PPE Precautions (Personal Protective Equipment) for Certified Perioperative Nurse (CNOR)
PPE Precautions (Personal Protective Equipment) Guidelines: Standard Precautions First tier of infection prevention, most important strategy for infection control Applies to ALL patients regardless of infection status Includes: Hand Hygiene Gloves Mask Eye protection Face shields Gowns Sharps Patient care equipment Linens Environmental control Patient placement Transmission-Based Precautions Second tier of infection prevention Known […]
Sterilization, Biological, Chemical Monitoring and Documentation for Certified Perioperative Nurse (CNOR)
Sterilization, Biological, Chemical Monitoring and Documentation Guidelines: Perioperative team members must review the manufacturer’s instructions for cleaning, packaging, and sterilizing to determine the correct sterilization process. Records of sterilization monitoring (mechanical, chemical, and biological) should be maintained long enough to comply with state and local regulations The CDC does not maintain information on time […]
Sterilization and Storage Environment Conditions for Certified Perioperative Nurse (CNOR)
Sterilization and Storage Environment Conditions Guidelines: Sterility is event-related and is dependent on the amount of handling, the conditions during transport and storage, the quality of the packaging material, and adherence to the packaging material manufacturer’s IFU Limit exposure to: Moisture Dust Direct sunlight Handling Temperature and humidity extremes Decreases the potential for contamination […]
Outside Instrument and Material Tracking (Regulatory Requirements) for Certified Perioperative Nurse (CNOR)
Outside Instrument and Material Tracking (Regulatory Requirements) Guidlines: Consider loaned instruments contaminated on arrival. They should be delivered directly to decontamination for reprocessing The facility should establish policies and procedures for managing outside instruments and materials Request loaned instruments when surgery is scheduled, delivery in sufficient time to allow in-house sterilization Obtain manufacturers IFU for […]
Surgical Attire Guideline Adherence (Surgical, Perioperative Zones) for Certified Perioperative Nurse (CNOR)
Surgical Attire Guideline Adherence (Surgical, Perioperative Zones) Guidelines: All persons entering the semi-restricted and restricted areas of the surgical suite should wear clean, facility-laundered surgical attire Purpose: To reduce bacterial and skin shedding and promote environmental control and cleanliness Perioperative Zones: Unrestricted = Outside the surgical suite Semi-restricted = Peripheral support areas within surgical […]
Hand Hygiene Guideline Adherence for Certified Perioperative Nurse (CNOR)
Hand Hygiene Guideline Adherence Guidelines: Hand hygiene and surgical hand antisepsis are effective, efficient methods to prevent infections in the perioperative setting Perioperative team members should perform appropriate hand hygiene: Before and after direct patient contact Assessing a patient, confirming a site marking, positioning a patient, completing surgical skin preparation Before completing a clean […]
Emergency Situation Identification for Certified Perioperative Nurse (CNOR)
Emergency Situation Identification Guidelines: Code (obvious) Facility specific policies “NOW” Trauma Cold leg hemorrhage “Within 24” Incarcerated hernia Perf Complicated fracture “Within 48” D/c Acute Chole “Routine” Life, Limb, Sight, Fertility Considerations: Emergencies: Bump other cases Utilize reserve resources – all needed Skip count(X-ray instead) Order sets best Facility specific, planned Strategically located […]
Malignant Hyperthermia (MH) Nursing Interventions for Certified Perioperative Nurse (CNOR)
Malignant Hyperthermia (MH) Nursing Interventions Guidelines: Often fully identified post-op Triggers Anesthetic gasses (“ane”) Succinylcholine Unknown Rhabdomyolysis Family history, muscle biopsy Previous exposure does not guarantee safety DANTROLENE MH cart Cold IVF Ryanodex (brand name, $$, important to know which you have) Considerations: Recognize-act Rising-etCO2 fighting vent settings Tachy Acidotic “Marathon” Hyperthermia could […]
Anaphylaxis Nursing Interventions for Certified Perioperative Nurse (CNOR)
Anaphylaxis Nursing Interventions Guidelines: Recognition Anes stat/code Epi Steroids Consider intubation Sedation ENT Trach Discuss dispo Considerations: Pediatric dosage sheet O2 source backup BVM Maneuver equipment out of the way back table Carm Nurse’s Role: Identify Alarm Assist Anticipate needs training Pitfalls: Cocky anesthesia Wrong sized tube Unstocked cart Allergies not communicated […]
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiac Arrest Nursing Interventions Guidelines: Train Screen risk patients Identify Alarm ACLS Preserve field as possible Anticipate internal massage Unique needs of surgical procedure (open abd) REVERSIBLE CAUSES Considerations: Foot traffic Sterility Compressions alongside surgery Reversible cause? Know patient history Cards pre-op Emergency instrument cart checks Anticipate high risk patient back pad before […]