Patient positioning - scout/scrub Flashcards
patient positioning
Various positions to provide access to surgical field, safe anaesthesia administration, and ensures optimal physiological function for all body systems.
how is the position determined:
- Type of operation to be performed
- Location of the lesion, injury or operative site
- The age, height, weight and general condition of the pt
- Surgical approach
positioning injuries
Pressure ulcers, bruising, skin lesions, alopecia and muscle and nerve injuries.
Factors that lower a pt pressure threshold
- Respiratory and circulatory disorders
- Malnutrition
- Advanced age
- Chronic immobility
- Dehydration
- Anaemia
- Corticosteroid therapy
- Chronic diseases
Shear forces
The movement of tissues and skeletal structures whilst the skin remains stationary.
Friction
The force of 2 surfaces rubbing together.
Maceration
Occurs when prolonged moisture on the skin saturates the epidermis, which in turn becomes weakened and more vulnerable to the detrimental effects of pressure, shear forces and friction.
Musculoskeletal injury
Surgical positioning can place unusual stress on the pt muscles, tendons, ligaments and joints.
Nerve injury
can induce loss of nervous system control and may prevent normal adaptation to pain and pressure sensation.
Vascular effects
Positioning and anaesthetic agents can affect the CV system.
Respiratory effects
Obese, obstetric and respiratory and cardiac disease pt have difficulty breathing when in the supine position.
The goals of surgical positioning
- Maintaining patient comfort and safety
- Providing optimum exposure and access to the surgical site
- Maintaining natural body alignment
- Supporting circulatory and respiratory function
- Protecting neuromuscular and skin integrity
- Allowing access to IV sites and anaesthetic support devices.
purpose of the ‘time out’
Establish a uniform approach to checking pt identification and matching that pt to their intended surgical intervention
sentinel events definition
subset of adverse patient safety events that are wholly preventable and result in serious harm to, or death of, a patient.
risk factors in sentinel events
- Emergency operations
- Unusual time pressures to start or complete a procedure
- Involvement of multiple surgeons
- Multiple procedures
- Breakdown of communication between team members and the surgical team with pt
- Lack of available information
- Lack of/ non-compliance with policy and procedures.
- Lack of marking
- Incomplete pt assessment
- Staffing issues
- Distractions
- Cultural and language barriers
- Illegible handwriting and inappropriate use of abbreviations
