SUR 111 LAB I

Resources

Textbook pages 148, 167-174, 310-313 Study guide skill assessments:12-1 and 7-1

through 7-5

Outline OR Attire Basic Handwash Instrument and Supply Preparation for Sterilization:

1. Envelope Fold2. Square Fold3. Peel Packs4. Container Systems

(12-1) OR Attire Purpose: Keep microbial count to minimum Protect staff and patient

OR Attire Variations in Attire: AORN Standards Facility policy School policy Examples: Fit (tucked, strings in), shoe covers, make-up,

cologne, nails, jewelry, name badges, hair cover, shoe type

OR Attire Consists of but not limited to: Scrub suit Shoe covers Hair cover (bouffant or other) Mask

OR Attire Variations Based on Traffic Patterns:

Unrestricted Semi-restricted Restricted

Other OR Attire Considerations Masks: type and appropriately tied Eyewear Gloves: Clean or sterile Sterile: Open gloving or closed gloving Surgical gown

(7-1) Basic Handwash Purpose: Reduce number of pathogenic

microorganisms on hands and wrists to reduce risk of transmission to patient or self

Basic Handwash When?: Before reporting to work station Before leaving work station Before and after personal hygiene Before and after eating Before and after patient contact or care Any time hands soiled

Basic Handwash Gather Equipment: Proper attire Sink Antiseptic soap Towels Nail cleaner/brush Lotion if necessary

Basic Handwash No jewelry Inspect hands for intactness and nails for need of nail cleaner Turn on faucet, adjust temperature Wet hands and wrists not allowing scrub suit or body to touch sink Apply soap Lather in circular motion with moderate friction, interlace fingers Cleanse minimum of 30 seconds to 2 minutes Rinse hands pointing down Avoid splashing Dry with patting or blotting motion Turn off faucet with a dry paper towel unless is foot controlled, then turn

off before drying Do not touch paper towel dispenser

Preparation for Sterilization Principle of Asepsis: All items that enter the

sterile field must be sterile Sterile is the absence of all microorganisms Contaminated is the presence of

microorganisms

Preparation for Sterilization Depending on the size and weight of the item there

are different methods of preparation for sterilization Items may be supplies, instruments or equipment Dirty or contaminated items such as instruments are

taken to a decontamination area after used in surgery There they are cleansed of gross soil/debris

(bioburden), sent through a washer-decontaminator (or washer-sterilizer), inspected, reassembled and prepared for re-use by a method of sterilization appropriate to the item’s composition

Preparation for Sterilization Methods of Preparation: Envelope Fold Square Fold Peel Packs Container System

(7-2) Envelope Fold Purpose: Used for packaging smaller items for sterilization Facilitates delivery of item to a sterile field though

can be style of fold to open on to a clean dry surface Needs: OR attire Basic handwash Gather supplies: Item to wrap, appropriate size wrapper (must cover

item), internal indicator, external indicator, labeling items

Envelope Fold Place wrapper diagonally Item in center Place internal indicator First flap nearest you fold over until covered, create

a 2-3” tab Left flap, as far as possible, cover, create 2-3” tab Right flap, as far as possible, should overlap second

flap, create 2-3” tab Final flap, bring towards self, miter or create flap

and tuck

Envelope Fold If this is the first of two wrappers repeat

above Secure final flap with appropriate external

chemical indicator tape Label Place in designated area for storage until

placed in the appropriate sterilizer Clean up work station

(7-3) Square Fold Purpose: Used for packaging larger items for sterilization Facilitates opening item on to a clean flat surface Needs: OR attire Basic handwash Gather supplies: Item to wrap, appropriate size wrapper (must cover

item), internal indicator, external indicator, labeling items

Square Fold Place wrapper square or rectangular Item in center Place internal indicator First flap nearest you fold over until covered, create

a 2-3” tab Second edge or farthest away, bring towards self,

miter or create flap and tuck Left end fold over, miter edge Right flap, fold over, secure with external indictor

tape

Square Fold If first of two wrappers, hold in place and

repeat previous steps Secure final wrap with external chemical

indicator tape Label Store in appropriate place Clean up work station

(7-4) Peel Packs Purpose: Single use or small count items to facilitate delivery

to sterile field or sterile team member OR attire Wash hands Assemble supplies: Item to wrap, appropriate size peel package, internal

indicator, external indicator (usually incorporated into packaging), heat sealer if not self-sealing, labeling items

Peel Packs Item and internal indicator placed in peel package Protect tips if necessary to prevent tearing through

packaging Orient item to prevent opening damage Expel air Seal with self-sealing tape or heat sealer Double package according to facility policy Label Store Clean up station

(7-5) Container System Purpose: Preferred Instrument Packaging Method Facilitates preserving instrument sterility and the

opening of instrument sets Instrument sets should not be wrapped due to their

weight and bulk which can breech or compromise a wrapper’s integrity rendering item contaminated

OR Attire Wash Hands

Container System Assemble equipment and supplies: Assembly will normally take place prior to this

(Skill 10-1) Instrument set Internal indicator Appropriate size container, lid Filters for lid or container External indicator (may be incorporated into locks) Locks or sealers Labeling item prn