Professional Documents
Culture Documents
Introduction to Asepsis
Asepsis
Is the absence of germs or pathogens. Aseptic technique: is an effort to keep the client free from hospital microorganisms
Contaimination
Is any object that becomes unsterile or unclean. Any object that is touched by an unsterile object is considered contaminated in a surgical aseptic procedure. It should be discarded and replaced. Example: anything that falls on the floor, bed side tables not cleaned, a bedpan, wet gauze lying on a bedside table or bed.
Nosocomial infections
Nosocomial infection Iatrogenic infection Exogenous nosocomial infection Endogenous nosocomial infection
Noscomial infections
The cost of noscomial infection: Increased length of stay Increased disability Delayed healing Prolonged recovery Increased risk for secondary medical problems The nurses role Protect the patient! Use proper technique Insuring others do so also Identify breaks in technique and stop them
Be observant!
Sterile fields
Wounds
Defined: is a disruption of the normal anatomical structures and function that results from a pathological process beginning internally or externally to an involved organ The classification of wounds are based on 1) status of skin integrity 2) causes of the wound 3) severity or extent of tissue injury or damage 4) cleanliness of the wound 5) descriptive qualities (color, swelling, drainage, etc.)
Causes of wounds
Intentional: wound resulting from a therapeutic procedureEx: incision or injection Unintentional: wound unexpected. Usually a traumatic injury. Ex: knife wound or burn.
Severity of an injury
Superficial: involves only the epidermal layer Penetrating: break in the epidermal surface, dermis, deeper tissue & organs Perforating: foreign body enters and exits an internal organ
Healing
GI tract- scar tissue can cause ADHESIONS which may lead to pain and alteration in bowel elimination Bone healing-1st stage is soft tissue healing. Blood clots occur between the ends of the bones. Granulation tissue then forms called procallus. 2nd stage-osteoblast enter the area and form cartilaginous tissue called callus.(similar to bone except it does not have calcium salt. Tends to be softer). 3rd stage-tissue remodels and calcium salt is laid down resulting in stronger bone.
Healing
Nerve tissue healing: Central nerves do not heal Peripheral nerves have shown to regenerate. Schwann cells form a sheath around the nerve fiber which is the key to regeneration. The avg regeneration is 2mm/day. If the connective tissue growth occurs over the path of the nerve fibers, the growth will be stopped. Hence there needs to be careful alignment of the nerve fibers at the close of a surgery to ensure healing.
Tissue separation-Fistula
Is an abnormal passage between two organs or between an organ and outside the body. Sometimes created intentionally by surgeon for TX reasons, may be the results of poor wound healing, trauma, radiation exposure, infection, disease state, cancer, and chronic drainage tracts.
Continued
At risk are the malnourished, infections, and morbid obese May occur with exaggerated coughing, vomiting or straining. Prevented with splinting the incision!!
Tissue separation-Evisceration
Is the total separation of the
wound layers. With protrusion of the organs through an opening. This is a true MEDICAL EMERGENCY What actions should be taken by the nurse?????
Blood tinged amber fluid consist of serum Normal for 1st 48hrs after injury Sudden increase in amount precedes wound dehiscence in wounds closed by 1st intention
Characteristic: creamy yellow pus, greenish-blue pus causing stain on dsg w/ fruity odor, brownish pus w/ fecal odor Significance: colonization w/ staphylococcus, pseudomonas, proteus, aerobic colliform and bacteroides (usually after Gi surgery)