Small Things- Big Trouble
The number and types of viable microorganisms (such as bacteria, fungi, and viruses) contaminating a specific object, surface, or environment.
What is microbial load?
According to the ORNAC standards, movement between these three restricted access levels should be controlled to reduce microbial load, ultimately reducing the number of microbes at the point of surgery.
What are unrestricted, semi-restricted, and restricted areas?
This action should be minimized during surgery to maintain positive pressure and airflow.
What is the door opening?
In restricted areas and in the presence of open sterile supplies, this PPE is required by all perioperative personnel to wear. It should be changed in between procedures, never hang around the neck or be stored in pockets.
What is a surgical mask?
What are clean, no longer than fingertip in length and be in good condition?
This OR access level includes unlimited access to limited persons, includes corridors and waiting areas where street clothes are permitted.
What is the unrestricted zone?
This generalized action within the OR should be minimized and prioritized as it has a direct correlation with increased microbial load.
What is movement?
Due to shedding, microorganisms have been recognized as a potential source of bacteria in the OR therefore ORNAC requires this to COMPLETELY confined using a clean hat/cap/bouffant and/or beard cover.
What is head and facial hair?
Along with being kept within the pocket of the surgical attire these should be cleaned daily/when visibly soiled with a low-level disinfectant
A specialized ventilation technique maintains higher air pressure inside the OR than in surrounding hallways and rooms. This ensures that when doors are opened, air flows out of the room rather than allowing contaminated air to rush in.
What is positive pressure?
This level access of the OR requires authorized persons to wear surgical attire. The presence of food, drink or personal belongings are not permitted. IE. clean/sterile supply storage space.
What is the semi-restricted zone?
These items should be gathered before incision to reduce unnecessary movement.
What are supplies and equipment?
Soiled clothing increases the risk of cross contamination. ORNAC states this is to be changed daily or whenever soiled.
What is surgical attire (scrubs, laundered hats/caps/warm up jackets)?
This ideal patient body temperature should be maintained perioperative, intraoperative and postoperative.
Increase in bacterial colony counts correlates to increase in room temperature. The ambient temperature should be maintained between ____ and ____ in the OR theatre.
What is 18 and 23 C?
Authorized persons wearing surgical attire AND appropriate PPE (depending on the area being entered/task being performed) are required in this OR access level because sterile procedures are performed here. This area also prohibits food/drink/personal belongings.
What is the restricted zone?
What is talking?
Surgical attire must not be worn IN the hospital OUTSIDE the perioperative area without this (NSHA)
What is a clean lab coat or appropriate cover up?
Although every patient should be assessed individually this antiseptic agent may be safely used on patients with an allergy to shellfish.
What is povidone iodine?
Lower levels of humidity may support the accumulation of static electricity, while higher levels of humidity may contribute to condensation of ambient moisture that could result in damp supplies] thus encouraging microbial growth. The relative humidity should be maintained between _____ and _____.
What is 30% and 60%?
The number of this in the OR should be kept to a minimum, as it influences the concentration of airborne microbes in the OR, therefore increasing microbial load.
What is personnel?
Along with minimizing distractions this potential patient outcome could be directly impacted by poor traffic control.
What is surgical site infection?
These items are to be removed by all personnel before entering both the semi-restricted and restricted zones (ORNAC).
What is all jewelry?
The circulation/removal of contaminated air and replacement with fresh air decreases the number of airborne contaminates, this should be occurring at a rate of ____ of outdoor air exchanges per hour or _____ of total air changes per hour.
What are 20 total air exchanges/hour, or at least 6 clean air exchanges drawn from the outside air?