Perioperative Nursing Flashcards
Perioperative Goals
Providing safety and well-being of patient
Collaborative teamwork of perioperative personnel
Maintain surgical standards of care (AORN*)
* The Association of PeriOperative Registered Nurses
Perioperative Nursing
Knowledge of:
Surgical anatomy
Physiologic alterations and their consequences
Intraoperative risk factors
Potential for injury and the means of prevention
Psychosocial effects of surgery for the patient and their family
The Perioperative TEAM
Preoperative Nurse
Circulating Nurse
Scrub Tech or RN
Anesthesia Personnel
PACU Nurse
Preoperative Nurse
Begins the surgical experience with the patient and their family
Confirms all surgical orders
Verifies informed consents
Checks lab work and informs surgeon of any discrepancies
Starts IV
Does all prep work prior to surgery
Circulating Nurse
Patient assessment before and during procedure
Collaboration with surgeon, anesthesiology and other OR personnel /anticipate needs
Management of OR
OR conditions, asepsis, equipment, coordinating OR team, surgical count, positioning of patient
Verify consent completion, lab work, documentation
Review pre-op checklist
Initiate “Time Out”
Ensure patient safety and a caring environment
Surgical Tech or RN
Performs hand scrub, sterile gown and gloves
Sets up sterile field/table
Prepares supplies/equipment
Assists with draping the patient
Passes instrumentation to the surgeon and assists with procedure
Tracks instruments, sponges, sharps
Confirms specimens with circulating RN
Assists with tracking irrigation fluids and blood loss
Anesthesia Personnel
MD or CRNA (Certified Registered Nurse Anesthetist)
Assess medical readiness for surgery
Maintain patient’s airway
Monitor and control patient’s vital life functions (i.e. HR, BP, Temp, fluid balance)
Control patient’s pain and level of consciousness
PACU Nurse
Post Anesthesia Care Unit
Monitor patient airway and level of consciousness
Monitor pain level and administer pain meds to reach a comfortable goal for the patient
Monitor vital signs and watch for any immediate postoperative complications
Prepare patient for next stage of recovery
Patient Safety
Patient identification
Verification of correct informed consent completed
Verification of records of health history and physical
Results of diagnostic tests
Allergies (include latex allergy)
Assessing special needs of patient (mobility, hearing, language)
Monitoring and modifying the physical environment
Safety measures such as grounding of equipment, restraints, and not leaving a sedated patient
Verification and accessibility of blood
Signing of the surgical site
National Patient Safety Goals
A critical method by which The Joint Commission promotes and enforces major changes in patient safety (minimize mistakes)
2 patient identifiers (Do you have the correct patient?)
Mark the operative site (Is this the correct side?)
Universal Protocols
Label specimen container in presence of patient
Or 2 OR personnel if patient is sedated
“Time Out”
Time Out
Occurs immediately before starting the invasive procedure or making the incision.
Standardized
Involves the immediate members of procedure team: surgeon, anesthesia, other OR staff
Team members agree, at a minimum, on the following:
Patient identity, correct site & procedure
Patient SafetySCIP (Surgical Care Improvement Project)
Prevention of Surgical Site Infection
Prophylactic Antibiotic: received within one hour prior to surgical incision
Appropriate hair removal immediately prior to incision (clip/not shave)
Prevent hypothermia: Ideally 36C within 15 min of arrival to PACU
Blood Glucose: <200mg/dl on POD1 and POD2 cardiac patients
VTE prophylaxis (SCD’s, TED Hose, Heparin therapy)
Beta Blocker treatment
Foley Catheter use has been decreased in the surgical population-only used if necessary to monitor for urine output or based on type of anesthesia
Principles of Surgical Asepsis
Medical asepsis: Practices that reduce the number, growth, transfer and spread of pathogenic microorganisms. They include hand washing, bathing, cleaning environment, gloving, gowning, wearing mask, hair and shoe covers, disinfecting articles and use of antiseptics.
Surgical asepsis: Practices that keep an area or objects free from all microorganisms non pathogenic and pathogenic including spores and viruses.
Surgical SuiteRestricted Areas
can only be accessed through a semi-restricted area
traffic in the restricted area is limited
personnel are required to wear surgical attire and cover head and facial hair. Masks are required where open sterile supplies or scrubbed persons may be located.
Surgical SuiteSemi-restricted area
peripheral support areas surrounding the restricted area of a surgical suite
storage areas for clean and sterile supplies, sterile processing rooms, work areas for storage and processing of instruments, scrub sink areas, corridors leading to the restricted areas
