The surgical procedure that I observed was the creation of an arteriovenous fistula. The purpose of an arteriovenous fistula is to make a connection between the native artery and vein in an extremity through surgery. The surgical procedure that I saw performed, which was done by a vascular surgeon, was an AV fistula on the upper right arm. These fistulas are used for hemodialysis and accessed/used for dialysis 2-5 times per week. Basically, the vascular surgeon creates this fistula so as to provide easier/more reliable access to the patient’s blood vessels. Fistulas provide vascular access for health care providers to be able to administer dialysis in a much faster and safer way. The AV fistula takes about 2-3 weeks to mature before it can be used for hemodialysis. The surgeon chose an arteriovenous fistula over an arteriovenous graft. The …show more content…
The surgical technician worked closely with the surgeon to pass him the correct surgical tools and pass him anything he would need should they be out of his reach or if a complication arose. She prepared and pre-counted all of the tools including any type of gauze that would need to be accounted for at the end of the procedure to avoid leaving any tools inside the patient. The circulating nurse’s job was to monitor vital signs to make sure the patient is stable during the procedure, keep track of surgical tools, and provide the surgical technician/surgeon any tools they may need. The circulating nurse also charted all of the information about the patient such the start and end time of the procedure, what position the patient was in, the patient’s vital signs, the side of the patient the procedure would be on and what procedure was being done. The circulating nurse also initiated the time out, wherein all members of the surgical team time out and verify that they have the correct patient, correct procedure and site of
Has anyone ever considered how medical devices are prepared before a surgical procedure? Central Sterile Processing Department (CSPD) consists of services within the Hospital, in which reusable medical devices will be cleaned, prepared, and processed. The role for CSPD is to prevent infection transmitted by usage of medical devices. The procedure for hospital medical devices before surgery has a four part workflow process in: Decontamination, to Instrumentation, to Sterilization and Sterile Storage (Case Carts). An example is given for reprocessing an Intestinal Set and the supplies needed for the preparation of this medical device set.
The lack of space required many places to be converted into temporary triage locations. Triage is a quick way to streamline examination and get serious cases handled first. Another issue was moving bedridden patients after their surgeries because of the narrow hatchways and doorways. The amount of patients required another ship to be dispatched to accommodate the patients. The lack of supplies and the variations of injuries caused continuous problems for surgeons, especially those who were becoming extremely fatigued. A common issue was that the extent of injuries could not have been determined completely until the patient was on the operating table. For example patients who were referred to as D and B in the report took the constant attention and the former succumbed to his injuries after two hours. the latter survived after given saline, but still needed constant attention. Another example is an unnamed patient who was not examined for over forty hours, had developed large maggots in his wounds. Unlike modern operating rooms, supplies could not be set up according to procedure. Because of the time required to properly sanitize blankets, many soldiers were without one. (Darby)
Having knowledge about this information will guide me in my practice to know when and what are the information I should disclose to TGLN coordinators. Working together with the coordinators and exchanging information regarding the status of the patient can have a substantial advance in donation rates. After confirmation that the deceased person is a donor it is a nurse duty to draw blood from the patient for serology testing, blood typing and test for communicable diseases such as hepatitis virus. In a surgical perspective, as an operating room nurse, preparing for the things needed prior to surgery will smooth the process of organ and tissue recovery. Being well informed of the different team and their roles in the process will help me as operating nurse as to whom should I seek information in a case of unfamiliar instrument; wherein I can ask a surgical recovery coordinator for more materials or instruction on how to used it. Right after everything is done, a nurse will do the post-mortem care and hospital policy and procedures should be reviewed especially if it’s a Coroner’s
Upon observation of the circulating nurse, I noticed that she was very interactive and involved in the surgery. One of the responsibilities of the circulating nurse is to retrieve any surgical supplies that are not available in the operating room and to make or receive any calls for the surgeon. During the surgery, I noticed the nurse call for an x-ray for the surgeon, the laboratory for biopsy samples, and the operating room floor front desk to inform them that the surgery would be later than expected. This is her responsibility as the surgeon cannot break sterility by touching the phone and it is easier for him to communicate through her and not leave the surgical site. Also in the operating room, I observed the scrub nurses’ roles. Before the operation, the scrub nurse opened all of the sterile packages, arranged them on the sterile field, and took count of what was there along with the circulating nurse. The scrub nurse did this because she is sterile during the entire procedure, and once the sterile packs are opened, the contents can only be handled by sterile personnel. The scrub nurse also was ready and waiting at the sterile field at all times to get the surgeon any equipment needed from the sterile field. This is helpful to the surgeon because it enables the surgeon to stay at the surgical site and convenient for when
The physician needs to insert a chest tube. What are your responsibilities as the nurse?
Surgical Technologists have an important role in the operation room (OR). There are different positions within the Surgical Technology field, including Scrub Surgical Technologist, Circulating Surgical Technologist, and Second Assisting Technologist. Scrub Surgical Technologists have a number of tasks, including prepping the patient for surgery, sterilizing the OR, gown and glove surgeons and assistants, and assists the surgeon and other surgical team members in a number of ways, such as passing instruments and dressing wounds. Circulating Surgical Technologists have a number of tasks as well, including checking patient’s charts, identifying patient and verifying the surgery that will be performed with consent forms, assisting anesthesia
Improperly sterilized instruments used in surgical procedures can introduce bacteria into a patient, which then sets up the risk for infection. Central service technicians are a part of the team of professionals dedicated to preventing such infections. Certification demonstrates a commitment to patient safety and quality of care from healthcare facilities. (p. 36)
A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon
“The Process Improvement in Stanford Hospital’s Operating Room” case has many issues when it comes to regards to its existing instrument provisioning process taking place within the Operating Room (OR) of Stanford’s Hospital. This process entails getting instruments ready for a surgery in the OR and the cleansing of these instruments afterwards; however, there are many problems that arise in this process.
VASNHS Surgical Specialty Outpatient department has a designated pre-operative management unit that oversees the patients undergoing surgery. The predicaments stem from various guidelines or protocol originating from numerous surgeons and clinics. At present, the pre-operative nurses abide simple pre-op instructions (NPO protocol, medications, what to bring, during the surgery, transportation, cancellation instructions) for the entire Surgical Specialty Outpatient department. Surgical procedures are being canceled due to lack of communications and cancelations of patients prior to surgery date.
B. Memorable Close: Operating Room Nurses and Scrub Technologist put the patient safety first. They are an important part of the surgical team and account for the items the surgeon uses during surgery. If you or a loved one has to have surgery, I hope you are comforted by
The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT
An autogenous arteriovenous fistula may be unsatisfactory, in patients (especially diabetics) with advanced atherosclerotic change extending to the radial artery, or in patients whose veins are too small, fragile or thin walled to mature sufficiently for repeated needle punctures (Azman et al., 2006).
Hemodialysis (HD) is one of several renal replacement therapies used for the treatment of end stage kidney disease (ESKD) and kidney failure. Dialysis removes excess fluids and waste products and restores chemical and electrolyte balance. HD involves passing the patient’s blood through an artificial semipermeable membrane to perform the filtering and excretion functions of the kidney. One important step before starting regular hemodialysis sessions is preparing the vascular access; ideally, a vascular access should be placed weeks or months before you start dialysis. The
First everyone had to put on a mask, wear surgical head covers, proper scrubs, and shoe covers. Inside the operation room, the surgeon and scrub tech had to put on a sterile attire, which included sterile scrubs,gloves, and equipment because they were the first people to have contact with patient. The circulator or documenting nurse and anesthesiologist were around the sterile field (aseptic technique) without any contact with the patient whatsoever. As you would have guessed, the surgeon was the one who performed the surgery with the help of the scrub tech and monitored by the circulator nurse and anesthesiologist. The main duties of the circulator nurse was to document everything during the surgery from what medications used to how many sterile dressings were used, proving supplies to the surgeon and the scrub tech as needed,and making sure the room was prepare for the assigned surgery. This nurse also provides conform measurements for the patient while in the operation room. For instance, there was a patient who was too big for the operation bed, so the circulator nurse had to find additional supplies that would prevent the patient from sliding down the bed. Nurses always provide the finest education towards their line of duty but also take the time to teach those people who starting the nursing