Random
How to properly date Peroxide and Alcohol?
Peroxide and Alcohol are multi-use and can be dated for 1 year after opening or manufacturer expiration date-whichever is soonest
Use sharpie to date all open bottles
What PPE should an individual who is scrubbed in wear?
Bonus: what is considered appropriate eye protection?
Mask
Eye Protection
Gown
Double gloves
How do you properly identify a patient?
Name and DOB
True or False
Betadine is a multi-patient use item?
False
Betadine is one time use. Open bottles must be thrown away
Environmental Joint Commission Concerns
Bonus: If you see something broken, what should you do?
no Dust
no Tape/tape residue
no damaged walls/floors/equipment-make sure work orders are placed.
Waste containers-properly labeled, not overflowing
No food/drink
Hallways free of obstruction
Know Emergency exits/fire extinguishers/pulls free of obstructions
Put a work order in, print out the work order and give it to the board runner
Tell an EMI/board runner/leadership member so we can put in a work order
What is the process with irricept?
Irricept should only go in the warmer if it is going to be used for the case.
Irricept needs to be dated/timed for a expiration date 7 days after being put into the warmer.
If irricept is not dated, or past the expiration date, it needs to be tossed
If a patient is on isolation precautions, what do you do?
Appropriate signage on the door
wear appropriate ppe
reference the isolation book on the isolation cart
have the isolation cart outside the OR door to have PPE available, for anyone who would need to enter.
What should be included in the pre-incision time out?
Patient ID
Allergies
Consent/Laterality
Fire Risk
DVT/Normothermia interventions
Antibiotics
any other applicable items?
True or False
It is okay for wipe containers to be left open or have wipes hanging out of the container?
False, wipes need to be closed with nothing hanging out
What goes in a red waste container?
What goes in a black waste container?
What goes in a yellow waste container?
What goes in a teal waste container?
What goes in a blue recycle container?
Red-Sharps
Black-Pharmacuetical waste/Large amounts chemo waste (empty vials in the trash)
Yellow-Trace chemo amounts
Teal-Stryker Recycle
Blue-patient information documents
True or false:
It is okay to store medications and formalin in each OR?
False
Medications should be returned to the pyxis, pharmacy, proper storage location.
Formalin should be returned to the soiled utility rooms for storage.
If a patient is in isolation precautions, the OR cabinets/warmers should continue to be accessed and unused supplies touched?
What should be included in a preop handoff?
Verify patient wristband-CRNA
Patient-Name, DOB, Surgery/Surgeon
Allergies, antibiotics, clipping region-visualize, site marking, anything special
How do you properly send dirty instruments/dirty case cart to CSP?
no fluids, garbage, sharps, bioburden
All clamped instruments open, multipiece instruments disassembled
Instruments are placed back in their original containers
everything sprayed with pre-enzymatic cleaner
True or false
Carrying oxygen/CO2 tanks around the unit is ok?
False
Tanks should never be carried or set on the ground.
Tanks should be transported utilizing the tank carts
Quality Improvement and Safety Initatives
First case on time starts
Surgical site infections: Colo and Spine Fusion Bundle Checklists
Antibiotics: Ancef for all
Hand Hygiene
How long does it take for complete OR air exchanges?
35 minutes
Rooms should sit for 35 minutes after aerosolizing procedures (ex intubations) for the applicable isolations (Droplet, Droplet plus, airborne, airborne plus)
What should be included in a post-procedure debrief?
Counts correct?
Specimens-Verify labels and names
Procedure
Post op diagnosis
EBL
Wound Class
Foley-removal or secure
If you need help, who do you call?
Bonus for in order of chain of command
(Not Ghostbusters :)
Float team
Board Runner
Team Lead
Educator
ACM
Manager
Director
Where are the emergency eye wash stations
By Board Runners Desk
Instrument/Soiled Utility between ORs C&D
When should you wash your hands/hand sanitize?
Before immediate contact with a patient/patient environment
Before performing a clean or sterile procedure
After contact with a patient/patient environment
After possible exposure to blood or body fluid.
*Gloves do not substitute the need for hand hygiene.
**Remind your teammates, every person/department should be 100% compliant 100% of the time and you never know who is watching.
Tell a CNA if a hand sanitizer is empty so it can be refilled.
Should PPE be worn in the hallways for isolation patients?
no.
PPE should only be worn in transport if patient care is being actively given. (If you are wearing PPE, you should not be touching community surfaces-doors, push buttons)
Patient bed rails should be wiped after patient is situated, but before transport
How should medications be labeled?
Bonus: How are medications transferred and by who?
Name
Strength/Concentration
Expiration date
Time if expire within 24 hours of being poured
Everything-container, syringes, aseptos and all medications/fluids etc that are removed from their originally labeled container
Only RNs can transfer medications to the field using a sterile transfer device. (Saline and Water can be poured by anyone)
1 RN and 1 Scrub, visually and audible
instruments counted before removed from stringer
Count softs then instruments
Counting from field-->mayo-->back table-->off the field
Correct count x-ray triggers:
Greater than 8 hours operative time
Multiple services operating at the same time or sequentially in the same surgical swound
intraoperative consultation requiring the consulting surgeon to scrub in.
final closure of previous surgical open cavity
greater than 5 scrub person or circulator changes in a case
How should you talk to a surveyor?
Bonus: What should you never say to a surveyor?
Smile, think about the question, relax
rephrase or clarify if you don't understand
Use your resources, answer the question the best you can, be brief and to the point.
Say "we"
Be appreciative of the feedback
I don't know, I am too busy, sometimes/usually, talk back, disagree.