chapter002 sterile procedures
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Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 2Sterile Technique
Chapter 2Sterile Technique
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hospital Acquired Infections (HAI) Hospital Acquired Infections (HAI)
• “nosocomial infections”
• Acquired by pt. whose natural defenses against infection are missing or overridden in the health care setting
• very $$$$ - money & human life
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Hospital Acquired Infections (HAI) (cont.) Hospital Acquired Infections (HAI) (cont.)
According to CDC -250,000 pts/yr have HAI from urinary catheters
-10% - 25% pts w HAI die
• Requires- ↑ tx, ↑ hospital stays, & costs
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Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Risk factors con’tRisk factors con’t
• Re-infection- get same illness again
• Cross-infection-get infection from another pt. or staff member
• Noscomial infection- acquired in a healthcare setting
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CarriersCarriers
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risk factors risk factors
• 1. Lines of defense against infection
• break in skin
• invasive procedure
• Spores in hospital
• Elderly, children
• Medications
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Types of micro-organismsTypes of micro-organisms
• Bacteria- strept throat, TB, pneumonia
• Virus- HIV, Hepatitis A,B,C, flu, cold
• Fungus- athletes foot, yeast infections
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TermsTerms
• Pathogen
• Non-pathogen
• Aerobic pathogen
• Non-aerobic pathogen
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Types of asepsisTypes of asepsis
• Medical
• Clean technique
• General disinfection
• Ex.- vital signs, bathing, tube-feeding
• Surgical
• Sterile technique
• Ex.- wound care, surgery, invasive procedures, trauma
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Modes of transmissionModes of transmission
• Direct contact
• Indirect contact
• Droplet
• Vehicle
• Vector
• Airborne
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Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Principles of asepsisPrinciples of asepsis
• Control m.o-
grooming
handwashing
disinfection
* destroys most m.o.
* spores still live
* Wash off visible contaminates then disinfect
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Principles con’tPrinciples con’t
• Sterilization
• Kills all m.o- including spores
• Types:
• -Steam
• - Dry Heat
• -Gas
• -Chemicals
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Sterile TechniqueSterile Technique
• Involves:
- a sterile field (a microbe-free area to work in)
– Using equipment & supplies that are sterile (completely free of microbes) to ↓ risk of infection
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Levels of Sterilization for Equipment and SuppliesLevels of Sterilization for Equipment and Supplies
Category I: Critical— carry a very high risk b/c they penetrate the skin or are placed in body cavities that are normally free of microbes. Ex. - catheter
Category II: Semi-critical—come into contact with mucous membranes & carry a moderate risk for causing infection ex.-dental
Category III: Non-critical— come into contact with intact skin & carry a lower risk for causing infection
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SterilizationSterilization• The most complete method of killing all microbes
• Kills microbes as well as endospores
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QuestionQuestion
What is the most complete method of killing all microbes as well as endospores?
A. High-level disinfection
B. Sanitation
C. Sterilization
D. Disinfection
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
C. Sterilization
Sterilization is the most complete method of killing all microbes; it kills microbes as well as endospores.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sterile PackagesSterile Packages
• Fabric-wrapped: items inside sterilized onsite
• Envelope-wrapped package: one corner is opened at a time to create a sterile field; may be fabric or paper
• Peel/sterilization pouches: small sterile items wrapped in a combination of paper & plastic.
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Using an Envelope-Wrapped PackageUsing an Envelope-Wrapped Package
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Using a Sterile DrapeUsing a Sterile Drape
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Indications That an Item Is SterileIndications That an Item Is Sterile
• Commercially prepared items - writing on outside of package
• Items that are sterilized onsite have 2 chemical indicator strips
– Outside strip changes color after being processed
– Indicator strip inside the package will also change color to show the sterilizing agent penetrated the packaging
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Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Indications That an Item Is Sterile (cont.)Indications That an Item Is Sterile (cont.)
• The sterility of items is maintained as long as a sterile package is stored properly & the package is not damaged or wet surface
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True or falseTrue or false
Sterilized items usually reach expiration in about 1 year. ?
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AnswerAnswer
B. False
Sterilized items have no expiration date.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Principles of sterile asepsisPrinciples of sterile asepsis
• Sterile + sterile = sterile
• Sterile object out of site = contaminated
• Sterile object with prolonged exposure air=contaminated
• Sterile object + water exposure = contaminated
• 1 inch outside border= contaminated
• Think before moving or touching
• Skin= clean
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• Inside of body= sterile
• Sterile water good for 24 hours
• Rinse lip of sterile water
• Palm bottle
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When Creating a Sterile Field, You Need: When Creating a Sterile Field, You Need:
• An area where sterile supplies can be opened, arranged, & moved around & not contaminate other items
• Sterile gloves to arrange & use sterile supplies within the sterile field,
• sterile transfer forceps may be used to move items around within the sterile field.
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Transfer ForcepsTransfer Forceps
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Sterile Gloves Sterile Gloves
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Procedures That Require a Sterile FieldProcedures That Require a Sterile Field
Inserting urinary catheters
Giving injections
Starting intravenous (IV) lines
Changing sterile dressings
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QuestionQuestion
All instruments, supplies, and gloved hands remain sterile so that _______ are not introduced into the body
A. Asepsis
B. Calories
C. Microbes
D. Disinfection
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AnswerAnswer
C. Microbes
Sterilization prevents endospores and microbes from entering the body.
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Pouring Liquid Into a Sterile ContainerPouring Liquid Into a Sterile Container
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Discussion Questions:Discussion Questions:
• You are assisting the RN with wound care and a sterile drsg. change. She asks you to open a peel pouch pkg. containing scissors that were processed at the hospital. You place the scissors on the sterile field prepped by the RN.
• A. How will you determine the scissors are sterile?
• B. How will you open this pkg. & place on the sterile field?
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Discussion questionsDiscussion questions
• While you are assisting the RN with the sterile drsg. Change, the RN wants you to hand sterile items to her as needed:
• A. Identify 2 methods that can be used to work within the sterile field. What are the advantages & disadvantages of each way?
• B. As you assist with the drsg change, your gloved hand brushes against the RN’s forearm. What should you do?
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