Preps
How long to wait after using an alcohol based prep
3 minutes
Specimen hand off
Hand off field asap with surgeon permission
have labeled sticker readily available to clarify with surgical team
Wear appropriate ppe during specimen transfer
specimen should be taken to destination: immediately for fresh/frozen
when going on break
immediately end of the case
When should bleach wipes be used for turnover?
Can fluid bags hang on the scrub sinks to drain?
What is the MSDS and how do you find it?
MSDS: Material Safety Data Sheet: Safety Precautions for chemicals
Digital Copy on one henry-->Quick links
Chloraprep: How to prep?
How long to scrub moist area?
How long to scrub dry area?
From incision site out to periphery without returning to incision site.
Moist Area-scrub 2 minutes
Dry Area-scrub 30 seconds
What to do for a formalin spill?
Where are the kits located?
Bonus: Should you dump small containers into a large container?
Exposure: Wash with soap and water or flush eyes for 15 minutes
Grab spill kit-yellow bag where formalin is stored
use neutralizer pad for small spill or pink jug for large spill to neutralize. Can be disposed of in garbage.
Wear appropriate PPE for clean up: eye protection, mask, gloves
Place RL
Place RL if you have any symptoms from exposure: throat, eyes, nose, irritation, cough/wheeze
Do NOT dump small containers into a large container, any transferring of formalin liquid should happen in pathology under a hood.
What wipes should be used for all turnovers?
Bonus: How long is the dwell time?
Double Bonus: What does dwell mean?
Oxivir wipes
1 minute
Dwell means how long the surface should be wet
Can you dump fluid that has been on a back table down the scrub sink or the garbage or linen bags?
No, this fluid is dirty and should be disposed of in a neptune or in a hopper
Where is the department emergency binder located?
Bonus: What is in it?
Emergency phone tree
What to do in an emergency: Power outage, active shooter, tornado etc
How to do a CHG Prep?
Bonus: How to do a vag prep?
Scrub 2 minutes
blot
scrub 2 minutes
blot
Vag Prep: 1 sponge middle, 1 sponge 1 leg, 1 sponge 2nd leg. blot. 1 sponge middle, 1 sponge 1 leg, 1 sponge 2nd leg. Blot external Internal Prep: 2 internal sponges, 1 dry sponge to blow.
If the fire risk score is a 3 what does the surgical team need to do?
Procedure site above or below xiphoid?
Ignition source present?
Discuss the fire risk 3 checklist, oxygen must be off for 1 minute prior to ignition source use and disable ignition source when not in use.
Examples of things that should go in the stryker teal recycle bin?
Bonus: Examples of things that should NOT go in the stryker teal recycle bin?
SHOULD: Disposable laparoscopic instruments, trocars, carter thompson, harmonic device (not cord), Myosure, arthroscopy shavers
Should NOT: Davinci stuff, ethicon staplers, sharps, anything not listed above.
What are important components of radiation safety?
How should lead be cared for?
badge switched out quarterly (monthly for CVOR)
Lead should be hung neatly, checked yearly for damage
What is RL and how to do it?
RL is the safety reporting system for any process improvement recommendations, accidental workplace injuries, and safety concerns.
Go to One Henry-->Quicklinks-->RLS
or scroll down a little on the one henry home page and see the icon.
What criteria helps decide appropriate prep choice?
Bonus: Where should 99.9% of clipping be done?
Double Bonus: What should you do if a surgeon asks you to prep outside of standards?
Patient allergies
Patient skin integrity
Surgical site
Surgeon preference
Bonus: Clipping done in preop
Double bonus: Document "prep per surgeon" or have the surgeon prep themselves
True or false
An open sterile field does not have to be constantly watched or covered?
False
An open sterile field must constantly be watched, it cannot be left unattended.
Field should be covered if delay is greater than 30-45 minutes
If a dual case the 2nd table can be covered if not being used for an extended period of time, example wound closure tray or combo service line case.
Chemo precautions?
Bonus: Send the patient to PACU with foley bag on or off?
PPE: 2 pairs of gloves (protexis is preferred), gown, eye protection
Signage required on all doors
If exposed: Wash with soap and water, flush eyes, change clothes
Spills: Call 6 legacy CUL, spill kit located in OR 6
Disposal: Heavy saturated-black bin-good for 1 year.
Trace amounts-yellow bin, 90 days
Laser Safety?
Bonus: What is specific to CO2 Laser?
Double Bonus: Who is our laser safety officer?
Windows covered, eye glasses & signage on doors
PPE: Eyewear required for all lasers
Water/Saline on field
Laser: in standby mode when not in use with laser settings clarified when changed.
Bonus: CO2 laser requires n95 and smoke evacuation
Double: Robin Ebersole
One Henry-->Click policy tab-->Edit location to Jackson
Chloraprep
Duraprep
Betadine
CHG
Duraprep: Paint, Iodine povacrylex and alcohol
Betadine: Scrub and Paint, povidone-iodine
CHG-Scrub, 4% CHG
True or false:
Patients can wear jewelry, hearing aids, dentures, glasses etc with no documentation or waiver?
False
If jewelry cannot be removed a waiver must be signed in preop
If the patient requires their dentures, hearing aids, glasses etc, you should document in the chart where these items end up and ensure they make the transfer to PACU. If anesthesia takes responsibility for them, document this as well.
When giving a break or a lunch, no report needs to be given and it is okay to say "I am just giving a lunch" ?
Whether nurse, scrub, or FA a report needs to be given about the patient, what is happening in the case, medications on the field, general location of counted items, tentative plan, anything PACU will need to know.
You have taken over care for a patient and need to know everything you need to know. The response "I am just giving a lunch" is not appropriate.
What is the wound closure process?
Bonus: What and where should it be documented?
Documented in the post procedure debrief section
Escalate if surgeon refusal
Please ensure completion of colo bundle checklist paper for all bowel patients.
What is exposure protocol?
Bonus: Where can you find it if you forget?
Immediately wash with soap and water or flush eyes depending on type of exposure
draw 2 gold labs and place appropriate blood orders under specimen tab
place RL
Go to Occupational Health or ER if needed.
Bonus: Sharepoint