Good Evening !!!!!!!

POST OPERATIVE INFECTION TROUBLE SHOOTING

PRE - OPERATIVE

INTRA – OPERATIVE

POST - OPERATIVE 

PRE - OPERATIVE

OUT PATIENT DEPARTMENT

WARD

THEATRE

OUT PATIENT DEPARTMENT Preop. examination Lids – blepharitis, meibominitis, chalazion,

pustules. Conj – congestion Cornea – Infiltrate , KPS Uveitis Investigations - Duct

-

Culture/Sensitivity

WARD

Instillation of regular antibiotic drops – 4 Times

Proper cleaning of eyes.Scrutinizing the case sheet.Preop. Counselling.

THEATRE

Patient factorNurse factorInstrument and Sterilization factor.Theatre products factorSurgeon factor

PATIENT FACTOR

Hygiene and cleanliness of individual.Difficulty in communication due to old

age ,illiteracy and deafness.Not telling about other systemic diseases

and hence the importance of proper Counselling.

NURSES FACTOR Personal hygiene Uncorrect way of washing and scrubbing. Contact with unstrelised part of microscope/ other

machines. Reuse of instrument should be avoided ie., From one

table to another table. Surgeons and scrub nurses should avoid keeping in

touch with the back side of the Table ( due to unsterility)

Running nurse should avoid contact with sterile area.

INSTRUMENTS AND STERILIZATION Proper and strict sterilization to be maintained

in all theatre activities. Block room OT Table In Between Sterilization General Sterilization Gas Sterilization Over all OT Atmosphere

BLOCK ROOM

Eye cleaning – TWICEInstillation of Eye Drops in sterile

mannerUse of sterile needles and swabs.

OT TABLE

Check the holes in the autoclaved bin Eye cleaning – 3rd time Sterile draping Checking the sterility of

instruments RL bottle Viscoelastic ( Autoclaved )

Cautery forceps Syringes Vitrectomy cutter Simcoe cannula Phacotubing Cassette Cannula , IV set Irrigating Vectis Microscope-sterile cups Gloves  Running nurses should always open the surgical things

in a sterile manner.  

IN BETWEEN STERILIZATION Strict usage of gloves. Washing of instruments with boiled mineral water. Simcoe cannula,phacotip, I/A hand piece, cannulas, vectis

all things should be washed with RL. KNIFE sets to be washed in a separate basin ( Boiled

water ) Autoclave indicator tape to be kept separately in each

instrument tray. Sterilization timing should be followed as below as 30 pound pressure : 121 degree Centigrade Temp : 10 Min Check the colour change in the indicator. Check whether the autoclaved things are dry.

GENERAL STERILIZATION Basin – 4 Mineral Water washing with Bodetex Forte Instruments should be Cleaned with brush and dried . Sterile Tip – Covered Bin should be washed and kept dry. Instruments bin should be packed loosely. Auto Clave indicator should be kept in 4 places. Daily dispose the Visco cannula . All Instruments should be cleaned once in 15 days

using Ultra Sound Cleaner. Sterilization timing should be followed as below as 20 Pound Pressure : 121 degree Temp : 45 Min

GAS STERILIZATION

All the plastic items should be

re-sterilised with Ethylene Oxide.Properly seal the cover.Strictly follow the gas Sterilization time .Check the colour change in the indicator

tape.

OT Cleaning OT should be cleaned thoroughly. Weekly once OT floor and Tiles should be washed. AC Filter should be cleaned weekly twice. Monthly once OT Culture should be taken. Daily Formaline Fumigation should be carried out at

OT. After OT Cleaning nobody should enter till next

morning. Stretcher Should be kept for inside and Outside

separately. Linen should be washed within the OT campus. Water tank should be cleaned once a month.

The Floor, tiles , Furniture etc., should be cleaned using the chemical as below  

Floor - Microl – F Tiles - Microl – F Furniture - Instrulean Equipments - Bacillol Instruments - Bodetex Forte

POST OPERATIVE CARE

Before cleaning the operated eye , sister should wash her hand.

After surgery, the patient eye should be cleaned properly.

After cleaning 20 patients, use hand rub to clean hands again.

The drops should be applied in Sterile Method. Ward should be clean. After surgery , post-op counselling should be advised. In case of patient feeling excessive pain, watering or

congestion inform doctor immediately.

Thank You Very much !!!!!!!