4. Anchor the cuff on your thumb. With yourfingers still under the cuff, pull the cuff up andaway from your hand and over the knitted cuffof the gown.5. Repeat the preceding step to glove your otherhand.6. The gloving process is complete.To gown and glove the surgeon, follow these steps:1. Pick up a gown from the sterile linen pack. Stepback from the sterile field and let the gownunfold in front of you. Hold the gown at theshoulder seams with the gown sleeves facingyou.2. Offer the gown to the surgeon. Once thesurgeon’s arms are in the sleeves, let go of thegown. Be careful not to touch anything but thesterile gown. The circulator will tie the gown.3. Pick up the right glove. With the thumb of theglove facing the surgeon, place your fingers andthumbs of both hands in the cuff of the glove andstretch it outward, making a circle of the cuff.Offer the glove to the surgeon. Be careful thatthe surgeon’s bare hand does not touch yourgloved hands.4. Repeat the preceding step for the left glove.Cleaning the Operating/Treatment RoomCleanliness in the operating room is an absolutemust. Cleaning routines must be clearly understoodand carefully followed. The cause of postoperativewound infections have, on occasion, been traced to theoperating room. Since no two patients are alike and allpatients have their own “resident” bacteria, everysurgical case must be considered to be contaminated.At the beginning of each day, all the fixtures,equipment, and furniture in each operating room willbe damp-dusted with an antiseptic germicide solution.During the operation, keep the room clean and orderlyat all times. Should sponges be dropped on the floor, orif blood or other body fluids spill, clean the areaimmediately using a disinfectant germicide solutionand a clean cloth. Between operations, clean all useditems. The area of the floor occupied by the surgicalteam must be cleaned using the wet vacuum method. Ifa wet vacuum is not available, mops may be used, but aclean mop head must be used following eachoperation. Gowns and gloves must be removed beforeleaving the room. All linens and surgical drapes mustbe bagged and removed from the room. All trash anddisposable items must be bagged and taken from theroom. All instruments must be washed by glovedhands or placed in perforated trays and put through awasher/sterilizer.At the completion of the day’s operations, eachoperating room should be terminally cleaned using anantiseptic germicide solution and the following tasksaccomplished.Clean all wall- or ceiling-mounted equipment.Clean all spotlights and lights on tracks.Thoroughly scrub all furniture used in the room,including the wheels.Clean metal buckets and other waste receptaclesand, if possible, put them through thewasher/sterilizer.Clean scrub sinks.Machine scrub the entire floor in each room. If amachine is not available, use a large floor brush.Suction up the disinfectant germicide solutionthat is used on the floor, using a wet vacuum. Ifmops are used, make sure a clean mop head isused for each room.NOTE: The use of mops in the operating roomis the LEAST DESIRABLE method ofcleaning.MANAGEMENT OF INFECTIOUSWASTELEARNING OBJECTIVE: I d e n t i f ymedical waste sorting, packaging, handling,and disposal procedures.Concern about potentially adverse effects ofinfectious waste on public health and the environmenthas gained widespread media attention. Whilescientific evidence shows that infectious waste is nogreater threat to the environment or public health thanresidential solid waste, medical facilities are perceivedto be a source of pollution. It is, therefore, imperativethat a medical facility establish an effective plan fordealing with infectious waste. This plan shouldinclude the segregation, packing and handling,storage, transportation, treatment, and disposal of such2-37
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