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ASEPTIC TECHNIQUE

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Laura Curtis-Clinical Instructor -OR ASEPTIC TECHNIQUE Asepsis In The Operating Room Patient surgical prep Maintaining a sterile field Using safe operative techniques ... – PowerPoint PPT presentation

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Title: ASEPTIC TECHNIQUE


1
ASEPTIC TECHNIQUE
  • Laura Curtis-
  • Clinical Instructor -OR

2
Introduction
  • Proper aseptic techniques is one of the most
    fundamental and essential principles of infection
    control in the clinical and surgical settings
  • Aseptic Techniques are those practices which
  • Standard Precautions
  • Remove or kill microorganisms from hands and
    objects
  • Employ sterile instruments and other items
  • Reduce patients risk of exposure to
    microorganisms that cannot be removed

3
OBJECTIVES
  • Describe aseptic technique
  • Explain the rules of asepsis
  • Describe the technique used to maintain asepsis
    in the operating room
  • Practice aseptic technique properly
  • Describe Standard Precautions as practiced during
    surgery

4
Cont
  • Aseptic technique is vital in reducing the
    morbidity and mortality associated with surgical
    infections.-SSI.
  • Therefore aseptic measures include surgery and
    the insertion of intravenous lines, urinary
    catheters, and drains.

5
Asepsis In The Operating Room
  • Aseptic technique is most strictly applied in the
    operating room because of the direct and often
    extensive disruption of skin and underlying
    tissue.
  • Aseptic technique helps to prevent or minimize
    postoperative infection.

6
Asepsis In The Operating Room(Before Entering
the OR and Procedures)
7
Introduction
  • Aseptic technique also encompasses practices
    performed immediately before and during a
    surgical procedure to reduce postoperative
    infection
  • Hand washing
  • Surgical Attire
  • Surgical scrub, sterile gowning gloving
  • Patients surgical skin prep
  • Using surgical barriers, including sterile
    surgical drapes and PPE
  • Maintaining a Sterile Field
  • Using safe operative technique
  • Maintaining a safe environment in the OR

8
OPERATING ROOM ENVIRONMENT CONTROL
The surgical suite should be designed in such a
way as to minimize and control the spread of
infectious organisms
AIM
9
ACCESS CONTROL
OPERATING ROOM COMPLEX DIVIDED INTO 3 AREAS
  • UNRESTRICTED AREA
  • SEMI RESTRICTED AREA
  • RESTRICTED AREA

10
  1. UNRESTRICTED AREA
  • Areas outside the theatre complex including
    control point to monitor the entrance of
    patients, personnel, visitors, etc
  • Street clothes are permitted in the area
  • Traffic is not limited

RED LINE
11
  1. SEMI - RESTRICTED AREA
  • Peripheral support areas within theatre complex,
    includes corridors leading to operating rooms,
    work areas (storage) etc.
  • All persons must wear scrub attire which should
    be made of low linting material that minimizes
    bacterial shedding, comfortable, clean and
    provides a professional appearance

12
  1. RESTRICTED AREA
  • Includes operating rooms, scrub areas and
    ante-rooms
  • Personnel must wear full surgical attire, hair
    coverings, masks where open sterile supplies and
    scrubbed persons are present
  • Masks are worn to reduce the dispersal of
    microbial droplets from the mouth and
    naso-pharynx of personnel high filtered
  • Masks must cover the mouth and nose entirely, and
    be tied securely to prevent venting
  • Metal strip in the top hem of the masks produces
    a firm contoured kit over the bridge of the nose

13
Surgical Attire
To provide effective barriers that prevent the
dissemination of microorganisms to patients To
protect personnel from contamination from blood
and body fluids of patients Proper attire is a
part of aseptic environmental control Protects
personnel against exposure to communicable
diseases and hazardous material
14
Surgical Attire Considerations
  • Proper attire must be worn within the
    semirestricted and restricted areas of the OR
    suite
  • Clean fresh attire is donned daily on arrival to
    the OR and intermittently when necessary if suit
    becomes wet or grossly soiled-source of
    cross-contamination.
  • OR attire should not be worn outdoors-this
    protects the OR environment from microorganisms
    inherent in the outdoor environment and
    vice-versa.
  • Before leaving the institution everyone should
    change to street clothes/uniforms
  • On occasion a cover gown may be worn over OR
    attire outside the suite
  • The practice of wearing cover gowns is Not
    encouraged

15
Head Cover
  • Hair is a gross contamination
  • Cap or hood is put on before the scrub suit to
    protect the garment from contamination by hair.
  • All facial and head hair is completely covered in
    the semi restricted and restricted areas.
  • Light weight caps/hoods made of disposable,
    lint-free fabric
  • Reusable caps should be freshly laundered daily
  • Skull caps do not cover the entire head, and hair
    can be shed from the inferior edges.

16
Shoe Cover
  • Unprotected street shoes can increase floor
    contamination
  • Shoes restricted to wear in the OR are preferable
    in reducing microbial transfer from the outside
    into the OR suite
  • Shoe covers may be worn as needed to protect from
    blood and body fluid
  • Some surgeons wear plastic or rubber boots during
    procedures wherein extensive fluid irrigation
    and/or blood loss can be anticipated
  • Shoe covers can inadvertently become soiled and
    harbor microorganisms and should be removed
    before leaving the OR

17
ASEPTIC TECHNIQUE
  • METHODS BY WHICH CONTAMINATION WITH
    MICROORGANISIMS IS PREVENTED (ALTERNATE TERM
    ASEPTIC PRACTICE TO MAINTAIN ASEPSIS).

18
PRINCIPLES OF ASEPSIS
  • ARE THE EFFORTS TAKEN TO KEEP THE PATIENT AS FREE
    FROM HOSPITAL MICROORGANISM AS POSSIBLE.
  • IT IS AMETHOD USED TO PREVENT CONTAMINATION OF
    WOUNDS AND OTHER SUSCEPTIBLE SITES BY ORGANISMS
    THAT COULD CAUSE INFECTION

19
Proper Surgical Hand Scrub
20
THE PROCESS OF REMOVING AS MANY ORGANISMS AS
POSSIBLE FROM THE HANDS AND ARMS BY MECHANICAL
WASHING AND CHEMICAL ANTISEPTIC BEFORE
PARTICIPATING IN AN OPERATION
21
before hand washing
Transient organisms
Resident organisms
22
after hand washing
Transient organisms
Resident organisms
23
SURGICAL HAND WASHING
24
AGENTS FOR ANTISEPSIS
  • A broad-spectrum antimicrobial agent.
  • Fast-acting and effective.
  • Nonirritating and nonsensitizing.
  • Prolonged-acting.

25
AGENTS FOR ANTISEPSIS
  • Chlorohexidine gluconate.
  • Iodophors.
  • Triclosan.
  • Alcohol.
  • Hexachlorophen.

26
PREPERATIONS BEFORE SCRUB
  • INSPECT HANDS FOR CUTS AND ABRASIONS.
  • REMOVE ALL FINGER JEWELRY.
  • BE SURE ALL HAIR IS COVERED BY HEADCAP.
  • ADJUST THE MASK FIRMLY AND COMFORTABLY OVER NOSE
    AND MOUTH.
  • CLEAN EYEGLASSES IF WORN.
  • ADJUST WATER TO A COMFORTABLE TEMPERATURE.

27
DURATION OF HAND WASHING
  • Surgical hand washing should not be less than 3
    minutes.

28
1).SURGICAL HAND SCRUB
  • APPLY ANTIMICROBIAL AGENT

29
(No Transcript)
30
GOWNING AND GLOVING
31
Assissted Gloving
32
All members of the sterile team are required to
perform a surgical hand scrub and don sterile
gown and gloves before touching sterile equipment
or the sterile field.
33
Rules Wearing Sterile Gown and Glove
  • Rules to observe while wearing sterile gown and
    gloves.
  • NEVER drop his hands below the level of the
    sterile area at which he is working.
  • NEVER touch his surgical gown above the level of
    the axilla or below the level of the sterile area
    where he is working.
  • NEVER put his hands behind his back he must
    keep them within his full view at all times.
  • NEVER tuck his gloved hands under his armpits, as
    the axillary region of his gown is contaminated.
  • NEVER reach across an unsterile area for an item.

34
Asepsis In The Operating Room
  • Patient surgical prep
  • Maintaining a sterile field
  • Using safe operative techniques
  • Maintaining a safe environment in the operating
    room

35
PRINCIPLES OF ASEPSIS
  • All articles used for a surgical procedures are
    sterilized prior to surgery.
  • Gowns are considered sterile only from waist to
    shoulder level in front and sleeves.
  • Personnel who are sterile only touch sterile
    articles personnel who are not sterile only
    touch unsterile items.
  • Sterile touching sterile remaining sterile.
  • Sterile touching unsterile contaminates all.

36
PRINCIPLES OF ASEPSIS
  • Arms not to be folded under axillae.
  • If in doubt about the sterility of any item,
    consider it unsterile.
  • Nonsterile personnel must avoid reaching over a
    sterile field, sterile personnel must avoid
    leaning over a sterile field.
  • The area approximate 2.5cm around the edge of the
    sterile field is considered unsterile.
  • Sterile personnel must be close to the sterile
    area, unsterile personnel must be away from the
    sterile area.

37
PRINCIPLES OF ASEPSIS
  • Moisture may cause contamination.
  • Pouring should be done at the edge of the table.
  • When passing in a sterile field, remember sterile
    to sterile.
  • The sterile field must be kept insight all the
    time.
  • The gloved hands must be kept insight all the
    time.
  • Once in position, drapes are never moved or
    shifted.
  • Avoid coughing, sneezing or unnecessary talking
    over a sterile field.

38
Principles of Sterile TechniqueSterile persons
pass each other back to back or front to front
39
Principles of Sterile Technique
  • Destruction Of The Integrity Of Microbial
    Barriers Results In Contamination
  • The integrity of a sterile package or sterile
    drape is destroyed by perforation puncture or
    strike through.
  • Strike-through is the soaking of moisture through
    unsterile layers to sterile layers or vice versa.
  • The integrity of a sterile package and its
    expiration date for sterility must be checked
    just prior to opening it.

40
REMOVING GOWN AND GLOVES
41
Conclusion
  • STERILITY IS NEVER TAKEN FOR GRANTED. IT MUST BE
    MAINTAINED AND CHECKED.
  • BASICALLY THERE IS NO COMPROMISE WITH STERILITY
  • OR PERSONNEL MUST MAINTAIN THE HIGH STANDARDS OF
    STERILE TECHNIQUE THEY KNOW ARE ESSENTIAL.

42
Thank you for active listening
Laura Curtis O.R. clinical instructor
KFMC
03\06\2006
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