Super Duper Stuff
Venous Thromboembolism risk management - "do NOT apply" sequential TEDS if ...
Patient has Lower extremity:
fracture, skin graft, dermatitis, DVT known of suspected in last 6 months, post-vein ligation, compartment syndrome, open or infected wounds, limb deformity.
During _________ , activities are suspended to the extent possible so that team members can focus on active confirmation of the patient, site, and procedure.
Time-out / Briefing
DOUBLE / DOUBLE Jeopardy question:
DeBriefing includes...
Briefing "Fire Risk" assessment
What is -
Number assigned following Briefing's review of risk for injury from "fire triangle"
-oxygen (procedures above the clavicles),
-ignition sources (cautery, LASER, fiberoptic cable, microscope) and
-fuel (alcohol in skin prep, drapes, sponges, dry patient tissue and hair).
This program is used for online access to all McLaren policies.
What is
SharePoint ("S" OneMcLaren icon)
Give an example of what NOT to say to a surveyor.
"I don't have time for this."
"I don't know."
Generally anything rude or dismissive.
Describe the proper process for donning PPE.
1. Remove anything artificial on hands and forearms that would be in the way of lower arm to fingertip hand hygiene. Nail lacquer should be free of chips and cracks.
2. Don head hair and facial hair covers
3. Don shoe covers (if non-fluid resistant shoes)
4. Wash hands (30 seconds to elbows) or cleanse hands with hand sanitizer
Name the major difference between Endo GI rooms and OR procedure room air pressures.
What is positive (OR) vs. negative pressure (Endo).
Utilizing alternative spaces for patient care or procedures due to a power outage, rescheduling cases if an operating room does not have working air pressure/flow, relocating patients/staff due to no clean water available.
What are
Utility interruptions
OneSource
What is
Location of product and equipment instructions for use (IFU).
The Joint Commission Universal Protocol
? What is:
1. Pre-procedure verification
2. Marking the procedure site
3. Performing a time-out
Do not use towels, sheets, or blankets as...
Positioning devices
Studies show they increase pressure, contribute to friction injuries, and decrease the pressure-redistributing properties of the support surface.
Note - Changing the degree of lateral rotation, elevating the head of the bed, moving the limbs) may be sufficient to redistribute pressure and prevent injury
Verification of Hair Removal, H&P, Consent, PreAnes Assessment, Preop Nursing Assessment, medications, implants, blood products ordered and available, results/reports, consults, radiographic/x-ray images, special equipment and medical devices that "are" or "may be" required for the procedure to be done is done before...
Before the the patient leaves the pre-procedure area
- Missing information, supplies or discrepancies are addressed.
P.A.S.S
R.A.C.E
P- Pull the pin A-Aim the nozzle at the base of the fire, S-Squeeze the handle, S-Sweep the nozzle from side to side
R-Remove patient of item A-Activate Alarm; call 2-2-2-2-2 C-Confine – close all doors/windows E-Extinguish or Evacuate
Two (2) staff perform a double check.
Counts
High-Alert Medications
Blood Products
Implants
When buying insurance
Labeling medication and solutions, both off and on the sterile field, includes
Name, Strength
Diluent name and volume
Note - all medications on the sterile field are discarded at the end of the procedure.
Infection Risk Management includes -
Control and minimize traffic and door opening
Equipment setup before sterile opening
Warming patient
Antibiotic dose and redose
Clean skin and hair control - patient and staff
No spitting in the wound
P1. This is the most important step in infection prevention.
P2. This is the minimum PPE we wear when with patients.
A1. What is handwashing?
A2. What are a mask and eye protection?
Types of Fire Extinguishers found in the OR procedure rooms versus outside the OR area.
In OR rooms = Carbon Dioxide (CO2)
Outside OR = Dry Chemical
Distractions that increase risk for error
High noise level
Talking during complex tasks (Omnicell use, counts)
Phone use
Out of sequence communication during Relief of Staff
The Corporate Compliance Officer for BAY.
Who is
Heather McAllister
Separate decontamination and High-level Disinfection (HLD) areas by this much space
At least 4 ft
between the decontamination sink and the area where devices are prepared for sterilization or HLD.
Online Search = SDS or MSDS + Chemical name.
What is
How to look up the first aid response to an exposure to a chemical?
This system is used to report all events that may or have contributed to an adverse event.
What is Safety 1st?
Damage to the skin and the underlying tissue caused by constant pressure or friction to skin particularly risky if over bony areas such as the heels, elbows, the back of the head and the tailbone (coccyx) may
start as red, blue, or purplish patches on the body. They don't blanch or turn white when touched.
Warning signs and symptoms that may suggest a pressure injury.
Note - Pressure wounds can be more severe than is visible to the naked eye.
The difference between a Failure Mode & Effects Analysis (FMEA) and a RCA (Root Cause Analysis).
FMEA - Analysis of a high risk process before it becomes a problem of affects a patient. (Prospective)
RCA - Analysis of a previous event to determine the cause and implement changes to prevent a repeat incident. (Retrospective)