Intraoperative patient care and safety pt. 2 Flashcards
Who developed the universal protocol?
the joint commission
Who developed the universal protocol in 2007?
The Who or World Health Organization
Who also recognizes the importance of patient safety and endorses the sign-in portion of the checklist?
the American society of anesthesiologists
What does the ASA ensure?
the RN circulator and anesthesia professional the opportunity to ensure not only the right patient and procedure, but also the right anesthetic approach and prophylactic antibiotic needs.
When does the universal protocol begin?
before the patient enters the operating room
When is the universal protocol performed?
at the sign-in, time out, and sign-out
When should the briefing be completed?
before incision or procedure start
When should the debriefing be completed?
after the procedure prior to the surgeon leaving the room
What are the 13 things that should be included in the briefing?
- team member introductions
- patient identification - 2 unique identifiers
- verification of signed consent
- procedure specific - name, laterality, site marking, length, goals
- diagnostic tests and results
- patient position
- risk assessment for: pressure injury, fire, VTE, blood loss, difficult airway
- skin antisepsis used and dry time
- availability of: equipment/instruments, implants, blood products
- allergies
- special precautions
- antibiotics: administration time, redosing requirements
- anticipated needs for: glucose monitoring, imaging, pathology, postoperative plan of care
What are 10 universal protocol debriefing elements?
- procedure name
- surgical counts affirmed
- procedural issues with: equipment, supplies, preference card updates
- blood loss
- wound classification
- physiological: glycemic controls, pain management, VTE prophylaxis
- safety concerns
- specimen considerations: name and location, label, markings, disposition
- surgical complications
- postoperative expectations
What is the responsibility of health care organization leaders in patient and personnel safety?
creating a safe perioperative environment for patients and personnel
What is the responsibility of RN in patient and personnel safety?
following established policies and procedures created to protect personnel and patients
What is the responsibility of the team in patient and personnel safety?
protecting the patient
What is ESSENTIAL to the role of the RN in patient and personnel safety?
implenting interventions to prevent injury to personnel, patients, and visitors due to chemical hazards, fire, smoke plume, radiation, lasers, surgical positioning, and ergonomics
Safe handling and disposal of chemicals is guided by who?
local, state, and federal regulations
Who requires facility managers to ensure that safety data sheets are available to employees?
occupational safety and health administration (OSHA)
What kind of information is included on chemicals in safety data sheets?
- physical properties
- composition of ingredients and compound stability
- toxicology information
- specific hazard identification
- instructions for use
- proper handling, include storage
- required personal protective equipment
- fire extinguishing details
- recommendations for accidental spills
- first aid for exposure
- proper disposal
How far should eye wash stations be located?
no further than 10 seconds away from an area where chemicals are located
What should team members know in the event of a chemical spill emergency?
- locations of PPE
- where emergency spill kits are
- where respiratory protection is (respirators, exhaust hoods, or specific air exchange mandates).
- where eye wash stations
What does a fire risk assessment include? hint: 4 things
- identifying fuel sources
- ignition sources
- oxidizers
- whether the surgical site will be above the level of the xiphoid
What are 3 examples of fuel sources?
- alcohol based preparation solutions
- drapes
- endotracheal tubes
What are examples of ignition sources?
- ESU
- fiberoptic light cords
- lasers
What should you do during head, face, neck, and upper chest surgery to decrease fire risk?
stop supplemental oxygen at least 1 minute before and during electrocautery, electrosurgery, or laser use, if possible
What is one way to reduce exposure to the contaminants released by smoke plume?
use of evacuation systems with capture devices that use ultra-low particulate air or high-efficiency particulate air filters