are required for any invasive procedure and when contact with any sterile site, tissue, or body cavity is expected (PIDAC, 2012). Sterile gloves help prevent surgical site infections and reduce the risk of exposure to blood and body fluid pathogens for the health care worker. Studies have shown that 18% to 35% of all sterile gloves have tiny holes after surgery, and up to 80% of the tiny puncture sites go unnoticed by the surgeon (Kennedy, 2013). Double gloving is known to reduce the risk of exposure and has become common practice, but does not reduce the risk of cross-contamination after surgery (Kennedy, 2013). To apply sterile gloves, follow the steps in Checklist 12. Checklist 12: Donning Sterile Gloves
Video 1.3Watch this Donning Sterile Gloves video for a demonstration on donning sterile gloves. Setting up a Sterile FieldAseptic procedures require a sterile area in which to work with sterile objects. A sterile field is a sterile surface on which to place sterile equipment that is considered free from microorganisms (Perry et al., 2014). A sterile field is required for all invasive procedures to prevent the transfer of microorganisms and reduce the potential for surgical site infections. Sterile fields can be created in the OR using drapes, or at the bedside using a prepackaged set of supplies for a sterile procedure or wound care. Many sterile kits contain a waterproof inner drape that can be set up as part of the sterile field. Sterile items can be linen wrapped or paper wrapped, depending on whether they are single- or multi-use. Always check hospital policy and doctor orders if a sterile field is required for a procedure. See Checklist 13 for the steps for preparing a sterile field. Checklist 13: Preparing a Sterile Field
Read this Surgical Aseptic Technique and Sterile Field PDF for information about surgical asepsis and setting up a sterile field at the bedside. Sterile Attire in the ORWearing sterile surgical attire (sterile gowns, closed gloving, and masks) and PPE is essential to keep the restricted and semi-restricted areas clean and to minimize sources of microbial transmission and contamination. It is important to minimize the patient’s exposure to the surgical team’s skin, mucous membranes, and hair by the proper application of surgical attire. An extensive list of recommendations for surgical attire can be located on the Association of periOperative Registered Nurses (AORN) website at Recommendations for surgical attire (Braswell & Spruce, 2012).
When opening a sterile package a nurse should quizlet?Do not reach across a sterile field, Always face the sterile field, Allow at least 6 inches between the body and the sterile field, Put on sterile gloves before handling the contents of a sterile package.
Which action by the nurse will result in contamination of a sterile object or a sterile field?The nurse must NEVER have the sterile field below the waist level. Coughing or sneezing over the sterile field contaminates the sterile field. The nurse must maintain a one-inch border around the sterile field that is not sterile. All sterile items and supplies are put inside of this one-inch border.
When pouring a sterile solution What care should the nurse take to avoid contamination of the solution?665. When pouring a sterile solution, what care should the nurse take to avoid contamination of the solution? Explanation: The nurse should pour and discard a small amount of the solution before each use to wash away airborne contaminants from the mouth of the container.
Which action would the nurse perform to ensure preparation of a sterile field?While preparing a sterile field, a nurse opens the outermost flap by stretching his or her arm away from the sterile field.
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