Surgical Safety Measures

Introduction:

Aseptic technique can be referred as the precautionary measure that is performed in operation theatre to avoid chances of contamination by any type of pathogens such as bacteria and virus to the surgical wounds (Andersson et al. 2018). This project report is going to discuss the importance of using aseptic technique inside operation room with depicting the aseptic procedures that are maintained inside the theatre to reduce the level of infection and pathogens contact into the surgical wound. With using evidence-based information this report will also discuss the needs of using aseptic technique during anaesthesia before starting surgery. The project report will also state the importance of using ANTT (Aseptic Non-Touch Technique) inside the operating room. With using proper evidences, the report will also state the risk associated with poor aseptic technique that pose adverse impact on overall surgical process.

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Background of the project:

Aseptic techniques are strictly maintained inside operation rooms, in terms of reducing as well as eliminating the chances of contamination of surgical wound by any types of pathogenic organism such as virus, fungi and bacteria (Dhakal et al. 2016). During operation, inside the operating room, only sanitise, clean and disinfect the medical equipment are not enough for maintaining sterilise environment inside the OT theatre, rather than doctors and nurse need to follow the standard and guidelines of aseptic techniques in term of eliminating the chances of access of any type of pathogens to the surgical wounds. One of the most common sources of microbes is human body, in which many pathogens can gather as well as colonise, but do not cause any health issues until they get direct access to tissues or blood in the human body (Team, 2019). During a well as just after the surgery, the wound is open and the patient is highly prevalent to affect in any pathogens to the wound area. Therefore, inside the operation room, health professional and the healthcare staffs maintain all the guidelines and standard associated with maintaining aseptic technique inside the OT, such as sterile all the surgical equipment that are need during surgery, sterilisation of anastasis needle, proper handwashing before as well as after the surgical process, use of surgical scrub and antimicrobial soap, sterilise surgical clothes and protective devices(Malik, 2019). In addition to this, healthcare board also assure that entire surgical team including doctors, nurse other healthcare staffs are highly professional in using aseptic techniques accurately as mentioned in the guidelines in terms of eliminating any chances of negligence and poor implementation of this technique inside the OT.

Discussion:

Findings:

Importance of aseptic techniques in operation theatre (OT):

In operation theatre using aseptic technique is one of the most crucial as well as necessary practice that assists all the health professional and healthcare staffs present in operation room to maintain sterile environment inside the room in terms of assuring that operating room is free from access of any pathogens. As mentioned by Hawker (2019), inside operation room aseptic technique is important for separating the operating room from outside non-sterile environment. Under the guidelines set by NICE (National Institute Care and Excellence), surgical team is obliged to abide by as well as follow the principles associated with using aseptic techniques inside the operation room in terms of sterilising all the surgical equipment and additional accessories that are used in this surgery (Kengar et al. 2019). Using aseptic technique inside the operation room, is also important for maintaining asepsis condition (free from any infection) inside the OT. In addition to this, academic based report have suggested that, using aseptic technique is not only important in reducing as well as eliminating chances of infection in surgical wounds but also assist the surgical team to make perfect maintenance of each surgical equipment by sterilising all of them , so that they can be used again in surgery. Therefore, aseptic technique assists healthcare authority to minimise their expenditure in buying surgical equipment that can be easily maintained through using sterilisation and aseptic procedures (Merry et al. 2017). Another importance of aseptic technique inside the operating room is this process enhances the quality and chances of success of entire surgical process, through maintaining sterile and fresh environment inside the operation room, which eliminates the chances of any infection in the wound. In this context Andersson et al. (2018) mentioned that, just after the surgery, patient is highly vulnerable to contamination different pathogens that can cause serious health issues such as infection in the surgical wounds, high fever and death. Therefore, aseptic technique assists the surgical team to maintain the sterile and asepsis environment inside the operation room, that eliminates the chances of contamination by pathogens to the wound thereby protecting health and wellbeing of patients. In this context Thomson and Francis (2019) stated that, on aseptic technique is important for each stages of a surgery. For anaesthesia that is done before the surgery, it is important for anaesthetists to use aseptic technique to sterilise the needle as well as the other additional equipment associated with the antithesis of patients which ensures that patients is now ready to be gone through the surgery. Aseptic technique is also important inside the operation theatres in term of performing innovative clinical intervention during surgery which is needed to meet the complex as well as critical needs of patients suffering from chronic disease.

Importance of using ANTT inside OT:

ANTT or Anti Non-Touch Technique, is modern aseptic technique used in the healthcare, specially inside the operation room, that prevents contamination of any surgical wounds as well as any susceptible sites by pathogen by assuring that only sterile fluids and objects would be in direct contact with these wounds (Goel, 2017). Association for Safe Aseptic Practice (ASAP) has mentioned that, under the Health and Social Care Act 2012, it is obligatory for all health professionals as well as healthcare staffs to use standardised aseptic ANTT technique inside the operation room during the surgery. The ANTT practice has improved the overall aseptic techniques used inside the OT by standardising the process in two ways, such as by introducing practice method that consist of robust sets of principles for healthcare professionals to maintain safe and sterile environment inside operation room and by assuring widespread use of the ANTT process into common medical intervention process to improve the quality of surgery (www.nursingtimes.net, 2001).Under the ANTT guidelines set by NICE and Association for Safe Aseptic Practice (ASAP), healthcare professionals are obliged to abide by entire principles of ANTT in the operating room that are as follows:

Health professionals need to be highly professional as well as skilled in conducting sterile as well as safe environment management inside the operation room, by using surgical ANTT procedures (Team, 2019). In this context, health professionals would be able to determine the associated risk and take proper risk assessment process in terms of eliminating the risk to reduce the chances of infection during surgery. Through using proper ANTT process, the working areas as well as surfaces inside the operation theatre would be disinfected (anmj.org.au, 2019).

Health professionals are obliged to have proper understanding about asepsis and how it can be maintained inside the operation theatre to eliminate chances of contamination of wound by pathogens (Malik, 2019). Poor knowledge regarding using aseptic techniques and ANTT process, would enhance not only the chances of patient’s infection but also raises the chances of community spread of disease that can lead to morbidity and mortality of entire community

During surgical ANTT, health professionals need to assure that they performed the equipment and personal decontamination in terms of protecting not only patient from attack of any pathogens but also the entire surgical team from being affected by contagious infection and disease (Hawker, 2019). In this context, health professionals need to abide by all the rules of surgical ANTT process such as washing of hands in proper manner, using surgical hand scrubs, sterilising gloves, clothes, surgical equipment, gown and using sterile mouth as well as eye protection devices (www.nursingtimes.net, 2001).

During using the surgical ANTT process, health professional must have proper understanding of aseptic field selection and management (Kengar et al. 2019). In this context, doctor would assure that the surgery is going to be held in a large critical aseptic field in which there is no chances of contamination by pathogens. In addition to this, health professional will also assure that, only sterilised equipment such as sterilised fluids and instruments would be in direct contact with the patients during surgery, which assure the protection of patient from any type of infection and disease.

Health professionals need to follow the standard and guidelines of maintaining non-touch technique inside operation theatre in which despite wearing sterile gloves health professionals wouldn’t tough the key sites and key part until there is urgent needs to touch them.

For cleaning and sterility of anaesthetics and surgery, health professionals need to use spirit and sanitizer (www.nursingtimes.net, 2001). Before using the surgical instrument and wearing surgical clothes, surgical team always use sanitizer in terms of sanitizing their hand. This process assures that there would not be any chances of entry of pathogen through the hand of the members of the surgical team. While using anaesthetic drug, the anaesthetist always uses gloves to maintain hygiene and aseptic process in the OT (anmj.org.au, 2019). The surgical team always avoid touching any objects, instruments or skin of patients by their hand, in terms of reducing the chances of infection. In addition to this, health professional also maintains sterile environment inside OT by reducing chances of infection.

Needs of Aseptic technique in anaesthetic procedure inn OT:

Anaesthesia can be defined as the balanced state of unconsciousness, that is accompanied by paralysis of skeletal muscles and absence of pain sensation (Kengar et al. 2019). During surgery, anaesthesia, is one of the most important process that is done by the professional anaesthetists to paralyse the muscles and tissues at the site in which the surgery will be done. Surgical ANTT and aseptic technique is highly crucial and mandatory, in case of conducting anaesthesia, in which the anaesthetist sterilise the needle, gloves, knife and other important clinical equipment needed for conducting successful anaesthesia. As mentioned by Merry et al. (2017), surgical ANTT assists anaesthetists to eliminate chances of entry of pathogens into patient’s body through injection. As in case of anaesthesia, injection in given into the necessary body part, there is high chances of direct contamination of patient’s blood by pathogens if the anaesthetist does not use surgical ANTT process during anaesthesia. On the other hand, sterilisation and disinfection of entire equipment used in the anaesthesia is important for assuring that the correct dose of anaesthetic medicines is injected into patient’s blood. As mentioned by Thomson and Francis (2019), anaesthetists need to have proper understanding about the guidelines and principles of aseptic techniques in terms of using the in proper manner during time of anaesthesia so that there will not be any chances access of pathogens to the surgical wounds. If aseptic techniques are not used inside the operation theatre by anaesthetist during anaesthesia, pathogens can get direct contact with patient’s blood through unsterilized needle, which then restricts the entry of the medicines into muscle thereby causing pain and infection (Puehler et al. 2017). Therefore, during anaesthesia before surgery, it is important for anaesthetists to use aseptic techniques in terms of assuring that all equipment that are used in this process are properly sterilised and disinfected to restrict entry as well as contact of microorganism and pathogens to the surgical wound of patient.

Analysis:

Analysing how using aseptic technique in the surgery is associated with the sooner recovery of wounds:

Through using aseptic technique, health professionals can protect the surgical wounds from contamination by any pathogens such as bacteria, fungi and virus. In addition to this, through using the surgical ANTT, health professionals assure that all the standard and codes of practices associated with using aseptic techniques is maintained during surgery to arrange sterilised and disinfectant environment inside the operation room. As mentioned by Puehler et al. (2017), for healing of wound it is important that wound is not only protected from contamination by pathogens but also wound would be cared properly by using disinfectant spirit, proper way of using medicines on the wound and maintaining hygienic environment surrounding the patient. Using surgical ANTT, health professionals are able to maintain clean and hygienic medical environment inside the OT as well as in the post-operative cabin for patient that improves the condition of wound and susceptible sites to be healed easily with use of proper medicines and regular dressings (Kengar et al. 2019). Aseptic technique inside the operation room, not only assists health professional to protect the wound of patient from any infection but also assist them to manage healthy and disinfectant environment inside operation room by separating OT from outside non-sterile environment, that protect surgical wounds from contact of any pathogen. In addition to this, by using aseptic process during surgery, it is possible for health professionals to use such sterilised fluids that can improves the overall blood supply and antibody formation at the site of wound that leads to sooner recovery of surgical wounds

Analysing the risks associated with poor aseptic techniques:

Poor aseptic techniques are associated with serious risk which are as follows:

Improper sterilisation of eth key surgical equipment and key sites will enhance the chances of direct contamination of the surgical wound by pathogens which not only cause infection in susceptible sites but also can lead to death of patient due to organ failure (Kengar et al. 2019).

If health professional included in the surgical team are not properly trained as ell as skilled in suing aseptic techniques and surgical ANTT, they would not be able to maintain sterilise and disinfectant environment inside the operation room (Merry et al. 2017). This not only enhance the chances infection of patients but also enhances the chances of spreading of contagious infection to the health professional as well as to the entire community.

If contaminated items are not removed from the operation sites during using surgical ANTT in inside operation room, single tough of these items with the clothes and others key equipment of surgery can make direct contact of pathogens to the susceptible sites in patient that will enhance the chances of infection as well as development of chronic diseases in them

Recommendation:

In term improvising the usage of aseptic technique inside OT, the health professional are recommended to do the below things:

Healthcare authority should enhance the inclusion of healthcare professionals and health care staffs into the training and development program regarding usage of surgical ANTT during surgery. In addition to this the healthcare authority will enhance the number of self-assessment test for surgical tea reading the use of aseptic technique during surgery.

Healthcare authority need to invest more money in improvising the overall aseptic technique by buying sterilising machines innovative instruments and highly modern clothes and gown for health professionals that will assists them to make betterment of the entire surgical process by using innovating aseptic tools rather than using the traditional one

Health professional should develop their professional standard as well as knowledge in using aseptic technique during surgery for assuring zero chances of infection in surgical; wounds.

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Conclusion:

From the overall discussion it can be stated that, aseptic technique is most important process during the surgery, that assists surgical team to create sterile environment inside operation theatre to protect patients from any kind of infection. Aseptic technique is associated with every aspects of surgery that assists health professionals to separate operation room from non-sterile environment outside by sterilising and disinfecting the key sites and key equipment. Finally, the report concludes that health professionals need to have proper understanding about using aseptic technique in correct way otherwise poor application of this technique can create severe health risk in patients as well as in the entire community through contamination of disease.

Reference list:

Andersson, A.E., Frödin, M., Dellenborg, L., Wallin, L., Hök, J., Gillespie, B.M. and Wikström, E., 2018. Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study. BMC health services research, 18(1), p.2.

Dhakal, B., Angadi, S. and Lopchan, M., 2016. Nurses' knowledge and practice of aseptic technique in the operation theatre at selected Hospitals of Bharatpur. International Journal of Nursing Education and Research, 4(3), pp.276-278.

Goel, A., 2017. Planning and management of operation theatre complex. Journal of Evolution of Medical and Dental Sciences, 6(30), pp.2471-2473.

Hawker, C., 2019. Aseptic technique: a mixed methods study exploring undergraduate nursing students' education and training in the United Kingdom (Doctoral dissertation, Cardiff University).

Kengar, M.D., Mane, I.V., Gaikwad, N.A., Tanboli, J.A. and Magdum, C.S., 2019. Aseptic Technique to Prevent Contamination. International Journal of Advanced Research in Medicinal Chemistry, 1(1), pp.1-7.

Khurana, S., Saini, S.S., Sundaram, V., Dutta, S. and Kumar, P., 2018. Reducing healthcare-associated infections in neonates by standardizing and improving compliance to aseptic non-touch techniques: A quality improvement approach. Indian pediatrics, 55(9), pp.748-752.

Malik, R., 2019. Assess the knowledge and practice regarding scrubbing technique among staff nurses working in operation theatres.

Merry, A.F., Gargiulo, D.A., Sheridan, J., Webster, C.S., Swift, S., Torrie, J., Weller, J., Henderson, K. and Hannam, J.A., 2017. Incorrect representation of aseptic techniques. European Journal of Hospital Pharmacy.

Puehler, T., Dia, M., Ibishi, A., El-Hashem, G., Renner, A., Hakim-Meibodi, K., Ensminger, S., Boergermann, J., Zittermann, A. and Gummert, J., 2017. Carotid Artery Stenosis does not Increase the Perioperative Risk of Stroke in Patients Undergoing Aortic Non-Clamping and No-touch off-pump Surgery-A Retrospective Single-Center Analysis. The Thoracic and Cardiovascular Surgeon, 65(S 01), p.OP189.

Team, A.F.E., 2019. Aseptic Technique (ANTT®) Tutorial. Acute Care.

Thomson, B.N. and Francis, D.M., 2019. Surgical techniques. Textbook of Surgery, pp.35-44.

Wikström, E., Dellenborg, L., Wallin, L., Gillespie, B.M. and Andersson, A.E., 2019. The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action. American journal of infection control, 47(3), pp.251-257.


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