BJC Core values & Hand Hygiene
Surgical Attire
Isolation Patients
Handling Blood Products
Code, Malignant Hyperthermia and OR safety
100
What is the BJC values expected for each staff member to practice?
100
What are the Unrestricted, Semi-Restricted, and Restricted Zones for the perioperative OR areas?
Unrestricted – street clothes, family, (pre/post)
Semi restricted – OR scrubs, hair coverings, CSPD unsterile area, pod desk
Restricted- Surgical Mask, OR room with open sterile supplies or patient, CSPD in sterile area
100
What precautions and PPE do you use for transporting Contact Isolation Patients?
Wear gown and gloves
Yellow isolation gown is NOT to be worn in the hallways when transporting the patient (unless providing direct patient care – such as CPR, ventilation) Wipe head-board with disinfecting wipe Place clean sheet over side rails and footboard Transport patient using covered head-board
If you are required to wear isolation PPE due to direct patient care, at least one other person must transport with you to push elevator buttons, open doors, et
100
How do you return Blood Products?
Blood is returned the same way it is delivered to the OR, by tube, or cooler.
Never combine blood products into one cooler, blood products must be returned in the cooler they were delivered in.
Platlets and Cryo are room temp only, never in a cooler.
100
Before entering an OR room, what precautions do you take if there is a laser or Xray being used?
Laser warning sign on OR door, wear laser safety glasses provided on OR door before entering room.
For radiology procedures make sure you have lead protection on before entering the room.
200
What does HR policy say about use of Cell phones, electronic devices, and social media at work?
Cell phones, pagers, or other electronic devices may be used during work time for work-related purposes. Employees are expected to refrain from using cell phones, pagers or other electronic devices for non-work-related purposes except in the event of an emergency
To protect the privacy of patients, visitors, and employees, the use of digital camera, recording or video functions of any electronic devices, including cell phones, is prohibited in patient care areas, hallways, lobbies and waiting areas and other areas frequented by the public, or in work areas where employees are working. The use of digital cameras, recording or video functions of cell phones or other electronic devices at work may be permitted in non-patient care areas at the discretion of management.
Use of electronic devices for playing music is prohibited in patient care areas, hallways, lobbies and waiting areas, and other areas frequented by the public, or in work areas where employees are working. Electronic devices may be permitted in non-patient care areas at the discretion of management. Non-Patient care areas would be the locker room or break room.
Whether the use of social media occurs during work time or outside of the workplace, employees are responsible for any content they publish, share or repost and should be careful not to violate their duties to BJC HealthCare or to patients as set forth in BJC HealthCare’s policies and procedures and applicable laws.
2. Employees may not publish information that reveals patients’ or other employees’ identity, health conditions or any other information that could potentially expose Personal Health Information (PHI) or Personal Identifying Information (PII).
3. Employees must make sure that their online activities do not interfere with the completion of their job responsibilities.
200
How do you know if you are in a restricted or Semi Restricted area of OR?
Big Red sign by the OR doors
Restricted if there are open sterile supplies or a procedure with a patient in progress. (masks must be on- must be a surgical mask)
200
When do you use bleach to clean a room if a patient is on contact precautions?
When the patient is on contact precautions for C-Diff infection
200
How do you retrieve Ice for a blood cooler?
Ice for blood cooler expires after 10 hours, ice replacement should be sent for at 8 hours.
PCT retrieves patient sticker from RN circulator
PCT walks to Blood Bank to retrieve ice and new expiration sticker BB will verify patient sticker with BB records
PCT delivers new ice and expiration sticker to RN circulator in OR
200
What can a PCT/ORT do if a code is called in the OR?
GRAB THE CRASH CART-take it to the code. If the defibrillator is on a rolling cart bring it also.
There are crash carts located on each POD. You should be familiar with the location(s) in your area.
You may do CPR
You may be asked to run for supplies or blood
You may have to get a bed or stretcher and help with transferring and transporting the patient
300
What do you wash your hands with when they have visible dirt on them? How long do you wash them?
Wet hands and wrists with water
Apply soap – work lather for 15 seconds over all surfaces
Rinse hands/wrists – keeping hands lower than elbows
Dry hands
Turn off water with paper towel
300
Name 3 things that is policy about Surgical Scrub Attire?
Blueberry scrubs only in Periop. Never to leave the hospital or go outside
Fresh, Hospital Laundered scrubs daily and as soiled
Underclothing must be covered Undershirts cannot extend beyond sleeves, above the collar line, or below the scrub top.
300
How do you transport a Patient on Droplet Precautions?
What PPE should you wear?
Diphtheria, H flu, seasonal flu, meningitis, adenovirus, pertussis, rubella patients are on droplet precautions
PPE = standard surgical/isolation mask & eye wear
Patient wears a standard surgical/isolation mask when transporting
300
How do you verify that you have delivered the blood products to the correct patient?
Upon delivery of blood products to OR, Anesthesia or Circulator and Blood Messenger (PCT) check each blood product for patient verification:
Patient name, DOB, MRN on the blood product with patient identification (patient name, DOB, MRN) on procedure consent (not blood consent). (Coolers must be opened and all units checked as outlined above).
300
What can a PCT/ORT do in a
Malignant Hyperthermia (MH) crisis?
Bring the MH cart to the OR room (or PACU bay)
Provide supplies under the direction of the provider
Bring cold saline or ice to cool down the patient- Cooling supply locations on each pod are in the binder on top of the MH cart
Run labs -Get Supplies
400
When do you use Alcohol Based Hand Rub for Hand Hygiene and how does it dry?
Preferred means of hand hygiene when hands are NOT visibly soiled
Directions for Use
Push sleeves above wrist
Dispense foam into palm
Work foam into all surfaces
Let hands air dry
400
Name when you need to wear protective eyewear, and what type of protective eyewear?
Protective eyewear with solid side shields should be worn whenever splash, spray, spatter, or droplets of bodily fluids or infectious material could be generated
Such as emptying a foley or any type of drain
400
What PPE does staff and the patient on airborne precautions wear during transport?
Patients wear a surgical/isolation mask, or an O2 mask-NOT N95 mask
When transporting airborne precaution patient from OR to post op, the patient can wear an O2 mask but staff transporting patient must have airborne precaution PPE on.
Staff wear your N-95 mask the size you have been fit tested for. You must be clean shaven for the N95 mask to seal and protect you.
Examples of types of Patients on Airborne Precautions: COVID-19, Measles, Chickenpox, Herpes Zoster, Shingles, TB
400
How do you get MTP emergency Blood Products?
RN circulator or provider may delegate the retrieval of blood in emergency situations From BB via approved Blood cooler.
PCT retrieves patient sticker from RN circulator for verification of patient identify with Blood Bank. Patient name, Date of Birth, MRN #
400
Name 2 safe ways to store Oxygen Tanks?
Always placed in an upright, secured container so they cannot fall over or roll -Do not leave lying on floor
-No gas cylinders outside of racks.
-If the rack is full, contact the charge nurse. Limit to how many tanks
can be stored on a division.
Store empty O2 tanks in red storage rack and full/partial O2 tanks in green storage rack
Empty is defined as less than 1000 psi
Stretchers have a designated O2 tank holder
500
Name 3 ways to prevent Transmissible Infections?
Practice standard universal precautions on all patients. -Frequent hand hygiene. -Use PPE to protect yourself from blood and other potentially infectious materials. 5 moments of hand hygiene (1) Before touching a patient (2) Before clean/aseptic procedure (3) After body fluid exposure risk (4) After touching patient (5) After touching Patient surroundings
500
What is the policy for nails and hair covering in the OR?
Short and clean fingernails, NO artificial, gel, acrylic, overlays, dips. Regular nail polish must be fresh with no chips
ALL HAIR must be covered, Head/neck and Facial hair when in ORs and CSPD. Beard covers worn for facial hair. Personal cloth headgear must be completely covered. Change Disposable hat daily and replaced as soiled
500
What do you do with the Isolation Patient's Bed or stretcher after arrival to OR room?
After helping transfer patient to the OR table- strip the bed or stretcher of all linens and wipe it down before leaving the OR room.
Take off your isolation gown and gloves before moving the wiped down bed or stretcher out of the OR room and use hand sanitizer.
Place the bed or stretcher in the OR hallway and then put clean linens on.
500
How do you retrieve emergency uncross-matched blood?
If you are sent to get uncross-matched blood from the emergency refrigerator in OR pod 2 (Pod 1 goes to L&D since they have badge access) you need 2 patient stickers.
When you remove the blood product from the refrigerator then the lab gets a signal and will call and ask who the blood is for. (In pod 2 if you give the pt. sticker to the charge nurse then she can answer the phone call from lab)
In the future Pod 1 OR may have an emergency blood refrigerator.
500
What do you do for a chemical spill?
Call (314)362-0911 to report the chemical spill
Indicate location, spilled solution, amount of spill, anyone at risk
Call the charge nurse
Remain at the spill location until spill response team arrives. Can use Hazorb pillows to contain spill.
Once spill is tended to, return specimen to OR for further direction from RN circulator or charge nurse