Surgical Report : Surgical Information

Has anyone ever considered how medical devices are prepared before a surgical procedure? Central Sterile Processing Department (CSPD) consists of services within the Hospital, in which reusable medical devices will be cleaned, prepared, and processed. The role for CSPD is to prevent infection transmitted by usage of medical devices. The procedure for hospital medical devices before surgery has a four part workflow process in: Decontamination, to Instrumentation, to Sterilization and Sterile Storage (Case Carts). An example is given for reprocessing an Intestinal Set and the supplies needed for the preparation of this medical device set.

For instance, the case of the “Green River Killer” (Hickey, 2010:24) may offer another possible explanation for what caused Jack the Ripper to become a serial killer. Gary Ridgway is America’s most notorious serial killer (Hickey, 2010), he “holds the record for the most serial murder convictions in the history of the United States” (Hickey, 2010:24). Ridgway is responsible for the deaths of 48 women (Hickey, 2010). Like Jack the Ripper, Ridgway selected prostitutes as his intended victims (Paley, 1995).

Surgical Technologists have an important role in the operation room (OR). There are different positions within the Surgical Technology field, including Scrub Surgical Technologist, Circulating Surgical Technologist, and Second Assisting Technologist. Scrub Surgical Technologists have a number of tasks, including prepping the patient for surgery, sterilizing the OR, gown and glove surgeons and assistants, and assists the surgeon and other surgical team members in a number of ways, such as passing instruments and dressing wounds. Circulating Surgical Technologists have a number of tasks as well, including checking patient’s charts, identifying patient and verifying the surgery that will be performed with consent forms, assisting anesthesia

Once the dressings were securely on and the procedure had been finished, I removed my apron and gloves and disposed of them in the plastic bag, along with everything thing else I had used and then washed my hands again. After leaving the patients home I discussed my practical experience with the Nurse who informed me that I although I had carried out the procedure well it was actually carried out using a clinically clean technique rather than the Aseptic Non Touch Technique as I had thought. As I had used the same gloves to remove the dirty dressings from the leg ulcer and then apply new sterile dressings I had not maintained the Aseptic Non Touch Technique. The Nurse informed me that this was perfectly suitable for the procedure I carried out as the wound was still kept as clean as possible and dressings and equipment used were sterile.

While shadowing my fellow upper cohorts during the clinic I had made many observations. Unfortunately I was only able to shadow one clinic, although I observed a lot. Marie was the first student that I was shadowing, she was the CA for the day. We started by stocking the cabinets with the necessities. Marie and I then took the dental tools out of the machines that cleaned, sterilized, and dried them. I was shown that there are two sides in the lab. What I mean by this is that the left side is a dirty side which you should always wear gloves so that you are always protected from the bacteria and germs that the tools carry. Everything on this side has to be handled carefully and you must always wash and sanitize your hands when you are through. The right side is the clean side where the tools and dental accessories are kept so that they stay clean and sterile. Next I was with Jennifer, although she had no patients that day due to a

Cleaning removes organic matter, and most micro-organisms it does not destroy all micro-organisms, this method also can be used prior to the sterilisation or disinfection of equipment Cleaning is a low grade form of decontamination, when a piece of equipment has not been in contact with a patient or a patient who has healthy unbroken skin. Cleaning is accomplished by using hot water with a detergent using a disposal cloth. I use this process as a social clean prior to the three-step wipe method for the flexible endoscopes we use in the department. When I have finished with the cloth it is disposed of in the yellow clinical waste along with the gloves. When cleaning equipment I ensure they are dried properly to prevent contamination.

The standard precautions are implemented at all times to decrease the risk of transmitting infectious agents. Assuming that all patients could carry an infection, this minimises the potential spread of HAI’s. These standard precautions include routine hand hygiene, the use of personal protective equipment, safe handling and disposure of sharps and routine environmental cleaning.4,5 In this situation, where blood is present, this is considered a biohazard. Hand hygiene must be performed before touching the patient, before and after any procedures or exposure to bodily substances and after touching the patient or any of the patient’s surroundings. The use of Personal protective equipment should be used when attending to the patient. This includes protective eye wear, a surgical mask and an apron for protection from any splashes or sprays of blood generated by the patient. Gloves should also be worn for single use only when coming in contact with open skin and bodily fluids. To minimise the spread of blood, the bystander with visibly soiled hands should also be advised to thoroughly clean them with soap and

Contact precautions include: the patients being placed in private rooms, performing proper hand hygiene with antimicrobial soap and water, using friction for 15 seconds, and using gloves and gowns during patient care (Keske and Letizia 332). “One should also ensure adequate cleaning and disinfection of environmental surfaces and reusable devices. The uses of both buffered and buffered phosphate hypochlite solutions (bleach) have been shown to decrease the rate of C. difficile contamination and helps in reducing Clostridium Difficile associated disease (CDAD) rates” (Patel 104).

All areas that are being used for healthcare activities should be cleaned with either disinfectant wipes each morning and in between patients/procedures. Equipment should be all new out of the packets and clean. For things more major such as vasectomy’s, minor surgery or family planning clinics, areas should be cleaned everywhere with a disinfectant fluid and also with wipes, gloves should always be worn as well as other PPE such as aprons and hats. All equipment should be new from the packet and only touched by the person who is using

The six week practical rotation I completed at SJOGH Mount Lawley operating theatre solidified my goal to be part of the theatre and recovery team. During this time I studied instrument names, passing technique, sterile scrub procedure and how to set up and maintain the sterile field. On several occasions I was able to act as scrub scout, only requiring supervision and assistance from my buddy nurse with medications because it was out of my scope of practice to

Put used gloves and gown in to yellow infectious waste bin, which should be either just inside the room or outside the door before leaving the room.

First, you clean your hands (either wash or use hand sanitizer) prior to entering patients room.

Since the dawn of human civilization, there has been an unfortunate but natural tendency to marginalize and oppress those belonging to "the other"--those not in power, not part of the most popular group and those who are different. One such manifestation of this fear of the different is Islamophobia--the "dread or hatred of Islam--and therefore [the] fear or dislike of all or most Muslims." Although the exact word "Islamophobia" was brought to public awareness in 1997 after an academic journal from the British Runnymede Report, it has existed for many years prior to the journal, as a term to describe the experiences of the oppressed and discriminated sections of Muslim communities. The simmering prejudice towards Muslims gained ferocious momentum

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora

As a student nurse we are challenged throughout the course of our education to become leaders among our peers, in the workplace, and within the community. According to the Institute of Medicine (2011) leadership skills are learned and mastered over time, and it is important to obtain a basic understanding of these skills beginning in school. Leadership can occur at any level within an organization and can be defined as a person that possesses qualities such as courage, innovation, trust, commitment, teamwork, communication, values relationships, and who engages others to share in their dedication (Porter O-Grady & Malloch, 2016). Leaders and managers differ because managers are usually in an authoritative role and produce orderliness and consistency, while leaders tend to generate change and movement through creativity (Porter O-Grady & Malloch, 2016). A clinical leader identified in the intensive care unit (ICU) at Yuma Regional Medical Center (YRMC) is my preceptor. She was recognized as a nurse leader, because she strives to promote innovative changes on the unit, through knowledge, teamwork, and advocacy. According to Kumar, Kumar, Deshmukh, and Adhish (2015), an effective leader makes an active effort to improve their skills and knowledge, stay current in their field, and promote creativeness and collaboration among their peers.