Transmissible Infection Prevention
Define routine practices
Measures put in place for every patient interaction regardless of diagnosis or infectious disease status—include hand hygiene, respiratory hygiene, and point of care risk assessment
This would be a reason to hold pre-op heparin
Planned spinal or epidural
Pending INR
Patient has not stopped blood thinners
Counts shall be performed by two individuals, one of whom shall be ___________
A registered nurse
The temperature in the OR should be maintained at ______
20-24 degrees Celsius (68-75 degrees Fahrenheit)
There is a patient booked on the slate with tuberculosis. What resources can you use to determine how to manage this patient in the OR?
Infection Prevention and Control website (ipac.vch.ca)
VCH Diseases and Conditions table
ORNAC
Infection Control Officer
CRN/CNE
Your patient reports having allergies to kiwi, bananas and avocado - this concerns you as you know these allergies have a cross sensitivity to this product.
Latex
True or False: Skin antiseptic agents may be warmed at the discretion of the surgeon
False—antiseptic agents shall not be warmed unless validated by the manufacturers' IFU
This is the anticipated wound classification for an elective bowel resection
Class II—clean-contaminated
True or False: If you get a needle stick injury, the best course of action is to report to the surgical team, unscrub ASAP, and wash the wound with soap and water
True—allow the wound to bleed freely (do not force bleeding), wash with soap and water (do not scrub with CHG, Manorapid, or alcohol swab)
These are times when a surgical count is required
Before the start of a procedure
At closure of a cavity within a cavity (e.g., uterus, bladder, etc.); prn
At closure of the cavity (e.g. periotoneum); prn
At skin closure / completion of procedure
At permanent relief of scrub or circulating nurse
When any member of the team requests a count
All items shall be counted ________ and viewed ________ by both the scrub and circulating nurses in a systematic/organized manner
audibly, concurrently
The most specific sign of a MH crisis is ________
increasing end-tidal CO2
In the chain of infection cuts in skin, catheters, tubes, mucous membranes are known as ________
portal of entry
You are checking in your patient who has refused the administration of blood products. Your buddy nurse states, "That's fine, we'll just cross it off the consent form". What is the correct course of action regarding documentation?
The Refusal to Accept Administration of Certain Blood Components/Products/Alternatives form must be filled out (in consultation with the surgeon/anesthesiologist)
True or False: According to ORNAC Standards, it is acceptable to gown and glove from the back table
False—The scrub personnel shall gown and glove from a separate surface than the main sterile field (2.13.2)
According to the VCH Surgical Count policy ,at closure, the direction of the surgical count is _________
sponge bucket → back table → mayo stand → operative field
At the end of a TB case, room access is restricted until __% of airborne particles have been filtered
99%
These are the two categories of muscle relaxants (and examples of each)
Depolarizing (succinylcholine)
Non-depolarizing (rocuronium)
According to ORNAC Standards, when should you considering covering a sterile set-up?
Delay
Periods of increased activity (i.e., Code Blue)
The Universal Protocol for preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery consists of these 3 key steps
Pre-procedure verification
Site marking
Time out