The Surgical Environment
Environmental Sanitation
Surgical Skin Antisepsis (Skin Prep)
Infection Prevention
Cleaning Procedures
100
True or False: The procedure suite is a sterile environment.
What is: FALSE?
100
The ultimate responsibility for maintaining a clean surgical environment rests with this surgical person.
What is: the CIRCULATING RN?
100
The use of this type of skip prep solution involves scrubbing the skin for 2 minutes in a circular motion, blot drying, then painting for 2 minutes.
What is: BETADINE WET PREP?
100
True or False: Research indicates that the number of airborne bacteria in a surgical suite is comparative to the number of people in the procedure room.
What is: TRUE?
100
True or False: The soiled linen and waste receptacles should be removed from the procedure suite while the procedure is in progress, to keep the room clean.
What is: FALSE?
200
This is the type of air pressure recommended for the procedural suite.
What is: POSITIVE PRESSURE?
200
According to the most current AORN recommended standards for perioperative practice, this should be done to all horizontal surfaces in the procedure suite before the first scheduled procedure of the day.
What is: DAMP DUSTING?
200
Which one of the following skin antisepsis practices is not recommended? a) Wash hands before starting skin prep. b) Cover arms and use sterile gloves. c) Start from periphery and move to the incision site. d) Remove hair at surgical site before taking patient to the procedure suite. e) Use pooling towels to prevent pooling of prep solutions. f) Let prep solution with flammable agents dry before draping patient.
What is: C?
200
A patient, who has a urinary tract infection, is admitted for an emergency angioplasty with stent placement. The procedure is completed without incident. This is the appropriate wound classification for this case.
What is: CLASS I - CLEAN?
200
Pre-procedure cleaning involves these recommended practices.
What are: 1. Damp-dusting all horizontal surfaces in the procedure suite before the start of the first case of the day. 2. Starting with higher surfaces and then moving to lower surfaces?
300
These are the three phases of perioperative nursing.
What are: PRE-OPERATIVE, INTRA-OPERATIVE, & POST-OPERATIVE?
300
This term is used to describe cleaning of the procedure suite in-between cases.
What is: INTERIM CLEANING?
300
True or False: a) Sterile gloves are required when using Chloraprep to clean the surgical site before an invasive procedure. b) The surgical site should be SHAVED on the day of surgery, before the patient is taken into the procedure suite.
What is: a) FALSE; b) FALSE?
300
These are the reasons that the use of spray bottles in the procedure suite is not recommended.
What are: 1. The substance in the bottle becomes aerosolized when sprayed; 2. The aerosolized substance can potentially contaminate the surgical environment; 3) The aerosolized substance can be hazardous to the patient and surgical personnel?
300
All of the following are recommended cleaning practices for preventing cross-infection in the procedure suite EXCEPT: a) Damp-dust all horizontal surfaces in the procedure suite before the first case of the day. b) Clean and disinfect procedure suite, work surfaces, and equipment after every procedure. c) Use mechanical friction and hospital-approved disinfecting agents to clean. d) Re-dip cleaning mop in disinfectant solution to ensure that the procedural suite is thoroughly cleaned. e) Clean all patient devices used during invasive procedure, immediately after the procedure has ended.
What is: D?
400
The perioperative environment is divided into these three zones.
What are: RESTRICTED, SEMI-RESTRICTED, & UNRESTRICTED?
400
This is the main reason that cleaning should always be done before disinfection.
What is: To Facilitate The Effectiveness Of The Disinfectant Solution When It Is Used?
400
This is the minimum information that must be documented when a skin prep procedure is performed before an invasive procedure.
What is: The area prepped, the person who performed the skin prep, the patient's skin condition before and after the prep was performed, and the type of prep solution used?
400
Which of the following practices are recommended to reduce airborne contamination during a procedure? (Select all that apply) a) Keep the procedure suite door open to allow for easy access by personnel and patients. b) Minimize the amount of personnel movement during procedures. c) Minimize the number of people and amount of talking in the procedure suite. d) Use aerosol sprays and feather dusters to clean the procedure suite. e) Wipe down horizontal surfaces with normal saline.
What are: B & C?
400
According to recommended practices, spills in the procedure suite must be cleaned up immediately because: (Select all that apply) a) This is a mandatory AORN standard that all hospitals must follow. b) Fluids and debris left on the floor may dry and flake. c) Movement within the room may cause the dry debris to become aerosolized and contaminate the field. d) Dry debris may pose a hazard to surgical personnel.
What are: B, C, & D?
500
a) Temperature in the restricted area should be maintained between these parameters, b) Humidity in the restricted area should be maintained between these parameters.
What are: a) 68-75 degrees F; & b) 20%-60%?
500
These are reasons that AORN recommends that all horizontal surfaces should be cleaned daily. (Select all that apply). a) Research has shown that dust in the surgical environment may contain human skin, hair, fabric fibers, pollens, mold, and fungi. b) Cleaning all horizontal surfaces daily will ELIMINATE the surgical patient’s risk of a surgical site infection. c) Proper cleaning of horizontal surfaces in the procedure suite helps to reduce airborne contaminants that may travel on dust and lint. d) Cleaning of all horizontal surfaces is mandated by the State of Florida.
What are: A & C?
500
These are recommended practices for using Chloraprep to clean the surgical site before surgery.
What are: a) Scrub over incision site for at least 30 seconds; b) Scrub for a total of 2 minutes using friction and coverage; c) Let the prep solution dry for 3 minutes before placing the surgical drapes; d) Place a drape or towel on either side of the patient to avoid pooling of the prep solution under the patient or on the procedure bed?
500
Match the following surgical procedures with the correct wound classifications: a) Class I: Clean b) Class II: Clean-contaminated c) Class III: Contaminated d) Class IV: Dirty ___Tumor Ablation ___Pacemaker Insertion ___Liver biopsy with presumed liver infection ___Percutaneous gastrostomy tube placement ___Abscess drainage ___Percutaneous biopsy
What are: B, A, C, B, D, A?
500
List three (3) potential sources of contamination associated with the invasive procedure suite.
What are: Patient, Healthcare Personnel, Inanimate Objects (furniture, equipment, or any devices used on the patient)?
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