Exam 1 Flashcards
1
Q
__ tardies = 1 occurrence
A
3
2
Q
1 absence / call in = __ occurrence
A
1
3
Q
If I call out for 3 consecutive shifts because I am sick how many occurrences have I accumulated
A
1
4
Q
If I call out 2 days in a row, work my next scheduled shift and then call out again for the following shift how many occurrences have I accumulated
A
2
5
Q
If I call out for 3 consecutive shifts but for different reasons each day how many occurrences have I accumulated
A
3
6
Q
T/F: If I am sent home from work by employee health it does not count as an occurrence
A
False
7
Q
If I call out for 3 consecutive shift d/t inclement weather how many occurrences have I accumulated
A
3
8
Q
All Ors should have ____ pressure rooms
A
positive
9
Q
What is the minimum number of air exchanges per hour for inside the OR
A
20
10
Q
acceptable temp range for inside OR
A
68-75 degrees F
11
Q
acceptable humidity range for inside OR
A
20-60%
12
Q
What are the 3 areas that relate to the traffic patterns in the OR (determine what is needed to maintain sterility)
A
- restricted
- semi restricted
- unrestricted
13
Q
What PPE is needed for the restricted area
A
- hospital scrubs
- hair cover
- mask
- shoe covers/OR shoes
- eye pro at sterile field
14
Q
What are examples of the restricted areas (2)
A
OR
Decontam area
15
Q
What PPE is needed for the semi restricted areas
A
- hospital scrubs
- hair coverings
16
Q
What are examples of semi restricted areas (7)
A
- OR corridor
- prep and pack
- sterile storage
- ortho workroom
- percussion workroom
- OR pharmacy
- anesthesia workroom
17
Q
PPE for unrestricted areas
A
none –> street clothes
18
Q
Examples of unrestricted areas
A
- control desk
- locker room
- holding room
- PACU
- Stat lab
19
Q
3 key takeaways to prevent infection (think broad)
A
- correct surgical attire
- traffic patterns
- air quality
20
Q
3 requirements for SCDs
A
- pt >60 yo
- surgery will last > 60 min
- any major surgery
21
Q
What are the 3 components of the fire triangle
A
- fule
- ignition
- O2 (other flammable gasses)
22
Q
What are examples of fuel for fire (5)
A
anything that will burn
- linens drapes sponges
- hair coverings
- EtOH based prep
- human hair
- trach tubes
23
Q
What are examples of ignition sources (3)
A
stuff that gets hot
- bovie tip
- light cord
- laser
24
Q
What are examples of oxidizing agents (2)
A
- O2
- anesthetic gasses
25
T/F: the fire concern is addressed in the incision timeout
False : it is addressed in the prep timeout
26
Who determines if we will evacuate the OR during a fire?
- anesthesiologist
- incident commander
27
RACE
- rescue
- alarm
- contain
- evacuate
28
A patient signed a correct consent form while they were at their doctors office. How long is this consent good for?
90 days
29
A patient admitted to the hospital after a MVA, a correct surgical consent is obtained for this patient. How long is this consent good for
30 days
30
A patient signs a serial consent, at what point is this consent no longer valid.
Once the procedure name would have to be changed to be accurate.
31
If a patient is undergoing 2 separate procedures preformed by different surgeons how many consents are needed? Would this be different if both procedures were preformed by the same surgeon?
- 2
- yes : you would only need 1 if the same surgeon was preforming both procedures
32
Can you change anything on the consent form after it has been signed? what do you do if changes need to be made?
- no
- get a whole new one
33
T/F: the physician can witness the signature on the consent form if they witness the patient signing the document?
false
34
A patient goes to the assessment clinic before surgery, the provider there provides and H&P. How long is this H&P good for?
30 days
35
When checking the chart for an H&P before surgery what are you looking for?
H&P w/I 30 days and 24 hour update --> if the patient is arriving from home this update cannot be done until the patient has checked in
36
A sentinel event occurs when ... (3 broad topics)
- patient death
- permanent harm
- severe temp harm
37
What are examples of sentinel events
- wrong pt
- wrong site
- wrong side
- wrong surgery
- unintentional RSI
- fire/flash/flare
38
3 goals of aseptic technique
- optimize wound healing
- prevent infection
- reduce recovery time
39
8 principles of ascetic technique
- everything used and in contact with wound must be sterile
- a permeated barrier is contaminated
- edged of wrapper are not sterile
- established sterile part of gown : nips to navel + 2in above elbow
- only table tops are sterile
- restrict moment around sterile field
- move sterile to sterile or unsterile to unsterile
- when in doubt throw it out
40
3 main components of surgical conscious
- personal awareness of each member to the sterile field
- strictly adhering to aseptic principles
- willing to speak up if contaminate
41
What is the best indicator of sterility
the biological indicator --> we don't check this tho...
42
4 high risk foods for latex allergy
- banana
- kiwi
- chestnut
- avo
43
What are the 3 types of latex allergy
- irritant contact dermatitis (mild - not an actual allergy)
- cell mediated contact dermatitis
- IgE mediated hypersensitivity
44
cell mediated contact dermatitis = type ___
type 4
45
IgE mediated hypersensitivity to latex = type ___
type 1
46
If a person has a know latex allergy what should we do to prevent a reaction (4)
- first case of the day : damp dust
- remove all latex and check supplies
- signs on door
- ensure bed and arm board are covered
47
When should you use RFID sponges
when you are working in a cavity or a cavity in a cavity --> don't use if not in a cavity
48
When should you wand for RFID sponges
before skin closure
49
T/F: you use FRID sponges in a foot I&D- you don't have to wand because you didn't go into a cavity
FALSE - required for all cases that use RFID
50
T/F: I don't have to count because I can wand for the RFID sponges
FALSE
51
Who can count?
RN&RN
RN&Scrub
52
When do you count
- initial
- adding on to field
- staff relief
- prior to closing a cavity in cavity
- prior to closing a cavity
- prior to skin closure
- at your discretion
53
What order do you count the stuff (categories)
- sponges
- sharps
- materials
- instruments
54
What order do you count in relation to where it is on the sterile field
- up
- mayo
- back table
- off field
55
4 situations that require automatic X-ray
- trauma where first count was omitted
- 3/+ permanent staff relief
- UNEXPECTED change in procedure - not in posting
- previously packed sponges removed and incision is closed
56
6 steps if your count is wrong
- recount
- announce to team
- look for it
- call charge
- call x ray
- tell anesthesia to keep patient asleep
57
When can the surgeon decline xray if the count is wrong
- the pt is so unstable : need to do it in ICU
- the needle is so small it is not thought to cx harm
58
8 ex of countable materials
- bovie tip
- vessel loops
- shods/ booties
- dr fog
- clips cartridge
- scratch pad
- bulldog / KK clip
- umbilical tape
59
3 parts of universal procedure and what does it do?
- pre procedure verification
- procedure site marking
- incision time out
--> prevent SE
60
When is the H&P, consent, and confirming any needed materials are on site done?
at or before sign in / pre procedure verification
61
When is the site marking checked
pre procedure verification
62
What are the 5 "timeouts"
- pre procedure verification
- chart label confirmation
- prep verification
- incision timeout
- closing timeout
63
When is the closing timeout completed
after closing counts are correct but before skin closure
64
CDJ def and cx
- human prion disease = neurodegenerative disorder
- cx by incorrectly folded proteins
65
What type of CJD is linked to cows
varient
66
what type is CDJ is transmitted through medical or surgical interventions
iatrogenic
67
how is CDJ dx
brain biopsy / autopsy
68
What type of instrument are used with CJD pts?
disposable
69
what do use to clean after a CJD case and what is the wet time
bleach 30 min - 1 hr
70
3 levels of disinfection
- critical : require sterilization
- semi critical : high level disinfectant
- non critical : low to moderate disinfection
71
ex of critical item for disinfection
items that enter a sterile body cavity or blood vessel
72
x of semi critical item for disinfection
non interact skin / mucus membranes (scopes)
73
6 steps of instrument processing cycle
- point of use clean
- decontam
- assembly
- packaging
- sterilization
- storage
74
What is point of use cleaning
cleaning that starts in the OR during and after procedure
- using STERILE WATER to rinse instruments
- spray foam for bioburden
75
4 parameter measured for steam sterilization
- temp
- time
- pressure
- moisture
76
most common way to sterilize
steam
77
4 phases of steam sterilization
- conditioning
- sterilization
- exhaust
- dry time
78
IUSS def
immediate use steam sterilization --> basically no dry time
79
What is event sterility
you assume the item is sterile until the package is damaged
80
when does terminal cleaning occur and what does it include
Q24H or after an isolation patient
EVERYTHING: wheels, lights and tracks, step stools, light switches, phones, push plates,
81
order to clean OR (4)
- overhead lights
- peripheral furniture
- bed
- mop
82
sanicloth dry time
3 min
83
bleach cloth dry time
4 min
84
isopropyl EtOH dry time
instant
