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| Pregunta | Respuesta |
| Sterile Conscience | is a mindset of constant vigilance. Taking ownership for the sterility of items from the time of processing through the termination of the procedure. |
| Guidelines for Sterile Conscience | 1. remove lab coats & any other clothing that could drag a crossed field, pull hair back before setting up tray 2. minimum traffic 3.items are either sterile or nonsterile 4. trays w/ drapes are only considered sterile at waist/table height 5. handle packs and drapes as little as possible 6. do not set up until right before physician comes into the room 7. always stand several inches from tray 8.outer 1 inch diameter around any sterile drape is not sterile 9. never drop items directly over field, sterile barrier between your hands and the sterile field. 10. do not toss or flip items into field 11. solution containers should be placed at the corner of tray 12. approach a sterile tray or a scrubbed person head on, not in between the two 13. never leave tray unattended. 14.once drape/item becomes wet it is contaminated 15.scrubbed personnel should never let hands drop below waist 16. avoid talking, coughing, sneezing, or laughing |
| National Patient Safety Goals that apply to a ambulatory surgery environment | 1. label all medications, container, or solutions on and off sterile field 2. reducing risks of surgical fires through education and equipment maintenance 3. Using protocal "wrong site, wrong person, wrong procedure" |
| Provide the Patient Instructions | -any fasting or medication instructions -any special prep -what clothing and shoes to wear & what not to wear -any paperwork, x-ray, or insurance info -who the patient should bring |
| Surgery Room Responsibilities | -block off the surgical suite in the app scheduler to prevent double booking -check all equipment -make certain all supplies that are needed are in stock and in good working order |
| Insurance Responsibilties | -notify the company of procedure -send precertification paperwork -obtain approval from company before procedure is scheduled |
| Surgical Card File | 1. Items that should be included on the tray 2. Items that should be placed on the side table 3. Skin prep instructions 4. Anesthetic preferences 5. Equipment that should be placed in the room 6. Glove and gown size of the physician 7. Any other specific instructions |
| Skin Prep Procedures | 1. Skin should be cleansed with an antibacterial soap 2. Skin should be shaved only if absolutely necessary and re-cleansed 3. Skin antiseptic should be applied to the area (usually iodine product) 4. The skin antiseptic should be allowed to completely dry before application of the fenestrated drape. 5. Apply the fenestrated drape (it has an opening that goes over the surgical site) |
| Concentric Circles | circles that start in the center and work their way out of periphery (used with surgical soap, and antiseptic) |
| During the Procedure | 1. handing the physician items that are not on the sterile tray, but on the side table 2. Replacing instruments that may become contaminated 3. Using that foot control to open the lid on various trash receptacles 4. receiving patient specimens from the physician |
| Closed Wounds | wounds that do not break the skin |
| Open Wounds | wounds that do break the skin |
| First Stage of Wound Healing | Inflammatory Stage Lasts for two to five days Consists of two different phases; hemostasis and inflammation Blood vessels dilate and white blood cells rush to the site to assist in the removal of bacteria and debris from the wound -hemostasis: clot formation -inflammation: removal of bacteria and debris |
| Second Stage (proliferative stage) | lasts anywhere from couple of days to weeks -granulation phase: fibroblasts stimulate the release of collagen which fills the wound -Contraction: the edges of the wound contract, helps pull wound together -Epithelization: epithelial tissue starts to form over the wound area |
| Third Stage (maturation & remodeling stage) | lasts a couple of weeks to 2 years collagen forms which creates scar tissue, gives the wound of new shape and strength |
| Good Wound Care | 1. Cleaning and Debridement 2. Application of sterile dressing 3. Preventing further injury 4. Preventing infection |
| Gauze | plain cotton material used on only minor wounds or secondary dressing absorbs drainage sticks to skin, can disrupt the wound bed |
| Hydrocolloids | main component is cellulose, which turns into a gel during exudates absorption and helps to keep the wound moist used on wounds with light to heavy drainage or on wounds that are granulating Promotes autolytic debridement Adheres to moist skin May promote hyper-granulation can cause the edges of the wound to become macerated |
| Hydrogeis | ploymer gel used on wounds that are sloughing off or that have necrotioc tissue should not be used on wounds with moderate to heavy exudates very useful on burns rehydrates tissue minimally absorbent cool and soothing to tissue may be slippery and difficult to keep in place may cause maceration of skin around wound edges |
| Alginates | calcium alginate, turns dressing into a gel promoting a moist environment good for clean exudating wounds, aids in debridement highly absorbment may be slightly hemostatic can dry a wound with limited drainage can dry out dressing |
| Collagens | hydrogel with collagen absorbs exudates, provides moist environment attacks macrophages and fibroblasts heat sensitive and some people may be allergic |
| Transparent Films | clear film dressing used as secoundary dressing great to secure IVs visibilty of wound contours to body waterproof difficulty applying and remvoing zero absorbency may irritate |
| Foams | polyurethane foam pad good for wounds with large amounts of drainage very absorbant breathable, less changes could promote wound drying may not adhere to deeper wounds |
| Primary Dressings | lay directly over the wound has some kind of ointment or water |
| Secondary Dressings | usually placed over primary dressings and assist with absorption of excess wound fluid or exudates from the inside, while keeping outside moisture and bacteria from entering the wound |
| Applying & Caring for Dressings | 1. Wash your hands thoroughly before bandaging 2. Use sterile technique and products when appying dressings to wounds that are open 3. Use an ointment only if directed to do so by the physician 4. Encourage patients to change dressings that appear dirty. 5. Avoid ripping or tearing a bandage away from a wound. soak bandage with normal saline for several minutes. |
| Serous | fluid that contains serum. Serous fluid may appear as a clear fluid but sometimes is also yellow. |
| Sanguineous | a discharge that contains blood |
| Serosanguineous | a discharge that contains both serum and blood |
| Purulent | a discharge containing pus |
| Bandage | 1. to hold a dressing in place 2. to immobilize a joint 3. to hold a dressing and to immobolize a joint |
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