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preoperative environment

How can a nurse maintain infection control and
prevention in the perioperative environment?
Identify a nursing problem or issue that relates to the specialty area of practice in which
you are completing your clinical placement for this unit.
Once you have identified a nursing problem/issue you will need to develop this into a
question for exploration which is subject to approval by your LIC/Tutor. This question
needs to be realistic in the context of your speciality clinical placement in relation to
nursing practice. This question will lead you to contemporary literature. From your
reading of this literature you will discover what is known or not known about your
question. The information that you have gained from your reading and your observation of
practice should then enable you to draw conclusions concerning your nursing question.


Perioperative environment maintenance will include the visual cleaning and inspection of
the operation theatre’s horizontal surface and anesthetic rooms preoperatively (Ousey et al.,
2015). The maintenance will also include the surgical lights, equipment, operating table and
furniture. The practice will be intraoperative to ensure that contamination is kept to the lowest
level. Terminal cleaning and postoperatively practice is done after each procedure at the end of
the operating lists. It is the role of the nurses to carry out preoperatively environment cleaning
and also oversee the delegation of cleaning tasks in an appropriate manner (Bowlt & Gasson,

Topic Identification
The topic under study under this research will entail the investigation of the best
strategies for controlling, prevention and maintenance of the preoperative environment. The
topic will expound more on the effective measures adopted by the nurses in ensuring the efficient
prevention and control of the infections in their area of practice that is the preoperative
environment (Wood et al., 2014).
Background Information
Effective prevention and control of infections must be everyday practice that should be
consistently applied by everyone. Safe working practices must be adopted regardless of the
suspected or known infections. The standard precautions will efficiently access the operations or
activities to be completed (Bowlt & Gasson, 2013). It is the right of every patient to be treated
with respect and dignity. One way of achieving this is the effective maintenance of the
preoperative environment. Standard precautions will be vital in the elimination of infection risks
in the most appropriate way. The topic will explore on some of the best ways to enhance the
operations are done successfully enough to bring positive results (Ousey et al, 2015). The
exploration will be made possible through the collection of information and necessary data from
the various sources.
Scope of the Report
The scope of the report will focus on the adherence of the measures that will ensure long-
term maintenance of the preoperative environment. The scope of the practices in which the
report will concentrate on will be based on the adherence to the standard precautions by the
nurses in the maintenance of the pre-operatively environment (Sallasa et al, 2014). Identification

of the principles that emphasize on the appropriate practices performed by the nurses at their
place of the work as they try to reduce the risks of infections will be essential.

Literature Review (Synopsis of the Articles/Journals)
According to the article inter-operative nursing care article, the main goal of the nurses in
this field will entail the safeguarding the rights of patients for the best surgical outcomes
(Kelvered et al, 2012). The environment and health are the main focus while carrying out the
individualized nursing care procedures. The nurses ensure patients safety through maintenance of
the aseptic environment, checking the amount of sterile equipment and also observing the
position of the patients. It is also essential to monitor circulation and fluid losses in the patients.
The introduction of the WHO checklist will promote the teamwork in the surgical team
especially the preoperative safety check (Kelvered et al, 2012).
In the journal patient culture and patient’s safety, evidence reviewed for the report credits
the work and efforts of the nurses in maintenance of the preoperative environment despite the
many threats to the patient safety. Mitigation of errors will be the basis for the efficient
performance of tasks in the theatre. The implementation of the evidence based for reducing the
surgical related infections e.g. the central-line associated blood stream infections will be crucial
in the prevention and control of infections in the pre-operatively environment. The vigilance by
the nurses is needed in many tasks to reduce the errors that mostly affect the patients under their
care. According to (Ulrich & Kear, 2014) the nurses also need to be proactive as they perform
the maintenance tasks to cultivate a patient safety culture which will highly reduce the high
prevalence of the infections occurring in the preoperative environment.

In the journal Nurses perception of standardized assessment, it is essential for nurses to
have positive perception that would help them in observance of the procedural standards for
controlling and prevention of infection arising in the pre-operative environment. The nurses are
supposed to carry out exposure prone procedures in their tasks. Provision of the sufficient
evidence confirming that the nurses have no infections is vital. The evidence concerning their
immunity should also be presented by the nurses as they seek to start their mission in effective
maintenance of the preoperative area from the various infections (Soh et al, 2013). Maintenance
of the personal hygiene by the nurses will be vital as they play a major role in influencing the
environment. The nurses ought to wear the theatre attire to minimize the transfer of the
microorganisms from the skin, mucous membrane to the patient from the surgical team.
Data collection Methods
Data collection will be essential in the acquisition of important information regarding the
project. Critical observation was made from the local health centers that have implemented these
measures and practices as proposed by the journals. An integrative literature review was
undertaken to collect information. The use of questionnaires and conducting interviews will be
necessary for the data collection process. The main interviewees will be some of the patients and
families that have undergone the theatre operations or had any experience concerning the
preoperative environment (Sallasa et al., 2014). The questioners to access the effectiveness of the
practices in reducing the infections risks as confirmed by the nurses and other health workers
will be used to collection information. The documented sources will be used as materials to
obtain data about the previous practices that were effective in reducing risks of infections. The
study methods carried out earlier before this research, were also were also adopted as sources of
the study that is vital information for the project (Salassa et al, 2014). The books and journals

will also be used as materials for collecting information concerning the appropriate standard
procedures for maintenance of the preoperative environment. The methods of collecting the data
were reliable and valid in nature which facilitated the effective acquisition of data from a large
number of respondents (Galor et al., 2013). The data can also be used to carry out statistical tests
to a show effectiveness of results.
It is important to replicate the project that promotes the adherence of the procedures and
strict observance of the standard procedures by the nurses. Similar projects have shown positive
results after their implementation (Farthing et al., 2013). Assessment of the results from the
project also approves the adoption of the project. In this case, the experiment project can be
replicated in future projects.
The results acquired after the implementation of the project indicate positive outcomes.
The operation related infections have reduced immensely as indicated by the statistics provided
by some of the healthcare centers where the project measures were implemented. The infections
have reduced from 15% to 10%.The maintenance of hygiene; sterilization and appropriate
handling of surgical equipment have been found to be most effective in control and prevention of
infections in the preoperative environment.
Discussion of observation/Conclusion
According to the results of the project after critical assessment, the adherence to the
standards and procedures of maintenance will be effective in reducing infections. These
measures will require the commitment of all nurses and support of the other health workers
(Farthing et al, 2013). These results will approve the importance of hygiene as key in prevention
and control of infections. In my area, statistics provided by the various health centers credits the

adherence to standards of procedural by nurses as practice that should be adopted for the
effective maintenance of the infections in the pre-operative area. The method used in acquiring
the results has its main limitation that is the acceptance rate and to be approved as most effective.
These results will be applied in areas with high prevalence of infections in the preoperative
Nurses should comply with glove procedure, gown and also the surgical rub requirements
whenever working in the theatre environment. Adherence to the hygiene policy is crucial for
observance by all the nurses as it helps in reduction of infection risks. Sterile field maintenance
observed by the nurses will ensure safe preoperative experience by the nurses (Wood et al,
2014). Safe transportation of endoscopes to the containers by the nurses should be ensured. The
endoscopes should be stored in designated places. Disinfection and cleaning of endoscopy
policies should be enhanced by the nurses working in the preoperative environment to reduce the
contaminations and risks of infections (Wood et al, 2014)


Bowlt, K., & Gasson, J. (2013). Perioperative infection control. Companion Animal, 18(2), 22-
Farthing, M. S. N., & Reigard, R. N. (2013). Winning the Battle Against Surgical Site Infections.
Galor, A., Goldhardt, R., Wellik, S. R., Gregori, N. Z., & Flynn, H. W. (2013). Management
strategies to reduce risk of postoperative infections. Current ophthalmology reports, 1(4),

Kelvered, M., Öhlén, J., & Gustafsson, B. Å. (2012). Operating theatre nurses’ experience of
patient-related, intraoperative nursing care. Scandinavian Journal Of Caring Sciences,
26(3), 449-457.

Ousey, K. J., Edward, K. L., Lui, S., Stephenson, J., Duff, J., Walker, K. N., & Leaper, D. J.
(2015). Perioperative warming therapy for preventing surgical site infection in adults
undergoing surgery. The Cochrane Library.
Salassa, T. E., & Swiontkowski, M. F. (2014). Surgical attire and the operating room: role in
infection prevention. The Journal of Bone & Joint Surgery, 96(17), 1485-1492.
Soh, K. L., Davidson, P. M., Leslie, G., Digiacomo, M., & Soh, K. G. (2013). Nurses’
perceptions of standardised assessment and prevention of complications in an ICU.
Journal Of Clinical Nursing, 22(5/6), 856-865.
Ulrich, B., & Kear, T. (2014). Patient Safety and Patient Safety Culture: Foundations of
Excellent Health Care Delivery. Nephrology Nursing Journal, 41(5), 447-457.
Wood, A. M., Moss, C., Keenan, A., Reed, M. R., & Leaper, D. J. (2014). Infection control
hazards associated with the use of forced-air warming in operating theatres. Journal of
Hospital Infection, 88(3), 132-140.

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