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Safety in the OR . Staff Safety Patient Safety Peggy Robinson RN Hope Austin RN. Good Morning. Please take at least one 3x5 note card and write ANY question you have about the OR or Perioperative Nursing on it When you are finished please deposit it in the basket
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Safety in the OR Staff Safety Patient Safety Peggy Robinson RN Hope Austin RN
Good Morning • Please take at least one 3x5 note card and write ANY question you have about the OR or Perioperative Nursing on it • When you are finished please deposit it in the basket • We’ll review the questions together at the end of class
Overview • Chemical and infectious agents that pose a risk to patients and personnel • Biological Hazards • High Risk equipment used in the OR • Techniques to reduce the risk of injury or infection to patients and personnel
Factors that impact Safety • Increasing regulations • Public scrutiny • Rising patient acuity • Staff Shortages • Increased workloads and responsibilities • Fear of injury and infections • Joint Commission NPSG
Creating a Culture of Safety • Involves the entire team • Policies clear and understood • Zero tolerance for non-compliance for non-reporting • No blaming or shaming, data used for improvement purposes
Factors Supporting Safety • Senior management support • Absence of workplace barriers • Cleanliness and order • Good communication • Frequent training and feedback • Availability of equipment
2017 Hospital National Safety GoalsThe Purpose: To improve patient safety The Goals focus on problems in health care safety and how to solve them • Identify Patients Correctly • Improve Staff Communication • Use Medicines Safely • Use Alarms Safely • Prevent Infection • Identify Patient Safety Risk • Prevent Mistakes in Surgery
Universal Protocol • Correct Surgical Schedule • Verbal Verification with the patient • Correct Consent • Site Marked • “Time-Out” Performed • All Aspects Documented
Other Hazards--Patient • Patient Transportation/Identification • Wrong-Site Surgery (Time-Out) • Skin Integrity (prepping, positioning, tourniquet use)
Hospital Hazard Material • Agents with the potential to affect a persons health or cause death if injury • Identified on Safety Data Sheet • Identified with cautionary product label • Unknown hazards
Chemical Hazards Included, but not limited to: Anesthetic Agents Detergents Disinfectants Sterilants Latex Plume Methyl Methacrylate (bone cement)
Phenolics and QuaternaryAmmonium Compounds • Primarily for housekeeping • Skin and eye irritation • Use PPE as directed • Comply with label instructions
Preservative– Formaldehyde • Carcinogen • Primary Safety Precautions • Minimize exposure • PPE • Spill Plan
Chemotherapeutic Agents • Bladder Instillations • Brain “Wafers” Written Precautions and procedures for handling, preparing, administering, disposing of cytotoxic agents in your facility should be followed
Patients undergoing chemo • Routine use of ‘chemo precautions’ for 48 hours post chemo • Double flush the toilet or hopper when emptying body fluids • Cover with a chux or drape to prevent splashing • Wear regular gloves when handling body fluids • If linens get soiled, place them in a yellow bag (from EVS) • Empty chemo directly into a chemotherapy waste bin (yellow)
Biological Hazards Blood Body Fluids Tissue Specimens
Blood Borne • HIV, HBV, HCV, West Nile Virus, CJD A penetrating injury or splash (into the eye, onto the mucus membranes) with fluid contaminated with blood or body fluid must not be ignored! • Stop activity immediately, and step back • Squeeze the skin around the needle stick or cut to expel blood and contaminants. • Clean the puncture site or flush the eye with cool water. Flush the cut with alcohol or iodine preparation. • Report the incident according to your facility P&P and seek medical attention.
Contact MRSA, VRE, Small Pox, C-diff • Methicillin-resistant Staphylococcus aureusis a bacterium responsible for several difficult-to-treat infections in humans. that has developed resistance to antibiotics, which include the penicillins and the cephalosporins. • Vancomycin-Resistant Enterococcus is usually spread by direct contact with hands, environmental surfaces or medical equipment that has been contaminated by the feces of an infected person. • Small Pox spreads easily from one person to another from saliva droplets. It may also be spread from bed sheets and clothing. • C. difficile spreads mainly on hands from person to person, but also on cart handles, bedrails, bedside tables, toilets, sinks, stethoscopes, thermometers — even telephones and remote controls.
Airborne TB, Influenza, Varicella, Measles, Mumps • Transfer of particles 5 microns or less in size into the air, either as airborne droplets or dust particles containing the infectious microorganism; can be produced by coughing, sneezing, talking or procedures such as bronchoscopy or suctioning; can remain in the air for up to several hours; and can be spread widely within a room or over longer distances. • Special air handling and ventilation are needed to prevent airborne transmission.
Regulations • CDC – Transmission based precautions • Hospital P&P ( contact, droplet and airborne) • HAND WASHING!!! Before and After Each Patient Contact • Find out where PPE are kept • Don’t be afraid to ask questions
Equipment Hazards in the OR • Electro surgery • Lasers • Electrical Equipment • Radiation/ X-Ray
Staff Safety Considerations • Lifting • Body Substances Exposures • Radiation Exposure • Latex Allergy
New Focus Area • Workplace Violence and its effect on patient and staff safety
Perioperative RN Role You are your Patients advocate Keep your patients safe Keep yourself safe