Surgical Specimen Flashcards
What can a surgical specimen help determine?
- a prognosis
- continuing medical care
- a specific treatment plan formulated on the pathology results
What can errors in specimen management result in?
- patient harm
- diagnosis errors
- treatment/procedure inaccuracies
- health care personnel and/or facility harm
What are examples of patient harm errors?
- physical injury
- psychological injury
- morbidity and mortality increases
What are examples of diagnosis errors?
- delayed diagnosis
- incomplete
- inaccurate
What are examples of treatment or procedure inaccuracies?
- delayed
- unnecessary/inappropriate
- additional
What are examples of health care personnel and/or facility harm?
- personnel exposure to other potentially infectious materials
- potential litigation
- community distrust
- additional costs to the facility/non-payment from insurance carriers
What are the 5 communication processes that results in specimen errors?
- spelling
- fear
- redundancy
- lack of a standardized process
- specimen transport method
what is a lack of knowledge of body part names and spelling
spelling
What is Nursing staff were afraid to ask for the correct spelling?
fear
What are the 2 things that contribute to redundancy?
- Personnel kept a running list of specimens collected and recorded by the pathology lab
- Identical information was required to be entered into multiple documents in the OR
What are the 2 things that contribute to lack of a standardized process?
- Inconsistent specimen read-back process use
2. Inaccuracies in patient and specimen information
What contributed to specimen transport material?
The green specimen transport bag was not transparent
When does the surgical team review specimen identification and labeling?
during the sign out
What are the 5 techniques for specimen handling on the sterile field?
- handle the specimen as little as possible.
- keep the specimen moist with sterile saline unless contraindicated
- cover/contain the specimen
- label the specimen
- protect the specimen
What is step 1 of transferring specimens off the sterile field?
as soon as possible
What is step 2 of transferring specimens off the sterile field?
verify patient name, specimen name, and type of test
What is step 3 of transferring specimens off the sterile field?
choose the correct container size
What is step 4 of transferring specimens off the sterile field?
any instrument used for the specimen transfer into an unsterile container is considered to be contaminated
What is important to remember with step 4?
remember to include that instrument in subsequent instrument counts
What is step 5 of transferring specimens off the sterile field?
use standard precautions when handling specimens
What are important parts of a container?
- lid
- be empty
- be leak proof
- be puncture resistant
- best fit to avoid crushing or hurting the specimen
What are the 4 types of specimen container available?
- culture tubes - w/ or w/o medium
- sterile containers -
- unfilled containers
- prefilled containers
At a minimum, what should the label identify?
- patient name, MRN, or another patient identifier
- specimen name, side, and tissue type
- date and time of collection
What 4 things should transport of specimens do?
- protect the specimen’s integrity
- maintain the patient’s confidentiality
- ensure that specimen identification is provided with each hand over
- protects health care personnel from exposure to blood, body fluids, other potentially infectious materials and chemicals
What is something important to remember when dealing with highly infectious specimens?
knowing your resources
What are 3 things to do when dealing with highly infectious specimens?
- Follow your facility’s policy and procedures
- Talk with more experienced colleagues who are knowledgeable about specimen handling
- consult with pathology department personnel
True or false; scales are used to weigh tissue after it is submerged in perservative
false
What happens if critical forensic evidence (metal foreign bodies) is collected using unprotected metal instrument?
can be altered
How are bullets collected?
with a non-metal instrument
What is an alternative solution if you have to use a metal instrument?
covering the metal instrument tips with rubber shoes or other protective devices
What are used in criminal investigations?
bullet markings
What can an unprotected metal instrument ultimately do?
scratch the bullet surface and alter important evidence
What happens if a tip protector slips off during the original foreign body retrieval?
it may become a retained surgical item
What is important to do with the instrument tip protector?
include it as part of the original count
What are the 3 important elements of the chain of custody?
- vital information
- regulation
- organizational policies/procedures
What is the vital information included in the chain of custody?
- evidence security
- collection details
- who handled the evidence
- who received it
What is the regulation in the chain of custody?
- follow all local, state, and federal regulations
2. evidence can be entered into a court of law
What is organizational policies/procedures?
follow your facility’s policy and procedure.
