Operating Room Observation

Information

Surgical Attire

Staff changed into scrubs at the hospital
Top is secured at waist, tucked in or close to body
Al hair is covered
No visible jewelry worn by scrubbed and non-scrubbed staff
Mask is worn by (secured with both ties) in the presence of open sterile items and equipment
Cover gowns/jackets are worn and secured to prevent inadvertent contamination while walking past sterile field
Dedicated shoes or shoe covers are worn

Sterile field is prepared close to time of surgery <1 hour
Sterile items are transported in covered or enclosed cases/carts
Sterile packages are inspected for punctures, tears, and expiration dates
Sterile field is maintained troughout the procedure with traffic patterns established with a minimum of one foot perimeter respected by the unsterile personnel
Sterile items are presented to scrubbed person or placed securely on field
Liquids are poured only once, without splashing, and the remainder is discarded
Draping is accomplished in a sterile manner:<br> * Draping is performed by a minimum of two people<br> * Hands are "cuffed" while presenting drapes to unsterile personnel<br> * Anesthesia screen is not dropped prior to placement<br> * Drapes are not lifted or moved after placement
Items are flashed sterilized only in an emergency situation and a closed container is used or transport to the sterile field

Hair is removed using clippers
Skin prep is performed according to manufacturer's directions and aspectic technique
Type of Prep used
Sufficient drying time is allowed prior to draping

Horizontal surfaces are free of dust and organic debris
After procedure, reusable patient items such as straps are cleaned between uses
After procedure, visibly soiled areas of the floor (three to four feet perimeter around the bed) is mopped free of all blood and debris
OR doors are closed between cases
Scrub tech removes excess tissue from instruments
Enzymatic spray prior to delivery to CS
Operating room's environmental temperature and humidity temperature range 68-73 degrees and humidity range 30-60%. Staff takes and documents corrective action if temperature and humidity ranges are not met
Linen, equipment and supplies are properly stored within the operating room and OR department, including appropriate covers and storage practices to minimize the potential for dust and contamination

Medications are labeled appropriately when in use
Safety devices are used whenever possible
Refrigerators are specific for medications, staff foods, etc.
Sharps are removed and disposed of appropriately at the completion of each case
Sharps containers are accessible, secured to wall/counter and emptied when the "full" line is reached
Unused medications/fluids are disposed of at the end of each case
Fluid warmers are checked for approved temperature ranges each day the OR is functioning. If the OR is closed it is documented on the warmer log.
Dirty / clean equipment is stored separately
Glass is disposed of in rigid sharps containers
Biohazard waste is labeled and covered
Cleaning supplies are labeled
Approved cleaning supplies

Soiled linens are placed in designated covered hampers
Under sink storage is limited to disinfectants / cleaners
No eating or drinking in patient care area
Clean equipment is labeled clean / clean label removed for used equipment
All sterile supplies are dry with intact packaging, not stored on the floor
Low storage areas must have solid surface shelving
Storage of sterile supplies is 8-10" above the floor and 2" away from exterior walls
Ice scoop is not stored in the ice machine
Staff know where to find and how to access infection prevention policies and procedures
CDC isolation guidelines are available on isolation carts or other designated areas in the department
Staff are aware of when to use Airborne isolation and which rooms are negative pressure
Staff are knowledgable about blood spill protocol
Staff know the kill time for disinfectants used
Staff have access to and are familiar with the MDRO list
Staff have knowledge of hand hygiene requirements and practice these requirements