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Mandatory at SBMC to be used when counting Raytec & Lap sponges
Sponge Counter Bag
Define 'Standard of Care'
Actions of a reasonably prudent nurse in the same or similar situation.
The circulators preoperative assessment should include joint and mobility concerns as it will impact
Positioning.
Define 'LAST'
Local Anesthesia Systemic Toxicity
The surgical field should be set up as close
To the time of surgery as possible
First thing an RN circulator must do when an incorrect count is suspected.
Tell the surgeon
Top 3/5 reasons a nurses get sued
•Failure to follow standards of care
•Failure to act as a patient advocate
•Failure to communicate
•Failure to assess and monitor
•Failure to document
• Failure to use equipment in a responsible manner
The Intraoperative Record is the legal document outlining
The care that the pt. received while in the operating room.
What is the name of the medication SBMC uses to reverse the affects of MH and where is it kept?
Ryanodex
3 5cc vials located in the MH cart in the Operating room located across from the OR front board.
According to AORN and AST, surgical field must be continuously monitored.
T/F Taping the OR doors is an acceptable method to manage this requirement.
FALSE and it is against SBMC policy
Instruments must be counted allowed and visualized simultaneously by ???
The scrub and circulator
The 3 primary roles of the Circulating Nurse
•Patient advocate
•Ensure patient safety
•Provide expert nursing care during entire perioperative process (QUALITY)
How many qualified personnel (including the anesthesia provider) are required to move an anesthetized patient from the OR table to the stretcher
4
What is DIC and provide 3 causes while in the operating room.
Disseminated Intravascular Coagulation
Massive Blood loss
Excessive blood transfusions of packed cells
Sepsis
Trauma
Infection
Liver failure
The system used to remove waste anesthesia gases from an operating room
Scavenging system
Name 3 elements of a handoff report related to counts.
1. Count all sponges, needles and misc. items
2. Count all instruments that can safely done without compromising the pt. condition.
3. Any sponges packed in the pt.
4. Any items counted in pieces for whole (but has pieces)
5. Any items added to the instrument count during the case, name, and amount.A wrong site surgery, conducting a procedure without a VALID consent, a retained surgical item are all considered ______&_______ in a court of law
Assault and Battery
What is the minimum number of qualified personnel are required to put a pt. into or out of the lithotomy position.
2 qualified people.
______ can induce a laryngospasm in a child during induction or emersion, thus all attention MUST BE ON THE CHILD DURING THESE TIMES.
Room Noise
A surgical case has been delayed for 1 hour. The best practice for the surgical team to employ is to
Cover the set using 2 drape sheets with cuffed folds, and observe the sterile field.
How many TOTAL sponge counts should be done for an abdominal myomectomy (the uterus has been opened)
NO RELIEF DURING THE CASE
(at least 4)
1. Initial
2. Closure of the cavity (uterus)
3. Closure of the peritoneum
4. Closure of skin
A positioning injury, pressure ulcer, skin tear, missing or mislabeled specimen, missing mandatory surgical documentation can all be considered examples of _____.
Negligence
The organization responsible for auditing and measuring quality at SBMC is
The Joint Commission
MTP or Massive Transfusion Protocols are characterized by alternating infusions of
Cell Mass (O neg), Platelets, FFP/Cryoprecipitate
When an item is double peel packed, the inner peel pack
1. (should/should) not be folded and
2. the plastic side of the inner peel pack must be facing the (same/opposite)______ direction of the outer peel pack.
1. Should not
2. Same side