Sterilization Validation and Surgical Care Protocols

Sterilization Validation Process

The objective of the sterilization validation process is to ensure effective sterilization.

Physical Controls

These involve charting values such as pressure, temperature, time, and humidity.

Chemical Controls

These are chemical compounds that change color when they interact with the sterilizing agent:

• External: Indicates that the sterilizing agent reached the surface of the package.
• Internal: Placed into the package. These confirm if the sterilization conditions were appropriate inside the package.
• Operation: Used to verify that the steam in the autoclave reaches every corner of the apparatus. This is used daily at the beginning of the day to check the vacuum autoclave for proper working. The Bowie-Dick test is the most common; it is a paper impregnated with a compound that changes color if successful.

Biological Control

These devices use microorganism spores that undergo a sterilization process. They are then placed in favorable conditions for growth; no development occurs if the sterilizing agent has worked correctly.

Types of Surgical Assistance

• Major Surgery: High-risk and complex interventions for the patient. These are performed in hospital operating rooms and require admission.
• Minor Surgery: Short and simple interventions with minimal risk, performed in health centers or clinics. In both cases, there is a risk of infection because the skin barrier is broken.

The Three Stages of Surgery

1. Preoperative: Starts when the decision to perform surgery is made and ends at the beginning of the intervention.
2. Surgery: The duration of the intervention (minutes to hours).
3. Postoperative: Begins when the patient enters the resuscitation or recovery unit and ends upon discharge (including wound care and stitch removal).

Preoperative Care and Objectives

The objective is to ensure the patient arrives at the operation in the best physical and psychological condition to decrease the risk of complications during and after surgery. The duration and care are variable. Nursing care includes:

• Assisting in complementary testing.
• Helping with the patient's body cleansing using antiseptic soap (umbilical area, nails, armpits, nostrils, and oral hygiene).
• Shaving the area to be operated on.
• Applying cleansing enemas.
• Assisting with food, nutrition, and hydration (the patient should not eat or drink before the operation).
• Assisting in the collection of vital signs records.
• Instructing the patient on mobilization and postural changes.
• Managing medication orders.
• Ensuring the patient urinates before the operation.
• Removing dentures, hearing aids, and contact lenses to be delivered to the family.
• Transporting the patient to the operating room: the patient should be clean, wearing a gown, with hair gathered (with or without a cap).
• If moving the patient in a bed, ensure clean linens are used.
• Accompanying the patient with their clinical history.
• Preparing the unit to receive the patient after the intervention and providing psychological support.