Stanford Hospital Operating Room Case Study

Second, the nurse commences assessment with an evaluation of patient’s airway, breathing, and circulation for any signs of inadequate oxygenation and ventilation. One of the patients’ temperature was 102 F and the physician recommended pain medication (dilaudid) and it was administered instantly. The nurse gets vital signs and compare the result with intraoperative care. The nurse chart vital signs every 5 mins for the next 15mins, every 15mins for the next hour depending on the recovery state of the patient. I also noticed that for diabetic patients, the nurse checks for blood glucose and also compare result with intraoperative care unit result. Third, the nurse assess pain although the patients receive pain medication before surgery. Fourth, the nurse assess surgical site (dressings and drainage). Fifth, the nurse assess neurologic (level of consciousness, orientation, sensory & motor status, pupil size and reaction. Finally, the nurse assess gastrointestinal (nausea, vomiting, intake of

Has anyone ever considered how medical devices are prepared before a surgical procedure? Central Sterile Processing Department (CSPD) consists of services within the Hospital, in which reusable medical devices will be cleaned, prepared, and processed. The role for CSPD is to prevent infection transmitted by usage of medical devices. The procedure for hospital medical devices before surgery has a four part workflow process in: Decontamination, to Instrumentation, to Sterilization and Sterile Storage (Case Carts). An example is given for reprocessing an Intestinal Set and the supplies needed for the preparation of this medical device set.

Use at least two patient identifiers when providing care. Double checking of ID bands and ID/Driver’s license of patient if possible. Using labels to mark all materials /items needed for the procedures. A two person check off procedure must be implemented. Items requiring labeling include: patient records, signed consents, and all assessments, diagnostic tests and x-rays. Also included should be any item that is needed for the procedure (blood products, devices, and equipment). Using a matching system, so that all items in the procedure area are matched to the patient. The matching system must be completed by a minimum of two staff members. These staff members should include a qualified staff member, nursing staff involved in the procedure, recovery room staff, and discharge staff.

Ambulatory Surgical Center provides same-day surgical care that includes diagnostic and preventive procedures. Ambulatory Surgical Center treats only patients who have already seen a health care provider and selected surgery as the appropriate treatment for their condition. Ambulatory Surgical Center must be certified and approved to enter into a written agreement with CMS. Ambulatory Surgical Center has a unique set of regulation and standards under the Medicare and Medicaid program or other third party payers. The outpatient payment provides a set payment for each surgical procedure. They must be licensed and inspected by the State and Federal government to see if they meet standards Certified facility standers.

The Seton Joint Ventures update was posted to BoardEffect for preview prior one week prior to the committee meeting.

Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when

We will make sure that per our hospital policy we will I.D. the site at admission, whenever there is a patient transfer, and at preop we will communicate this with the patient whenever the patient is aware. We will strive to make sure that the surgical sites are appropriately marked per the site I.D. policy and that the patient is interactive in the process when applicable. As part of this policy we will also make sure that all necessary medical records and labs are readily available for the procedure. We will also make sure that all possibly needed equipment and supplies are present.

Surgical Technologists have an important role in the operation room (OR). There are different positions within the Surgical Technology field, including Scrub Surgical Technologist, Circulating Surgical Technologist, and Second Assisting Technologist. Scrub Surgical Technologists have a number of tasks, including prepping the patient for surgery, sterilizing the OR, gown and glove surgeons and assistants, and assists the surgeon and other surgical team members in a number of ways, such as passing instruments and dressing wounds. Circulating Surgical Technologists have a number of tasks as well, including checking patient’s charts, identifying patient and verifying the surgery that will be performed with consent forms, assisting anesthesia

The facility must be explained and delivered to the patient by knowledgeable staff prior to delivery of the procedure, and the staff must answered any questions prior to the procedure.

Quality control processes are also a major part of a Sterile Processing technicians daily task. As pointed out on the Infection Control Today’s website “Healthcare facilities should allow adequate time for reprocessing to ensure adherence to all steps recommended by the device manufacturer, including drying, proper storage, and transport of reprocessed devices”. (“Immediate Need to Review,”2015) This involves a detailed policy and procedure manual and manufactures instructions available for all technicians to reference to ensure proper measures are taken for the cleaning and processing of medical products to ensure patient

After all these setbacks, Mr. Grieg and his teams continued to strategize ways to resolve this issue. The team where knowledgeable about VH’s in house repairs of certain hospital equipments and had to figure out if the company where capable of repairing the endoscope due to the complicated nature of the equipment. One of the team members, Steve Elder suggested a coordination process between Victoria Hospital and its affiliated partners. This suggestion was due to a meeting Mr. Elder had attended in Toronto where multiple hospitals combined their purchasing budgets to form an in house repair department.

The Evansville Surgery Center is seeking a full-time CNA. The Evansville Surgery Center opened its doors in 1984. According to their website, they are the most respected outpatient surgery center in the tri-state area. Since 1984, the Evansville Surgery Center has expanded onto the Deaconess Hospital Campus, as well as the Gateway on the Deaconess Women’s Hospital campus. Some of the services offered at this facility are Mastectomy’s (surgical procedure in which part, or all, of the breast is removed), Breast Biopsy / Lumpectomy (Lumpectomy is the surgical removal of a cancerous lump (or tumor) in the breast), and Hernia Repair (all types).

Thesis: My goal is to inform my audience the importance of counting the instruments and sterile supplies for Surgical Procedures.

The CBOC Audiology uses RME that is not processes here in SPS. The clinic practices soaking of instruments within their procedure rooms. This is not acceptable and needs to be stopped. The practice is NOT in congruence with the VA #1116 Directives. This issue has been discussed both in Infection Control Committee and RME Committee. Both Committees recommends that CBOC Audiology be converted to disposable instruments.

Lastly, in the surgery theatre, misidentification may happen due to the same factors formerly mention plus failure to mark site/side of surgery, failure to properly perform time-out, and multiple surgical teams (Chan et al., 2010). To analyze the risk for these errors, few factors will be analyzed including human factors (staffing, scheduling, supervision, and qualification), equipment and technology (scanners, computers, and software), Communication (between staff and patients, between staff, between staff and physician, between physician and patient, and between units), environmental factors (physical, safety, security, and preparedness), and procedures and policies (planning, staff education, patient education, protocols, patient identification, and patient observation) (Chan et al., 2010).