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AORN Periop 101
Terms in this set (36)
A study conducted on children's response to pain. (Example)
Implementation of infection control principles based on current research (Example)
An initiative to determine the relevance of patient discharge instructions. (Example)
An intentional act or an act of omission causing physical, financial, emotional, psychosocial, and/or cognitive damage to the person in the nurse's care. (There are two tiers: Primary ((related to bedside skills)) and Secondary ((revolve around shared responsibilities such Dx, surgery))).
"Let the master answer" an employer is vicariously liable for the behavior of an employee working within his or her scope of employment
A breach of duty to another person as outlined by law.
Standard of Care
Actions of a reasonable and prudent professional in the same or similar circumstance.
5 Rights of Delegation
1. Right task
2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation
US Regulatory Organizations at the State Level include (3 entities)
1. Public Health depts
2. Licensing Boards
3. Insurance commissioners
US Accreditation Agencies (4 entities)
1. AAAHC (Ambulatory Health Care)
2. ACHC (Health Care)
3. DNV GL
4. TJC (The Joint Commission)
Professional Organizations to help guide practice (2 entities)
1. ASCA (Surgery Center Association)
2. AORN (Association of periOperative Registered Nurses)
4 Elements of Safety Culture
1. Consistent and safe delivery of services.
2. Collaborative efforts among all teams and disciplines.
3. Environment that places reporting of errors and near misses ahead of blaming and recrimination.
4. Commitment of resources that focuses on safety.
Key takeaways from IOM "To Err is Human: Building a Safer Health System"
44,000 to 98,000 patient deaths may occur each year in the U.S. from PREVENTABLE MEDICAL ERRORS
2010 Future of Nursing IOM Report (4 recommendations)
1. Nurses should strive for higher levels of education and training.
2. Nurses should practice to the full extent of their education and training.
3. Nurses should be full partners with all health professionals in the redesign of US health care.
4. Better data collection and information infrastructure are necessary for workforce planning and policy creation.
Types of Errors (3 types)
1. Skill-based error (ex: incorrect ESU settings, wrong button pushed, etc)
2. Situational factor error (ex: under stress, etc)
3. Knowledge-based performance error (ex: fails to respond to an alarm)
What type of culture changes care delivery as a result of an error?
Culture of Safety
AORN advocates through Guidelines for Perioperative Practice and: (3 terms)
1. Position Statements
2. Tool Kits
3. Mission, Vision, and Values Statements
The Surgical Safety Checklist was an initiative of what organization?
WHO (World Health Organization)
Which major entity publishes regulatory requirements?
Centers for Medicare & Medicaid Services (CMMS)
Surgical sire marking is a regulatory requirement. What is true about marking?
Patient should be identified prior to site marking.
Organizational safety culture elements include:
Consistent and safe delivery of services
IOM, now NAMI, in "To Err is Human", published and reported: (3 statements)
1. To prevent errors a safer system needed to be designed.
2. When an error occurs, the system needs to be examined.
3. Standardization of process
What are examples of skill-based behavior errors? (3 examples)
1. RN programs a new ESU based on the machine she has used in the past.
2. RN hits the wrong button instead of the correct button beside it.
3. RN forgets to retrieve a unit of blood when called to do a sponge count.
A situational factor can occur because of:
A lack of attention
What's the minimum number of air exchanges per hour in the OR?
Timeout Criteria (Minimum of 4)
1. Correct patient
2. Correct site
3. Correct patient position
4. Correct procedure
Hallways leading to the OR and the sterile processing areas are designated as:
The airflow in the OR has what type of relationship to the adjacent OR hallway?
The only area in the perioperative environment that is designated as a restricted area is?
The Operating Room
This person establishes the sterile field and passes instruments to the surgeon
Your patient is experiencing a Malignant Hyperthermia crisis. Which medications should be readily available in the MH cart?
1. Dantrolene Sodium (2.5 mg/kg while infusing IV fluids)
2. Calcium Chloride 10% (10 mg/kg)
3. Sodium Bicarbonate 8.4% (maximum dose 50 mEq)
4. Refrigerated regular insulin
Which devices are responsible for fire IGNITION?
Which items are responsible for fire FUEL ?
1. Surgical drapes
3. Alcohol-based preoperative skin antisepsis solutions
What items are responsible for fire OXIDIZER?
1. Nitrous Oxide
Steps in an airway or chest fire
1. Immediately remove the endotracheal tube and any segments of the burned tube that remain in the airway
2. Discontinue the flow of breathing gases to the patient
Local anesthetic systemic toxicity (LAST) is a life-threatening adverse event that may occur after the administration of local anesthetic drugs through a variety of routes. What medication should be available?
1. 20% lipid emulsion (Bolus: 1.5mL/kg over 1 min) (Infusion: 0.25mL/kg/min over 30-60 min, may double rate as needed)
2. Use benzodiazepines for seizure suppression (NO PROPOFOL)
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