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Flashcards in Intra-Op Deck (24):
1

Intraoperative period

time enter the OR until you go to the PACU

2

Main concerns of perioperative nurses

patient safety and advocacy

3

4 fundamental purposes of physical environment of operating room

geographic isolation
bacteriological isolation (infection control, priority)
centralize equipment (all equip ready to go)
centralize trained personnel

Located in separate area to restrict flow of people traffic and decrease contamination

4

3 distinct areas:

unrestricted, semi-restricted, restricted

5

unrestricted area

street clothes, point of entry for patients

6

Semi-restricted

authorized personnel must wear scrubs

7

Restricted area

OR, scrub sink, clean core

8

Bacteriological isolation

special clothing & footwear
separate water supply, airflow system, laundry, and disposal systems

9

Biggest risk for contamination

PEOPLE

10

Centralization of equipment

contains all equipment to facilitate safe and effective surgery

11

Centralization if trained personnel

teamwork in an isolated, restricted environment

12

Operating room

4 designs
interior walls, ceiling, floors = smooth, nonporous surface (no windows, waterproof, soundproof, fire resistant)
doors: double or sliding to decrease air currents
fresh filtered air for infection control and to prevent accumulation of anesthetic gases (~25 air exchanges per hour)
low humidity (30-60%) and temp (68-75)

13

4 basic designs of OR

central corridor or "hotel plan"
double central corridor/clean core plan
peripheral corridor/ racetrack plan
grouping or cluster

14

processing rooms

utility rooms for clean-up, instrument prep, storage, communication system

15

OR team concept

-a group of people who recognize common goals & coordinate efforts to achieve them
-positive outcome for patient
-delivery of psychologically & physiologically prepared patient to surgery

16

Scrubbed sterile team

-enter the sterile field
Operating surgeon, assisting surgeons, scrub nurses and techs

17

Unscrubbed, unsterile team

DO NOT enter sterile field
-anesthesiologist, circulating nurse, x-ray, patho, etc

18

Only sterile can touch...

STERILE

19

Surgeon

(sterile, scrub team)
Responsible for: pre-op H&P, assessment/management, OR consent form, pt safety & management in OR, performing surgery, & post-op management of pt

20

Surgeon assistant

(MD, PA, or RNFA) sterile scrub, assists surgeon during procedure.
-may perform portions of the procedure under supervision
-assist with hemostasis and suturing

21

Anesthesia Care provider (non-sterile), Anesthesiologist/CRNA

-administer agents during surgery, monitor cardiac/resp func.
-supervise post-anesthesia recovery in PACU (for first 24 hrs post-op)
-supervise PCEA for duration of use

22

Scrub nurse

(sterile)
-Sets up sterile field, assists with prep of room
-scrub, gown, & glove self and others
-prep instrument table & organize equip
-assist w/ draping
-pass instruments
-keep count of sponges, needles, instruments
-monitor aseptic technique

23

Circulating Nurse

(non-sterile)
-oversees/participates in care
-check equip(available & sterile) & environmental factors
-insert foley, IV, NG, labels specimens
-monitor aseptic technique & blood loss
-count equip w/ scrub nurse
-complete intra-op record
-gives report to PACU RN

24

Other surgical team members

holding area nurse- ensures pt ready for surgery (verifies documentation, assess pt, coordinates manages care in pre-surg holding area)
specialty nurses- trained in particular type surgery