Part one - Pre-op case management
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| What are the 3 Phases of Surgical Case Management? | -Preoperative
-Intraoperative
-Postoperative
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| Preoperative case management: Prepare the ___. Pull necessary _____________(s). Prepare and maintain the __________ field. _______, gown, and _______. Count. Drape. Don ___. | - OR
- Supplies
- PPE
- Sterile
- Scrub,gown,and glove
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| Intraoperative case management: Maintain the ________ field. ________________ team members needs. Pass __________(s) and ___________(s) as needed. Prepare and handle med_____(s). Speciman ______. Dressings. | - Maintain the STERILE field.
- ANTICIPATE
- Instruments and supplies
- Medications
- Specimen CARE
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| Postoperative case management: Maintain _______ field until patient is transported. Transport used instruments and equipment to _______________ area. Prepare OR for next patient. Dispose of ______(s). | - STERILE FIELD
- Decontamination area
- Sharps
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| Maintain the sterile field Anticipate team members needs Pass instruments and supplies as needed Prepare and handle medications Specimen care Dressings | Intraoperative case management
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| Prepare the OR Pull necessary supplies Don PPE Prepare and maintain the sterile field Scrub, gown, and glove Count Drape | Preoperative case management
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| Maintain sterile field until patient is transported Transport used instruments and equipment to decontamination area Prepare OR for next patient Dispose of sharps | Postoperative case management
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| A POSitive CARE approach. What do the letters in CARE stand for? | C - Caring attitude
A - Application
R - Role
E - Enviormental Concern
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| APOS? | A - Anatomy
P - Pathology
O - Operative (procedure)
S - Specific (variations)
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| Identifying goal or problem Gathering and evaluating information Use A POSitive CARE Approach Generating one or more responses Implementing the best response Assessing the results | The five steps to critical thinking.
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| What is the first step in the five steps to critical thinking? | 1. Identifying the goal or problem
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| What is the second step in the five steps to critical thinking? | 2. Gathering and evauluating information.
( Use A POSitive CARE approach).
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| What is the third step in the five steps to critical thinking? | 3. Generating one or more responses
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| What is the fourth step in the five steps to critical thinking? | 4. Implementing the best response
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| What is the final step in the five steps to critical thinking? | 5. Assesing the results
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| Where can you gather information about the surgeon and what he wants? | Surgeons prefrence card
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| NAME THREE PHYSIOLOGICAL NEEDS: | -breathing
-food
-water
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| Name three physicological needs : | -safety
-belonging
-love
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| Reminder Never judge a patient Condition Behaviors that led to condition Personal appearance Surgical choices Always view patients with compassion This is called : | Respect
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| Laboratory results Radiology reports Previous pathology reports Surgical consent (review) History and physical report (H&P) Preoperative checklist Allergies, handicaps, or other limitations Nurses notes | All of these things should be in the patient chart.
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| Surgical consents? | -Permission to perform an action.
-permission to touch
(voluntary- can be taken away at any time).
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| Touching without permission can be_______. | Battery
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| Informed Consent: Obtain for all invasive procedures Protects patients and providers Patient is aware of: | - Their condition
- Proposed procedure
- Risks
- Viariables
- alternatives
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| The responsibility for securing written, informed consent belongs with the: | Surgeon
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| Preoperative Patient Education reduces ____________.Significant increase in patient __________________. Proven to shorten hospital stay. | - Anxiety.
- Compliance
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| Patient should shower or bath the night or morning prior to surgery Practice good oral hygiene Hair should be washed Preop shave As close to the time of surgery as possible NPO eight hours prior to surgery Comfortable clothing | PREOPERATIVE
( before admitting to hosptial for surgery).
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| Nail polish should be removed to better measure blood oxygen saturation Pulse oximeter Makeup should be removed Skin tone Infection | PREOPERATIVE
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| All ______________ should be removed prior to surgery. Dentures, prostheses, and implants also need to be removed. | Jewelery
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| Jewelary, Dentures, Prostheses, etc. need to be ______________ and placed with patient possesions. This includes wigs and hairpins. | Labeled
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| Once patient possisions are collected: | - Give to family members
- Lock in the hospital safe
- Labeled and kept with patients chart
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| Preoperative medications are used to: | - Alleviate anxiety
- Decrease nausea
- Produce amnesia
- Decrease saliva and gastric juices
-
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| These medications should be taken __ to __ hours before surgery. | 1 to 2
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| The paitent should not be left alone after administration of Pre OP meds. | True that.
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| Know the proper attire for the surgical technologist. | - Hat
- Masks
- Scrub suit
- Shoe covers
- Protective eyewear
- radiation protection
- gloves
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| Scrub suits are changed _____. | Daily
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| Shirts and drawstrings tucked __. | In
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| Need to change _______(s) if they become soiled. | Need to change SCRUBS if they become soiled.
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| Wear a cover gown or ____ ______ when leaving the O.R. environment. It looks professional and it prevents cross-contamination. | Lab coat
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| Hair covers are donned prior to the scrub suit to prevent shedding Reusable hats must be washed everyday Completely cover hair Space helmets Skullcap bouffant | True
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| Masks are worn at all times in _________________ areas. Tied snugly to fit over mouth and nose Strings of mask should not be crossed On or off Not hanging around neck Handled with strings Minimal Changed between all cases. | -Restricted
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| Shoe covers protect your _____. Remove when soiled. Remove when leaving surgical site. | Shoes
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| Gowns are sterile from ______ _______ to ___ ______. | Waist level to mid level.
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| Sleeves circumferentially to _____ inches above elbows. | two
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| Cuffs of the gown are considered ___ ______________, | Non sterile
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| _________(s) Should be worn anytime contact with broken skin or body fluids is expected. | Gloves
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| Always examine package and inspect ___________ of package before opening and putting on back table. | Integrity
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| Check the ________ date. | Expiration
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| Open __________ table first. | Back
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| ____________ items to ____________ items. | Larger items to smaller items.
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| STSR’s gown and gloves should not be opened on the ____ _______. | Back table
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| During a surgical scrub hands and arms need to be __" above the elbow. | 2
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| Surgical scrub should provide a film that lasts for several __________. | hours
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| There are two types of surgical scrubs: | -Timed method and -Counted brush stroke method. ( Hospital policy will dictate Number of strokes Required number of minutes 5-10)
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| Open door with back Keep hands between waist and midchest Avoid touching anything Don a surgical gown Minimize big movements Do not turn your back on sterile field “closed gloving” | Self drying and gloving
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| Keep hand in sight Keeps hands in sterile zone Establish a routine Drape the mayo stand Organize the back table Move as little as possible Keep body centered Work in sections Handle each item only once Be aware of environment | Preperation of sterile field
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| Sponges. Packs of __ or __. | 5 or 10
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| __________. sponges should not be used until after final count | Dressing sponges.
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| Patient Transport | Feet first Slowly Elevator Head first
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| Apply safety strap __” above knee Proximal to knee. Never leave patient alone. | 2 inches above knee
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| Normal temp values: Oral: Rectal: Axillary: | Oral: 98.6 Rectal: 99.6 Axillary: 97.6
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| Tempature monitoring Methods: Noninvasive: Invasive: | Noninvasive: -touch -skin sticker -ear -axilla INVASIVE: -Oral -Rectal -Esophogeal -Bladder
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| Normal Pulse Values: ------------------- Birth: Infants: Children ( 1 to 7): Children ( over 7): Adults: | Birth: 130-160 Infants:110-130 Children (1-7): 80-120 Children (over 7): 80-90 Adults: 60-80
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| Normal Respirations: Infants Children Adults | Infants: 30-60 per minute Children: 18-30 per minute Adults: 12-20 per minute
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| Normal BP for a newborn: | 50-52 SYSTOLIC/25-30 DIASTOLIC
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| Normal BP for a child under six years of age: | 95/62
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| Normal BP for a child to ten years old: | 100/65
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| Normal BP for an adolescent: | 118/75
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| Three basic positions: | -Supine -Prone -Lateral
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| Patient Positionins: | Supine Prone Fowler’s Trendelenburg Reverse Trendelenburg Lithotomy Kraske Lateral
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Created by:
Dmercer