Surgical Report : Surgical Information

The general principals for environmental cleaning are to ensure the hospital environment is as clean as possible to reduce the risk of infection, and that all precautions are taken in accordance to legislation and Healthcare policy’s and guidelines. “To prevent the transfer of micro-organisms which may cause infection, and to prevent the transfer of foreign protein which may cause adverse reaction and pose the risk of spreading diseases e.g. vCJD. “

Has anyone ever considered how medical devices are prepared before a surgical procedure? Central Sterile Processing Department (CSPD) consists of services within the Hospital, in which reusable medical devices will be cleaned, prepared, and processed. The role for CSPD is to prevent infection transmitted by usage of medical devices. The procedure for hospital medical devices before surgery has a four part workflow process in: Decontamination, to Instrumentation, to Sterilization and Sterile Storage (Case Carts). An example is given for reprocessing an Intestinal Set and the supplies needed for the preparation of this medical device set.

All areas that are being used for healthcare activities should be cleaned with either disinfectant wipes each morning and in between patients/procedures. Equipment should be all new out of the packets and clean. For things more major such as vasectomy’s, minor surgery or family planning clinics, areas should be cleaned everywhere with a disinfectant fluid and also with wipes, gloves should always be worn as well as other PPE such as aprons and hats. All equipment should be new from the packet and only touched by the person who is using

Once the dressings were securely on and the procedure had been finished, I removed my apron and gloves and disposed of them in the plastic bag, along with everything thing else I had used and then washed my hands again. After leaving the patients home I discussed my practical experience with the Nurse who informed me that I although I had carried out the procedure well it was actually carried out using a clinically clean technique rather than the Aseptic Non Touch Technique as I had thought. As I had used the same gloves to remove the dirty dressings from the leg ulcer and then apply new sterile dressings I had not maintained the Aseptic Non Touch Technique. The Nurse informed me that this was perfectly suitable for the procedure I carried out as the wound was still kept as clean as possible and dressings and equipment used were sterile.

While shadowing my fellow upper cohorts during the clinic I had made many observations. Unfortunately I was only able to shadow one clinic, although I observed a lot. Marie was the first student that I was shadowing, she was the CA for the day. We started by stocking the cabinets with the necessities. Marie and I then took the dental tools out of the machines that cleaned, sterilized, and dried them. I was shown that there are two sides in the lab. What I mean by this is that the left side is a dirty side which you should always wear gloves so that you are always protected from the bacteria and germs that the tools carry. Everything on this side has to be handled carefully and you must always wash and sanitize your hands when you are through. The right side is the clean side where the tools and dental accessories are kept so that they stay clean and sterile. Next I was with Jennifer, although she had no patients that day due to a

Surgical Technologists have an important role in the operation room (OR). There are different positions within the Surgical Technology field, including Scrub Surgical Technologist, Circulating Surgical Technologist, and Second Assisting Technologist. Scrub Surgical Technologists have a number of tasks, including prepping the patient for surgery, sterilizing the OR, gown and glove surgeons and assistants, and assists the surgeon and other surgical team members in a number of ways, such as passing instruments and dressing wounds. Circulating Surgical Technologists have a number of tasks as well, including checking patient’s charts, identifying patient and verifying the surgery that will be performed with consent forms, assisting anesthesia

The standard precautions are implemented at all times to decrease the risk of transmitting infectious agents. Assuming that all patients could carry an infection, this minimises the potential spread of HAI’s. These standard precautions include routine hand hygiene, the use of personal protective equipment, safe handling and disposure of sharps and routine environmental cleaning.4,5 In this situation, where blood is present, this is considered a biohazard. Hand hygiene must be performed before touching the patient, before and after any procedures or exposure to bodily substances and after touching the patient or any of the patient’s surroundings. The use of Personal protective equipment should be used when attending to the patient. This includes protective eye wear, a surgical mask and an apron for protection from any splashes or sprays of blood generated by the patient. Gloves should also be worn for single use only when coming in contact with open skin and bodily fluids. To minimise the spread of blood, the bystander with visibly soiled hands should also be advised to thoroughly clean them with soap and

Hart (2004) states the principle of Aseptic Technique is to prevent the spread of micro organisms to wounds and to protects the nurse and patient from healthcare-associated infections (HCIA). The technique used for less invasive procedures such as intravenous drugs and wound care is the Aseptic No-touch Technique (ANTT) (Pratt et al 2007).

Contact precautions include: the patients being placed in private rooms, performing proper hand hygiene with antimicrobial soap and water, using friction for 15 seconds, and using gloves and gowns during patient care (Keske and Letizia 332). “One should also ensure adequate cleaning and disinfection of environmental surfaces and reusable devices. The uses of both buffered and buffered phosphate hypochlite solutions (bleach) have been shown to decrease the rate of C. difficile contamination and helps in reducing Clostridium Difficile associated disease (CDAD) rates” (Patel 104).

Health Care providers must implement infection control at all times. This is essential in order to avoid any sources of contamination that would put patients at risk for infection as well as all hospital personnel. There are two important aseptic techniques: Medical Asepsis, and Surgical Asepsis. The first one includes hand hygiene, use of gloves, masks, gowns and routine

Put used gloves and gown in to yellow infectious waste bin, which should be either just inside the room or outside the door before leaving the room.

The six week practical rotation I completed at SJOGH Mount Lawley operating theatre solidified my goal to be part of the theatre and recovery team. During this time I studied instrument names, passing technique, sterile scrub procedure and how to set up and maintain the sterile field. On several occasions I was able to act as scrub scout, only requiring supervision and assistance from my buddy nurse with medications because it was out of my scope of practice to

First, you clean your hands (either wash or use hand sanitizer) prior to entering patients room.

Research shows that Surgical site infections are preventable. According to the CDC, hand hygiene is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Ensuring the use of infection control prevention is an important component of nursing care. Infection control prevention policies must be communicated undoubtedly to all employees. Staffers who do not comply must be re-educated to ensure that all are complying. Speaking up and pointing out that a nurse forgot to wash his or her hands, or notifying the surgical team that surgical instruments were not adequately cleaned may seem like small issues; but at the same time, not acknowledging a break in a sterile technique could mean the difference between life and death for a patient. One hospital that was struggling with high levels of infection related to surgical procedures, implemented a pre-procedure huddle as a team. This innovate way decreased the spread of infection and was a great way to improve the quality of care for patients. As mandated by the Joint commission, infection prevention personnel should provide multidisciplinary education on SSI prevention, to all team members, including

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora