The Nurse's Role in Assistance to Anesthesia

83 Pages·2014·3 MB·English

The Nurse’s Role in Assistance to
Anesthesia
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Twilla Shrout, BSN MBA RN CPAN CAPA
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Immediate Past President of the American Society of
Perianesthesia Nurses (ASPAN)
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Staff Nurse at Harry S Truman Memorial Veterans’
Hospital
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[email protected]
1
Objectives
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Identify methods to assist the anesthesia team
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Discuss methods to stay current in perianesthesia
nursing
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Preadmission
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(cid:1) -Psychosocial status
-Relevant preoperative
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status -Substance/alcohol
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-Physical assessment -Anesthetic history
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-Cognitive ability -Discharge Planning
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-Patient safety needs -Procurement supplies /
(cid:1) equipment
-Pain assessment
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(cid:1) -Learning needs
-Comfort assessment
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(cid:1) -Preop pt. teaching
-Name preference
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(cid:1) -Plan of care
-Cultural / language
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(cid:1) -Referrals
-Advance directives
Day of Surgery
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-Review / complete (cid:1)
-Anesthetic history
preoperative assessment
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-Verify pt. ID
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-Relevant preoperative
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-Verify prescribed
status
surgical prep
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-Normothermia
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-Responsible adult/ assist
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-Pain assessment
home
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-Comfort assessment (cid:1)
-Safe transport
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-Patient safety needs (cid:1)
-Preprocedural teaching
ASA Status
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ASA 1-normal, healthy
●
ASA 2-mild, systemic disease
(i.e. chronic bronchitis, moderate obesity,
DM Type 2, mild HTN, old MI etc)
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ASA 3-severe systemic disease (CAD with
angina)
ASA Status
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ASA 4-severe systemic disease that is a constant
threat to life (cardiac insufficiency, dysrhythmias,
advanced pulmonary, renal, hepatic or endocrine
insufficiency)
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ASA 5-not expected to survive without operation
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ASA 6-brain dead who’s organs are being used
as donor
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“E” emergency patient with unknown history
World Health Organization
Guidelines for Safe Surgery 2009
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Safe Surgery Saves Live
(cid:1) The purpose is to improve the safety of surgical care
around the world by defining a core set of safety
standards that can be applied to all countries and
settings.
Why the Checklist is Important
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The team must work together
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All components of the checklist must be completed
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Prevents poor communication among the surgical
team members
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Prevent surgical errors or deaths
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Prevents adverse legal issues
Human Factors Principles
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Avoid reliance on memory
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Simplify
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Standardize
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Use protocols and checklists
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Improve information access
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Reduce handoffs
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Increase feedback
Pre Procedure CHECK-IN
Patient/patient representative
In Holding Area
actively confirms with RN
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Identify (cid:1)
Beta blocker medication given
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Procedure and procedure site
(SCIP)
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Consent(s)
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Venous thromboembolism
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Site Marked by person performing
prophylaxis (SCIP)
the procedure
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RN confirms presence of Normothermia measures (SCIP)
(cid:1) H/P, Pre anesthesia assessment,
diagnostic and radiological
results, blood products and any
special
equipment/devices/implants