ERAS
Clean Up Your Act
Documentation
Check Yourself
Abbreviations
100
What does ERAS stand for?
Enhanced Recovery After Surgery
100
The scrub nurse is cleaning up her back table after surgery. How should she send the spring retractors back to MDRD?
Placed open in the sharps pan with tips facing down.
100
What 2 areas of the Pre-Operative Checklist require initials/sign off by the OR RN?
1) Surgical Site Marking Verification
2) Final Pre-op Checks
100
When checking in the patient, any patient over ____ years old requires an ECG.
50 years old
100
PAC
Pre-Admission Clinic
200
Some pre-op components of the ERAS protocol include pre-op education, decreased fasting time and no/selective bowel prep. List 3 other considerations.
- Carbohydrate loading (clear juice)
- Antibiotic prophylaxis (60min before incision)
- VTE prophylaxis
- Pre-warming
200
Your patient is on cytotoxic precautions therefore all items that have come into contact with blood and body fluids shall be treated as cytotoxic waste. How should this waste be disposed of?
Red cytotoxic waste containers, red bags/liners for garbage bag, labelled with cytotoxic waste stickers.
200
List 4 times that are documented on the OR Record.
- Set up start
- Patient enter OR
- Anesthesia start
- Anesthesia ready
- Surgery Start
-Surgery Stop
- Patient exit OR
200
When checking in the patient, the RN checks the patient name, DOB, and MRN on the _________ and ___________.
Patient ID band & facesheet
200
SDA
Same Day Admit
300
List 3 intra-operative components of the ERAS protocol.
- Active warming
- Goal directed perioperative fluid management
- Multi-modal pain and nausea management
- Antibiotic re-dosing (cases 3-4hrs)
- Avoidance of prophylactic tubes/drains
- Surgical technique (MIS vs open)
300
After a case, what types of items should the scrub nurse place in the green bin for reprocessing?
Harmonic scalpel, ligasure, disposable trocars, staplers.
300
"Case costing" is done to ensure standardization and to monitor actual supply use in OR cases. What type of cases are NOT costed?
- Any non-scheduled (ER) patient
- Any case that is not a good snapshot of a "standard" case (procedure changes drastically/serious unexpected complications)
300
During your patient interview, the patient states he has had a "very bad rash" when wearing latex gloves. A latex allergy was not noted on the slate. What should be your FIRST course of action.
Call into the room to notify the team.
300
ELOS
Estimated Length of Stay
400
Which of these is NOT a post-op component of ERAS: a) Early feeding
b) Early family support
c) Early ambulation
d) Use of chewing gum
b) Early family support
400
How should the batteries from the powered Echelon staplers be disposed of at the end of the case?
Removed from the stapler and placed in the yellow bin by the decontam elevator.
400
Implantable devices or implants are items such as cement, plates, screws, mesh, ureteric stents, breast implants, etc. Where should these items be documented?
Implant record or explosion sheet
400
This practice, which is completed in PCC, has been shown to significantly reduce hospital acquired infections and is required for services such as cardiac, spine, ortho, thoracic, neuro, vascular, and plastics (breast only).
Nasal decolonization
400
OOT
Out of Town
500
Name 2 outcomes we expect to improve through the implementation of ERAS.
- decrease length of stay
- reduce complications
- improved patient experience/patient centered care
- increase patient flow
- decrease patient stress
- optimize recovery
500
What types of flexible scopes are pre-cleaned with an enzymatic solution and water before sending to MDRD?
Bronchoscope, colonoscope, gastroscope.
500
During room change over, housekeeping staff is very busy cleaning multiple ORs which results in a delay of 20 minutes. Your buddy nurse says "let's make sure to document the delay". Where/how is this documented?
OR Record, top of first page under Quality Control.
500
Which antibiotics MUST remain on the IV pump?
Vancomycin & antibiotics for all ERAS patients.
500
DSD
Discharge Same Day