Role of circulating practitioner in and outside a theatre room - Essay Example

?Running Head: CRITICAL INCIDENT ANALYSIS OF A SIGNIFICANT EVENT IN PRACTICE Nursing   Insert Insert Insert Name: Date: Introduction Theatre is a delicate unit within the health care Unit. However, the it is necessary to have somebody in place to be able to ensure that the requirements are put in place before the procedure begins to enhance proper and time saving procedure to assist bring back life which is a concern in medical practice. A trained nurse in handling the theatre assistance services who works with the surgeon as well as the medical team in the operation theatre is a scrub nurse. They both provide support within and outside the theatre, although the career is very demanding it also pays well but it requires a lot of diligence and ability to expand and learn on the crucial professionalism in the health care (Wicker, 2010, p. 77). Fig 1. Accessed from: http://www.wisegeek.com/images/people/health-wellness-11.gif on 3rd Dec, 2011. Through expertise in theatre issues surgeons go as far as seeking assistance from specific scrubs who are well conversant with the procedure to be undertaken hence its adept to train and be able to learn more while on practical theatre situation (Zatlin, 2005, p. 19). This calls for a dedicated person to carry out the roles of circulating practitioner in a theatre. As a second year student, we are obliged to practically face the situation during internship to equip us with the relevant information and skills that shapes our focus and perception of what awaits us after the completion of the studies (Waldie, 2007, p. 39). However, being an scrub does not enable an individual to be certain while handling instruments and disposables within the theatre, this could be confirmed through an incident that happened during a procedure when a scratch pad was misplaced within the theatre hall just to base all blames on me despite being innocent oblivious of the consequences that would follow should I be found guilty of an offence not committed (Wicker, 2010, p. 84). As a scrub it is within my mandate to confirm that all the necessary instruments and all the relevant information and materials are put in place so that the surgeon would not have to waste a lot of time waiting for the instruments to be brought to the theatre hall, in fact no one is allowed to leave the theatre hall when a procedure is on (Thomson,, 2002, p. 106). I have to ensure that all the instruments brought to the theatre are sterilized and able to perform the procedure in accordance with the surgeons’ perception being a life saving procedure a lot of care should be taken in order to accomplish the procedure. This includes a confirmation that all the people within the theatre hall are putting on in accordance with the rules and codes of ethics in medics (Wicker, 2010, p. 87). Through effective procedure there would be uni-effetive patient recovery and care for instance, the instruments that are supposed to be used only once should not be re used in any way under what come may (Pudner, 2000, p. 53). This is one of the ways through which poor patient handling arises from causing un-expected complications which would be avoided through following procedural implications within the theatre hall (Zatlin, 2005, p. 24). The key function within the practice is that patient care and preoperative environment entirely relies on our practice. It is within the health and safety rules state that accountability and responsibilities under which the duties are to be performed within the theatre. Hence any fault that arises within the theatre must be dealt with beyond reasonable doubt so ascertain that the patient care is maintained within our practice (Waldie, 2007, p. 42). In the process, we have to countercheck the instruments and affirm their states before, within the procedure and afterwards to ensure that the quality of services to deal with both appropriateness and efficiency in reducing harm to the patient under procedure (Thomson,, 2002, p. 123. Disease control and management are the only way forward when dealing with procedures within the theatre. However, in order to fully perform the roles of a scrub, all useful equipments should be well utilized and disposed of in accordance to the instruction on usage so that there would be control of the predisposing organisms in future. Nevertheless, to some extent theatre staff is to blame on the infective, preventive and control measures that are support be well conducted (Wicker, 2010, p. 90). Through precaution in nursing and medical practices the contemporary growth in number of diseases that would have been contained in order to come up with an idea that bound sole. However, it is within my jurisprudence to consult with my supervisors in order to handle the cases and equipment monitoring procedures with the concern required (Pudner, 2000, p. 59). When taking into consideration sterilization of equipments, a process which is economical as the materials may be reused after sterilization process (Association, 2010, p. 5-9). Not all situations would be in favour of the sterilizer, but when considering all the methods of disposing off and/ or cleaning the medical equipments, it is the most preferred process with low chances of re-infection (Bleich, 1977, p. 24). Being that diseases differ in nature of attack, and with individuals, control measures are necessary in order to completely eradicate the pandemic. In the process of achieving better health services, health institutions also should embrace sterilizer method of cleansing equipment in medical centres (Wicker, 2010, p. 94). I hereby admit that it is necessary to have a sterilizing machine within the hospitals in order to be certain of the level of sterilization of equipment especially for the delicate machines, which requires a lot of care to ensure that the components are primarily used for the purpose to which they were intended for instance the diathermy machine, its mostly used in theatre to stop blood flow through burning the ruptured and cut blood vessels to sustain the patients’ life and health (Waldie, 2007, p. 49). Such machines are non disposables hence require a lot of the (Cook, 2001, p. 18). when there is an outbreak of an infectious disease it is advisable that the health institution recommend sterilization of used equipment before either storage of disposal to the right places like incinerator to create enough space for ordering for new hygienic protective gears as well as cleansing products and ingredients which assists in total service delivery to the needy citizens (Werner, 2001, p. 34). However, ways of dealing with waste management are not perfect for instance when sterilizing instruments it would reach a point that you could by mistake damp instruments could be carelessly damped then taken by other means to the source of food or at the children’s playground, this would lead to re-infection (CDC, 2000, p. 14). On the other hand, disposal of used instruments is not safe either considering the factors that influenced the decision to be engaged in data collection (Cook, 2001, p. 65). The conflict of interest in the quest to come up with discrete information is underway, but when considering each and every option we can conclude that sterilizing of the used instruments is best option that should be adopted to control and management equipment due to the numerous threats of causing further re-infection or destruction (Zatlin, 2005, p. 43). Equipment maintenance Taking Autoclave equipment for instance, through identifying the autoclave serial number and additional unique batch code, the medical engineers would be able to identify the key tarts that would lead to fault hence easy to maintain and repair. Otherwise all the equipments would be replace every time a fault occur rendering the health institution heavy losses which are due to ignorance just from the people using the machines, recording department and also lack of information from the maintenance department on the kind of equipment details that would assist tem solve the different faults occur within the instrument (Cook, 2001, p. 10). Just like the instruments should be monitored for any fault, the same applies to the packaging of the instruments. Some instruments are well wrapped while they are not in sterile condition for instance, in the orthopedic tray you may find fluid that penetrates the wrapping tampering with other instruments within then wrapping. Such set of instruments should not be termed as sterile anymore and should be returned to the sterilizing department and be issued with alternative sets that meet the requirements of the law that governs theatre (Waldie, 2007, p. 72). All the wrapping materials for example crepe, linen and pouches wrappers must meet the requirements of the BS EN ISO 11607-2006, which was commissioned to monitor and safeguard all terminally sterilized devices within the medical field (Hughes et, al., 2002, p. 32). Role of circulating practitioner in and outside a theatre room There are two types of practitioners, the circulation and scrubbed, however, as a scrub practitioner the circulation practitioner is supposed to assist me with information updates as well as being able to tally the records to ascertain accuracy on record keeping (Zatlin, 2005, p. 48). The circulating practitioners are also mandated to avail the other requirements that could not be necessary but the need to use arises within the procedure. This is a kind of support that could not be assigned to any other person unless the person is eligible to work in a theatre set up with the knowledge of the safety and other regulations that should be observed within the room. They are not supposed to sit and relax until the procedure is terminated. They serve the purpose of completion of procedure (Thomson,, 2002, p. 128). In most theatre, you realize that they move with information up and down to the various departments fulfilling the theatre form and also the instrument confirmation form to the sterile department for confirmation of the necessary updates and expiration issues so that the expired drugs and equipments would not be utilized on any patient what so ever (Werner, 2001, p. 57). Additionally, when the theatre trays are correctly filled with the required information and equipment, then the assisting/ circulating scrubs are supposed to assist further in monitoring the efficiency of the equipments and machines so that any faulty one may be replaced or taken care of in a way that it would not affect the procedure (Zatlin, 2005, p. 51). However, should there be any error in the instrument tray, the circulating scrub and the other scrubs should take note of the missing instruments immediately the error is detected and recorded in the tray list/ record, so that the local reporting procedure is to be followed with support of any additional information that would enhance transparency detailing the discrepancies (Cook, 2001, p. 23 & Pudner, 2000, p. 78). In the process of carrying out the procedure, the circulating scrub is supposed to complete the records about the theatre session, stating the procedure, requirements for the procedure, date of use, patient case, and patient number considering that any health practitioner is mandated to carry out confidentiality while dealing with patient information, not forgetting the theatre number and the names of corresponding scrubbed and/ or circulating practitioners (Hughes et, al., 2002, p. 45). Through the thoroughly doctored instrument tray list, the equipments used will be derived after confirmation from two members of staff. This is very serious as it determines the key requirements in performing such a procedure; hence among the two members of staff involved in the confirmation of the instruments must be a registered practitioner. The confirmation should also be performed twice with one confirmation done prior to the procedure and the other at the tail end by the two members to ascertain accuracy in information delivery (Werner, 2001, p. 68). The functions of circulating scrub are complicated hence they should be well organized to avoid intermingling information that does not belong to the same records. They have also to the responsibility to scrutinize the integrity of information on the instruments and both wrappings and labels to confirm the descriptive information to ensure that there are not cases that involve compliance (Cook, 2001, p. 31). All the equipments and tools required in the theatre should be compliant to the laid worn laws of carrying out the procedures. Should the circulating practitioners spot any instrument that lacks compliance they are obliged to report and replace immediately (Zatlin, 2005, p. 59). All the labels that contain specimen and other information in regard to the procedure should be kept well without tear or wear so that the same information documented is the same and corresponds in all the documentaries in the patient care plan which entirely depends on the organizational policy in regard to health care. Each organization exhibits their own procedural way of record keeping, hence it is advisable for the scrub to study the organization properly before resorting to handling information in regard to procedure in any theatre room (Block, 2001, p. 45). However, considering the number of records required for accountability, the health care administration should put into place a channel of protocols which would be utilized to implement the instrument recording process during the procedure. I suppose that this could be done through provision of additional recording sheets per patient, to enhance the functionality of the practitioners in determining the kind on instruments that are packed for the patient (Pudner, 2000, p. 97). This would ensure that extra instruments which are not supposed to be kept with one patient are taken back to the store so that other students would also assemble for their procedures. Any additional instruments are supposed to be placed in a different instrument tray which is able to be both traceable and tracked (Zatlin, 2005, p. 79). Within the practice it is important for the practitioners to ensure and be aware that some devices have go limited life for instance the diathermy leads, forceps laryngeal mask airways. However, through participation in traceability within the system it is essential and all the instruments with limited time are discarded after maximising their uses but not beyond the specified number of reuse (Cook, 2001, p. 44). This would assist in preventing the failure risks that are associated with such delicate and sensitive equipments that determine the quality of procedures within the theatre (Hughes et, al., 2002, p. 62). Impacts of circulating practitioners on the care given to the patients In any procedure to be carried out, it is the mandate of the circulating practitioner to carry out the necessary preparations so that the procedure would commence. However, the work of the practitioner is of great significance to the patients through prompt attendance to the patience so that they avoid wasting a lot of time oblivious of the consequences of delay in such critical situation (Zatlin, 2005, p. 69). Through support to the surgeon in availing t he requirements at the surgeon’s disposal. Considering the required logistics, they perform their duties in a way that it should not affect the patent care negatively (Werner, 2001, p. 71). The surgeon performs the procedure but all the remaining functions rely on the circulation practitioner and the scrub. This confirms how important the support team is in the event of carrying out procedures within the theatre room (Thomson,, 2002, p. 135). Other functions that they perform include monitoring the oscilloscopes, oxygen masks and to ensure that all the monitoring machines to ensure that they operate in accordance with the required conditions. Through the other procedure and nursing services required till the patient regains stability, they work tirelessly to support the patient within both the High dependency unit and the intensive care units respectively (Cook, 2001, p. 48). However, considering the reports which are derived from the care and treatment procedure, it is the mandate of the circulating practitioners to carry out the respective duties and write the reports which are essential in generating the patient treatment bills (Zatlin, 2005, p. 103). This information is then forwarded to the financial department to scrutinize and use the relevant insurance policies to validate the final patient report on billing which would be used for patient discharge from the health institution later when they get better (Malik, 2008, p. 104 & Pencheon, 2006, p. 66). As a practitioner, it’s ethical to consider the patient’s life more important in the event of treatment and to carry out all possible procedures and duties as assigned within then shortest time possible to salvage the patient where necessary. To some extent being a practitioner requires a special call within an individual’s heart to be able to diligently carry out the functions allocated (Block, 2001, p. 65). Under normal conditions, an individual would not wish to stay more than 12hours without a single meal. But when you are decided to work within the theatre it is authentic that you are not able to leave the room till the end of a procedure. You have to survive within the room will diligence and dedication towards the success of the procedure (Werner, 2001, p. 74). Clinical governance and risk management In the health sector issues of dealing with life requires adequate knowledge and governing rules under which the medics could survive otherwise in case of death all the blames should not be upon them. However, in order to convince the court that the doctors and surgeons are not to blame, there have to be restrictions under which the health institution must operate in order to secure protection from the lawmakers (Zatlin, 2005, p. 106). Through clinical governance, a body mandated to oversee the issues within clinic and health sector, they have to come and continuously inspect the operation of the health institutions to affirm that the institutions follow the regulations of the board (Cook, 2001, p. 50). In any case that a life threatening issue arises, the medics have to take the risk with due protection clinical governance department which is a government body mandated to exercise patient protection creating a rapport within the health institutions (Malik, 2008, p. 104 & Pencheon, 2006, p. 66). Appendix 1 Fig 1. Accessed from: http://www.wisegeek.com/images/people/health-wellness-11.gif on 3rd Dec, 2011. References Bankaitis, A.U. & Kemp, R.J. (2002). Hearing aid related infection control. In: M. Valente (Ed) Strategies for Selecting and Verifying Hearing Aid Fittings, 2nd Edition (pp. 369–383). Thieme Publishing Group, New York, New York Bleich, David. (1977). Contemporary halakhic problems. London- UK: House Inc. Block, S. Stanton. (2001). Disinfection, sterilization, and preservation. New York- USA: Lippincortt. Centers for Disease Control and Prevention (2002). Guideline for hand hygiene in healthcare settings. Available: http://www.cdc.gov/handhygiene. Cook, Rosemary. (2001). 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