Long Summer Road Trip
When possible, foley catheter use in the OR is avoided to prevent the risk of a patient developing a _________.
What is a CAUTI (catheter-associated urinary tract infection).
This device can cause skin tears if applied or removed improperly.
What are adhesives or tape?
We have also seen tourniquets (from IV placements) and foley stat lock devices.
This team member is primarily responsible for performing counts with the RN circulator?
Who is the first scrub person?
This word is Elliot’s universal safety phrase, empowering any team member to stop the moment, get everyone’s attention, and raise a concern.
What is "hard stop"
Operating room staff RNs and Scrub Techs have a competency-based orientations (CBOs). This file can be found in ________ and can be signed off by their preceptor as they learn new skills!
What is healthstream?
(tip: complete in real time at the end of your shift)
Before inserting a foley catheter, what patient related information must be reviewed?
What are allergies? (i.e. LATEX)
Skin tears most commonly occur in this age group in the perioperative setting?
Who are the elderly and pediatric populations?
List counts that are required prior to skin closure count.
What is the initial count and when wound closure begins.
(additional as needed include a cavity count, transfer/relief count, when new items are added, or at the request of any team member)
True or false: It is an approved practice to label the medication cup on the sterile field once the preference card has been reviewed for dosing accuracy.
What is false.
What is ensuring safety patient care while providing guidance and teaching?
This step must be confirmed before inflating the Foley balloon to prevent injury.
What is verifying urine return?
What OR activity is frequently the cause of perioperative skin tears?
What is patient repositioning or transfer?
When should a count not be performed?
What is during the time-out or debrief, critical dissections, confirming and opening implants, induction/emergence of anesthesia, and handling specimens.
Describe two times when a site marking is not required.
Examples: During single organ cases, IR cases (catheter insertion side might not be determined), teeth/dental cases, obvious wounds or lesions (unless there are multiple)
The preceptee should escalate concerns about patient safety to this person first in most situations.
What is the preceptor.
(charge nurse or educator depending on situation/needs)
This position of the drainage bag helps prevent urine reflux and infection.
What is keeping the drainage bag below the level of the bladder?
(not on the floor!)
Excessive pulling during this step may result in a skin tear.
What is surgical draping or undraping.
True or false: Pediatric instrument closing count may be deferred when the wound is such that no instrument could inadvertently be retained.
What is true.
List (at least) five items that should be included in a transfer report to a relieved scrubbed staff member.
Options: the procedure (laterality, current stage), patient name, patient allergies, medication on field, instruments the MD is currently using, items/instruments IN the wound/cavity, counted items off the field, any count concerns/pending counts to complete, specimens already out or anticipated, surgeon preferences, etc.
If a preceptee is unsure about a task, they should do this immediately.
What is ask for clarification or help?
The most common cause of traumatic Foley catheter remove in the perioperative setting is ___________?
What is during patient transfer or movement?
This should be done immediately after identifying a skin tear in the OR.
What is notify the MD and protect the area from further injury (apply dressing as directed).
When completing a portable x-ray for a miscount, what must be included in the Epic order?
What is a comment stating: "To rule out retained surgical item."
(call MD to describe item if necessary)
When should a hand-off report be completed?
What is any time a new staff member is assuming patient care duties.
When a preceptor adjusts teaching to match the orientee's learning style, this is called:
What is individualized teaching?