Patient safety Flashcards
What are the 11 components of the preoperative patient safety?
- a safe environment
- appropriate staffing levels
- correct instrument care and cleaning
- fire safety
- infection prevention
- patient-centeredness
- Prevention of pt. falls
- Prevention of sharps injury
- Safe patient handling and movement
- Sharps safety
- teamwork
What are the 3 zones in the perioperative zone?
- unrestricted zone
- semi-restricted zone
- restricted zone
What are examples of unrestricted zone?
public hallways and patient waiting areas
What are permitted in the unrestricted zone?
street clothes
What are semi-restricted areas secured from?
public areas
What is used to secure the semi-restricted?
- signage
- doors
- security measures –> doors, electronic access, badge requirements to enter.
What are examples of semi-restricted areas?
- hallways adjacent to the operating rooms
- sterile supply storage
- sterile processing department
What can you wear in a semi-restricted areas?
- clean surgical attire
- head cover
- facility-approved shoes
What are in the restricted zone?
operating rooms
How are restricted zones accessed?
only through semi-restricted areas
How are operating rooms (restricted zone) separated?
by doors
What can you wear in the restricted zone?
- surgical attire
- head cover
- mask
- facility-approved shoes
What should you wear in the restricted zone if there is a potential for exposure to blood and other bodily fluids?
protective eyewear and shoe covers
What kind of pressure is used in the OR?
positive pressure
Who is part of the basic team in the OR?
- surgeon
- first assistant
- scrub person
- RN circulator
- anesthesia
Who is part of the sterile field in the OR?
surgeon, first assist, scrub person
Who is part of the non sterile field in the OR?
RN circulator, anesthesia
Who are health care providers that care for the surgical patient?
- allied health personnel
- post anesthesia care unit RNs and team members
- Perianesthesia RNs and team members
- Pharmacists, other physicians
- Radiology and laboratory team members
- support personnel
When is team communication most important? what 4 times?
- admission
- transport
- hand-over
- immediately B4 surgery
What should be followed to prevent wrong patient, wrong site, and wrong procedure?
standardized preoperative verification and communication processes
What are the 5 parts of the preoperative verification process?
- include the patient in the verification process
- use standardized safety checklists
- patient identification
- surgical site marking
- time out
How many identifiers should you use for patient identification?
- patient name
- date of birth
- -> MRN, procedure
Who marks the surgical site?
- surgeon
2. proceduralist
What is a time out?
is a pause in patient care immediately before the procedure begins to conduct a final assessment of the patient.
When do you conduct a time out?
- regional block
- surgery
- other invasive procedure
What are the 3 elements of the fire triangle?
- an ignition source
- fuel
- oxidizer
What are examples of an ignition source?
- electrosurgical pencil
- argon beam coat
- power tools
- laser
- defibrillator elect. equip
What are examples of fuel?
- flammable preoperative skin antiseptic products
2. surgical drapes
What are examples of an oxidizer?
- oxygen
2. nitrous oxide
What do you want to perform before you start a procedure?
fire risk assessment
What are the elements of a fire risk assessment?
- alcohol based prep?
- surgical procedure above or below diploid?
- oxygen or nitrous oxide being used?
- ESU, laser, fiberoptic light cord, any other contributors?
What are life safety events in the OR?
- fire in the OR
- malignant hyperthermia
- local anesthesia systemic toxicity
- cardiac arrest
- latex allergy
What do you want to do to prevent life safety events?
- identify pt.’s at risk for MH, LAST, latex allergy, and cardiac events
- locate emergency supplies, equipment, and carts
What are 3 ways you can prevent patient falls?
- assess patients for their risk for falls
- implement fall prevention practices
- document fall precautions
What are s/sx of LAST?
- metallic taste
- tongue/lip numbness
- auditory changes
- dizziness
- diplopia
- dysarthria
- shivering
- tremors
- delirium
- syncope
- seizures
- coma
- cardiac events
- resp. arrest
How is LAST treated?
- stop admin of anesthetic call for HELP
- bring in LAST supplies/rescue kit
- maintain pt. airway
- ventilate pt. w/100% oxygen
- basic or adv. life support
- verify IV access
- 20% lipid emulsion therapy
What are 3 ways to prevent patient falls in the Periop setting?
- lock beds
- safety strap
- appropriate amount of people
When is a fire risk assessment performed in the OR?
- during timeout
2. pre-briefing
What are 3 ways to prevent a fire in the OR?
- chloraprep - wait 3 min
- keep cautery in holder
- turn off lights when you aren’t using it
What are early s/sx of MH?
- increase in ETCO2
- muscle rigidity
- tachycardia
What is a late s/sx of MH?
temp change
What is the medication used to treat MH?
dantrolene
How is dantrolene prepared?
dantrolene and sterile water
