Question

10-4Thinking It Through

Frank Gello is very excited about his new position as a surgical technologist at the local hospital, although he is somewhat intimidated by the person who is orienting him and is anxious to complete his training and work more independently. As they set up for the next surgery, his preceptor positions himself on the opposite side of the sterile field. As Frank opens the sterile instruments to place them on the sterile field, his preceptor talks him through the procedure and on several occasions he reaches across impatiently to move Frank's placement of the instruments. Frank also knows that he should check all of the packaging on the instruments for integrity to insure sterility has been maintained, but his preceptor abruptly states “I have already done that. Don't waste my time. Keep going as the surgeon is arriving in a few minutes.”

Does this scenario refer to medical or surgical asepsis? What is the difference between medical and surgical asepsis?

Were any of the aseptic principles broken? If so, what are they?

Should Frank perform a double-check on the packaging to verify the integrity of the sterility of the instruments even if his preceptor states he has already performed that check?

Answer 1

This scenario refers to surgical asepsis. In the given case study it is clearly stated that sterility check of instruments should be ensured. Surgical asepsis is ensuring an environment free from all microorganisms,If present it leads to infection to patients. Usually surgical asepsis is used when a foreign object is being introduced into a patient body,thereby opening a possible route of transmission for an infectious agent. For example if a patient needs a urinary catheter,it should be inserted in patients bladder using surgical asepsis. All the components involved in the procedure-tools,work area and workers must be free of micro organisms. While Medical Asepsis is a cleaning technique but not sterile technique.All practices that reduces growth,transfer and spread of micro organisms. They include hand washing,bathing,cleaning,wearing mask ,use of antiseptics etc.

Yes , aseptic principles are broken. One should not talk while they are near patient or in operation theatre. The instruments which are sterile will get infectious again by continuous talking, as droplets of saliva contains huge number of micro organisms. It is also stated that the preceptor moves impatiently to change the place of instruments. This should be avoided as the patient should be given enough space ,without touching them . If at all there is a need to touch a technologist should wear gloves.

Even if the preceptor says that he has already performed the check of instruments, Frank should recheck again as it is his duty to check and keep the patient in a safe zone by avoiding spread of infectious organisms. Staff should not take any risks in case of patients health.