Modern-Day Perioperative Practices - Essay Example

Order 227323 PERIOPERATIVE PRACTICES Introduction Conventionally the basic safety issues in a perioperative environment as well as practices comprise: sterile surgical theaters with corresponding recovery rooms and sterile modern apparatus; surgical asepsis and basic infection control; Management Stages and Apt Medical surgical staff; checklist and medical record. 1. Sterile surgical theaters Modern day perioperative practices can be conducted simultaneously in set of six or more dissimilar theatres of the surgical departments in medical hospital settings. Independently, this may consists of high technology support accommodations, recovery division, and a stylish computer with refined video scheme that may permit personnel to check activities all through the service area from a central control quarter and to be in touch with each other easily (McIndoe Surgical Centre, rets: 8/31/08). The individual surgical theatre is usually provided with ground-breaking beams that would supply an illumination necessary for most advantageous facility at an assortment of events for reduced eye strain for surgeons. On the other hand, pre-surgical areas may be tinted with muted to white finishing, to come up with an environment well enough for the warmness essential to on patients on their road to recovery (McIndoe Surgical Centre, Rets: 8/31/08). Mainstream, this plan gives confidence and working efficiency because of the proposed reduced surgical section operational activities. Similarly, the theatres are designed to roughly support minimal invasive surgery or the usual MIS. 1.1. Diagrams MEDICAL SURGICAL DEPARTMENT The recovery room as illustrated above may hold beds for patients and most likely support others. While the excellent surgical areas considered above, make sure of an outstanding provision to any patrons' in the surgery department. From the preoperative zone, through the intra-operative time, up to the postoperative stage, surgical patients are planned to increase in sense of worth in the course of healing. 1.1.1. Traffic Flow of patients and Security Aspects As exemplified in the diagram above, conventionally, after a patient is confirmed to undergo curative surgery, the patient will be subjected to benchmarked laboratory test. Then, when the calendar for surgery is in place, the patient will be delivered to the anaesthesia room. After having effectively sedated, the patient will be transported to the surgical theatre. As soon as surgical procedures are concluded, the patient will be transported to the recovery room. Normally, all proceedings from the anaesthesia room to the recovery room are confined to the medical surgical department to ensure safety of the medical staff as well as the patients. Safety and security are as well the usual basis for the departmentalization of the medical system. 1.1.2. Fire precautions As a rule, in case of fire and other disasters, huge emergency exits are provided at the back of the medical surgical section. The paths are typically guided by a corresponding map at the lobby of this particular hospital section. As well, fire extinguishers are on accessible locations. Telephone lines are also accessible to call for help when essential. 1.1.3. The Materials used for Flooring and Walls Leading UK construction materials dealer identified laminate flooring materials for high-end hospital floors. These are hygienic, durable and anti-static materials, ideal for high-use (http://www.jewson.co.uk/en/templates/product/templateA.jsppageType=Product&itemId=prod340025) hospital environments like medical surgical department. 1.1.4. Theatre lighting Traditionally, customized innovative lighting equipments are attached on individual operating theatre ceiling that would allow an adequate amount of light essential for most favourable facility at an assortment of events while reducing eye strain for surgical medical team. ((http://www.jewson.co.uk/en/templates/product/templateA.jsppageType=Product&itemId=prod340025). 1.1.5. Ventilation Systems Traditionally, operating room ventilation is provided by first the choice of size of the room, second, the height of the roof, and third cooling device. Appropriate aeration and its consequential flow are additionally supplied with air from these cooling devices, but, the cool air is first filtered by the now commonly known laminar flow filters that sieve off micro organisms (HNHSFT - AT, 2008). Additionally, the preference of the flooring and walling materials above are essential to provide an exceptional environment that is free from all forms of micro organism. 2. Surgical Asepsis and Basic Infection control Traditionally, operating theatres are geared up prior to any surgical process to maintain a perioperative mandatory environment (HNHSFT - AT, 2008). All forms of micro organisms are eliminated from these surgical rooms by additional asepsis. This technique was set out by a British surgeon named Joseph Lister in 1860. Basically, aseptic techniques are employed starting with the cleaning of floors, walls and apparatus by means of standardized disinfectants and disinfection techniques (HNHSFT - AT, 2008). Appropriate aeration and its consequential flow are then supplied through air filters now commonly known as laminar flow filters that sieve off micro organisms (HNHSFT - AT, 2008). Other materials that will be used for comprehensive measures normally called invasive procedures are prepared following stringent surgical aseptic precautions (McIndoe Surgical Centre, Rets: 8/31/08). Typically, these inflexible aseptic conditions take account of: 1.) intensive hand and fingernail scrub with soap and water for approximately ten minutes; 2.) donning only germ-free: gloves, mask, gown, and shoes; 3.) employing only pure solutions and dressings; 4.) using only untainted drapes and making a germ-free field; 5.) using only heat sterilized surgical instruments (HNHSFT - AT, 2008) . In the subsequent stages of the Perioperative period, benchmark sterile techniques and aseptic techniques are correctly and in particular observed. This code of behavioural preparations make certain the keeping out of pathogens within the entire process which is a conventional set of rules in the universal surgical room practice (HNHSFT - AT, 2008). This is in line with the certainty that in the whole Perioperative process, nosocomial infectious micro organisms as well as Iatrogeneic infectious micro organisms are almost certainly driven into the patient as a result of casual and inconsiderate actions (HNHSFT - AT, 2008). Inside the Perioperative system, the nurse on call, the Laboratory Medical Technologists, and the Medical-Surgical doctor for the medical-surgical task utilize no more than totally sterilized equipment, dressings, medications, and all the other materials to uphold medical asepsis (HNHSFT - AT, 2008). The Medical-Surgical players as well keep personal asepsis while on their rounds of duty to keep away from transmission of pathogens (HNHSFT - AT, 2008). Mainstream, hospitals make use of the code of behavioural hand washing within the Perioperative course, and throw away all possibly tainted throwaway materials, while the reusable tools are sterilized again under standard hospital procedures for sterilizing materials. In general, established or standardized precautionary policy measures are strictly in placed in hospital surgical settings. 3. Management Stages and Medical-Surgical Staff The subsequent benchmark medical-surgical clinical management stages are scientifically in line with the preoperative interlude: set up the patient on calendar for surgery; preoperative preparation right before surgery; preoperative medications; transporting the patient to surgery; preparing the patient's room for postoperative care; and caring for the significant others (Lewis, Heitkemper, and Dirksen, 2001). The next stage of the medical surgery period is the intraoperative period. This is usually done in the surgery theatre by members of the medical surgical team, attended to by a queue of perioperative nursing staff such as circulating nurse, registered nurse first assistant, certified registered nurse anaesthetist, head nurse, educator nurse, case manager nurse, and clinical nurse specialist (Lewis, Heitkemper, and Dirksen, 2001). Finally, the postoperative interval subsequent to intraoperative and a continuation of the nursing care chore, up to an extent whilst the patient is in the customary physical form (Lewis, Heitkemper, and Dirksen, 2001). 4. Checklist and Medical Record In a report by Medical News Today dated 25 June 2008, the UK Medical-Surgical practitioners have adopted a tool or a checklist which will largely increase welfare in surgery (Laurance pdf, 2008). The checklist format was issued by the World Health Organization for ease with which a circulating nurse records critical observations with the following headings: Sign in - prior to induction of Anaesthesia, verify; Time out - prior to skin incision (Attending Surgeon Begins Checklist Here); Sign out - prior to wound closure; signature; and date (http://seattletimes.nwsource.com/ABPub/2008/06/24/2008015136.pdf. rets: 8/31/08). Actually, this checklist was a product of consitent and persitent trials by Dr. Atul Gawande and associates with the ultimate aim of reduction in the number of postoperative complications as well as death. (http://www.youtube.com/watchv=w-ytSK_QRCM rets: 8/31/08). Besides, the design of the checklist is such that it is applicable to all hospitals globally. Besides, the design of the checklist is such that it is applicable to all hospitals in the world. . All hospitals in the UK as well as all surgeons and nurses are then obliged to employ the device on their regular tour of duty to minimize undue damage as well as lost of lives. Essentially, this is another important advancement in the medical field next to stethoscope (Laurance, 2008). This is because, in the UK alone, out the eight million surgical cases, approximately one hundred twenty nine thousand were unduly endangered according to the National Patient Safety Agency. With the advent of the checklist, and the substantial increase in its usage, marked decrease in unjustified mortality among surgical patients were observed (http://www.dh.gov.uk/en/Aboutus/MinistersandDepartmentLeaders/ChiefMedicalOfficer/AboutTheChiefMedicalOfficerCMO/CMOAtLarge/DH_085832. Rets: 8/31/08). Reference Berntsen, Karin Janine. 2004. The Patient's Guide to Preventing Medical Errors. Westport, CT: Praeger. http://www.questia.com/PM.qsta=o&d=113171329. Cook, Richard I. 1996. Adapting to New Technology in the Operating Room. Human Factors 38, no. 4: 593+. http://www.questia.com/PM.qsta=o&d=5000452218. Health Canada. CCDR. 1999. Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care. 25S4. www.hc-sc.gc/pphb-dgspsp e.html#infection. Garner, Julia S. 1996. Guideline for Isolation Precautions in Hospitals: Infection Control and Hospital Epidemiology. www.cdc.gov.ncidod/hip/isolat/isolat.htm. Lewis, S., Heitkemper, and Dirksen. 2001. Medical Surgical: Assessment and Mangement of Clinical Problems. 5th edition. UK: Mosby. Website Chief Medical Officer http://www.dh.gov.uk/en/Aboutus/Ministersand DepartmentLeaders/ChiefMedicalOfficer/AboutTheChiefMedicalOfficerC MO/CMOAtLarge/DH_085832. Rets: 8/31/08/ Infection Control Lead Nurse and Infection Control Committee. Berkshire Healthcare NHS Foundation Trust - Aseptic Technique. 9th April 2008. http://www.berkshirehct.nhs.uk/documents/store/ICC018AsepticTechniqueV1.pdf. Rets: 8/31/08. Laurance, J. ed. 2008. A surgical revolution: checklist that could prevent thousands of deaths. http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/a-surgical-revolution-checklist-that-could-prevent-thousands-of-deaths-853507.html. 8/31/08. National Patient Safety Agency. http://www.npsa.nhs.uk/. Rets: 8/31/08. Nurses lead the fight against hospital acquired infections. 07 Oct 2003. http://www.uclh.nhs.uk/News/2003/October/. Rets: 8/31/08/ McIndoe Surgical Centre. Surgical Theatre Facilities. http://www.mcindoe- surgical.co.uk/mcindoe-theatre-facilities.htm. Rets: 8/31/08. World Health Organization. Surgical Safety Checklist. http://seattletimes. nwsource. com/ABPub/2008/06/24/2008015136.pdf. rets: 8/31/08. http://www.jewson.co.uk/en/templates/product/templateA.jsppageType=Product&itemId=prod340025. Rets: 9/1/08. Read More