Counting
Counting must be performed and visualized by (# of people & positions)
2 People. One must be an RN
What are ways that an instrument packs/trays can be contaminated
Bioburden, strike-through, moisture, holes
Time Out should be conducted _________ prior to incision/start of procedure
Immediately
Person responsible for wiping, flushing, and spraying instruments immediately upon completion of the case to prevent drying of blood and particles on the instrument's surface
Scrub Person
According to AORN and HCA Policy, these should never be worn in the OR by any personal, as they harbor bacteria/pathogens.
Artificial Nails
Radiopaque sponges must be completely __________ when counting in performed.
separated
The direction to face when two sterile persons pass each other
front-to-front, or back-to-back
All activities must be ______ during the time out. (JACHO watches for this)
Types of instruments that should be flushed at point of use with sterile water to prevent obstruction from organic debris
Cannulated aka channel instruments
Instruments with lumens/hollow
The IFU required amount of time ChloraPrep should dry prior to draping the patient.
Minimum of 3 min. You should allow longer if still has a shiny appearance.
bottom to top
When implementing SSI reduction techniques, the OR team should do this at the time of wound closure.
Change gown and gloves
____ ____ are required for surgeries/procedures to support decisions on laterality
Medical Images
Saline
Identifying results of counts, confirmation of SX procedure performed & diagnosis, specimens, and preference card changes are some items that are done during what period of time?
Debriefing
It is recommended that counts be done in the following order
Sponges, Sharps, Misc, & Instruments
The humidity level of the OR must remain within these conditions.
20%-60% relative humidity
Your patient is having a bilateral mastectomy, and reconstruction with two different surgeons. You need how may time-outs
Two.
Or 1 if both teams are present for initial timeout.
Proper instrument transportation to decontam includes
In a closed container/case cart that is leak-proof, puncture resistant, labeled biohazard.
The only time you can remove a countable item from the room.
Prior to the initial count.
Nothing should ever be removed during the procedure or when patient enters the room.
When a count discrepancy cannot be reconciled, the Radiology Imaging Protocol will be implemented and __________ will be obtained and interpreted prior to closure.
two opposing view radiographs
Begins with the knowledge of the principles of aseptic technique, infection control, and safety, and is supported by constant awareness of self and surroundings to maintain sterile integrity. Involves ethical and moral decision-making and an obligation to speak up and act with courage on behalf of the patient.
Surgical Conscience
Date of National Time Out Day
June 11th OR 2nd Wed of June
An accumulated mass of bioburden that adheres to the surface of an instrument, making it difficult to effectively clean and sterilize the instrument
Biofilm
Contaminated!
IFU!!