Additional Information
Book Details
Abstract
The only book devoted to this increasingly important issue, Perioperative Safety helps you reduce risk in a setting where even small errors can lead to life-threatening complications. Expert author Donna Watson addresses essential safety principles and concepts, covering patient safety with topics such as the latest safety strategies and initiatives, perioperative safe medication use, preventing infections, anesthesia safety, normothermia management, and electrosurgery. Coverage of staff and workplace safety helps you minimize risk with bloodborne pathogens, latex allergy, the use of lasers, and radiation exposure. Case studies show the application of safety concepts in real-world situations.
- Unique! The only book devoted to the increasingly important issue of perioperative safety, where small errors can lead to life-threatening complications.
- Unique! Highly qualified writers are some of the leading experts in the perioperative field, so material is up to date and emphasizes the most important information.
- Unique! Clinical Points boxes call attention to key points in promoting safety for both patients and staff in the perioperative setting.
- Unique! Case studies describe real-life scenarios related to promoting patient safety.
- Figures and tables are used to support important content.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Perioperative Safety | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Reviewers | ix | ||
| Preface | xi | ||
| Contents | xiii | ||
| Unit I: Overview of Perioperative Safety | 1 | ||
| Chapter 1: Essential Components for a Patient Safety Strategy | 1 | ||
| The Case For Safe And Reliable Health Care | 1 | ||
| The Operating Room As A System | 2 | ||
| Process Steps | 2 | ||
| Achieving Reliability In Systems | 3 | ||
| An Environment Of Continuous Learning | 3 | ||
| A Just And Fair Culture | 4 | ||
| The Good Health Care Team | 6 | ||
| Team Leaders: The Critical Role Of Leadership | 6 | ||
| Communication Techniques | 10 | ||
| Situation Awareness And Conflict Resolution | 13 | ||
| Leaders Engaged In Safety And Reliability Through The Use Of Data | 14 | ||
| Health Literacy | 14 | ||
| Disclosing Unanticipated Adverse Events And Just Culture | 15 | ||
| Conclusion | 15 | ||
| References | 16 | ||
| Chapter 2: Initiatives to Improve Patient Safety | 18 | ||
| Defining Health Care | 18 | ||
| Health Care Costs | 18 | ||
| Current Health Care Systems | 18 | ||
| Government Initiatives | 19 | ||
| Science Of Safety | 21 | ||
| Private Initiatives | 26 | ||
| Conclusion | 28 | ||
| References | 28 | ||
| Chapter 3: Use of Medmarx Data for the Support and Development of Perioperative Medication Policy | 30 | ||
| Review of Literature | 30 | ||
| Methods | 33 | ||
| Results | 35 | ||
| Discussion | 35 | ||
| Conclusion | 37 | ||
| References | 37 | ||
| Chapter 4: Competence, Nursing Practice, and Safe Patient Care | 39 | ||
| The Competence Continuum | 39 | ||
| National Patient Safety Goals | 41 | ||
| Association Of Perioperative Registered Nurses | 41 | ||
| American Nurses Credentialing Center | 42 | ||
| Competency And Credentialing Institute | 42 | ||
| Competence Applications | 43 | ||
| Competence, Operating Room Nursing Practice, And Safe Patient Care | 44 | ||
| Conclusion | 45 | ||
| References | 45 | ||
| Unit II: Patient Safety | 46 | ||
| Chapter 5: Perioperative Safe Medication Use | 46 | ||
| Nationally And Internationally Recognized Concepts Associated With Errors | 47 | ||
| State Of The Science In Perioperative Safe Medication Use | 49 | ||
| Initiatives For Improving Perioperative Medication Safety | 53 | ||
| Conclusion | 56 | ||
| References | 56 | ||
| Chapter 6: Fire Prevention in the Perioperative Setting | 58 | ||
| Prevention | 59 | ||
| Suppression | 62 | ||
| Evacuation | 64 | ||
| Communication | 65 | ||
| Education And Competency Assessment | 66 | ||
| Conducting Fire Drills | 66 | ||
| Fire Extinguishers | 67 | ||
| Ecri Institute Recommendations | 68 | ||
| The Joint Commission Recommendations | 68 | ||
| Reporting Surgical Fires—The Legal Requirements | 68 | ||
| Conclusion | 69 | ||
| References | 69 | ||
| Chapter 7: Bloodless Surgery and Patient Safety Issues | 70 | ||
| Medical Ethics | 71 | ||
| Associated Risks From Transfusion | 72 | ||
| Professional Considerations | 72 | ||
| Preoperative Considerations | 73 | ||
| Medications To Control Bleeding | 75 | ||
| Preoperative Autologous Blood Donation—Good Medicine? | 75 | ||
| Intraoperative Considerations | 76 | ||
| Postoperative Considerations | 78 | ||
| Conclusion | 79 | ||
| References | 80 | ||
| Chapter 8: Perioperative Patient Safety and Procedural Sedation | 82 | ||
| Sedation Issues Relating To Patient Safety | 82 | ||
| Sedation Practice Issues | 84 | ||
| Safe Sedation Practice | 88 | ||
| Conclusion | 92 | ||
| References | 93 | ||
| Chapter 9: Incidence of Deep Venous Thrombosis in the Surgical Patient Population and Prophylactic Measures | 96 | ||
| Pathophysiology | 96 | ||
| Signs And Symptoms Of Dvt And Pe | 99 | ||
| Methods Of Prophylaxis | 99 | ||
| Economic Implications | 103 | ||
| Incidence And Prophylaxis Of Vte In Surgery | 103 | ||
| Nursing Implications | 111 | ||
| Conclusion | 112 | ||
| Acknowledgments | 112 | ||
| References | 112 | ||
| Chapter 10: Preventive Measures for Wrong-Site, Wrong-Person, and Wrong-Procedure Error in the Perioperative Setting | 114 | ||
| Historical Review Of Patient Safety And Wrong-Site Surgery Prevention | 114 | ||
| Statement Of The Problem And Impact | 117 | ||
| Risk Factors For Wrong-Site Surgery | 117 | ||
| Strategies To Prevent Wrong-Site Procedures | 119 | ||
| Performance Measurement | 124 | ||
| Conclusion | 126 | ||
| References | 126 | ||
| Chapter 11: To Count or Not to Count | 128 | ||
| Normalization Of Deviance | 128 | ||
| Risk Factors | 128 | ||
| Legal Standard Of Care | 128 | ||
| Review Of The Literature | 129 | ||
| Sentinel Event | 130 | ||
| Root Cause Analysis | 131 | ||
| Adjunct Counting Technology | 132 | ||
| Evidence-Based Practice | 132 | ||
| Conclusion | 133 | ||
| References | 133 | ||
| Chapter 12: Anesthesia and Perioperative Safety | 134 | ||
| Types Of Anesthesia | 135 | ||
| Monitored Anesthesia Care (Sedation And Analgesia) | 152 | ||
| Other Causes Of Anesthesia-Related Crises | 153 | ||
| Conclusion | 153 | ||
| Dedication | 153 | ||
| References | 153 | ||
| Chapter 13: Preventing Surgical Site Infections | 156 | ||
| Challenges | 156 | ||
| Surgical Site Infection Guidelines | 157 | ||
| Surgical Environment | 158 | ||
| Health Care Provider Issues | 159 | ||
| Patient Issues | 161 | ||
| Conclusion | 165 | ||
| References | 165 | ||
| Chapter 14: Prevention of Positioning Injuries | 167 | ||
| Adverse Events | 167 | ||
| Most Common Surgical Positions | 171 | ||
| Positioning Equipment And Devices | 175 | ||
| Conclusion | 177 | ||
| References | 177 | ||
| Chapter 15: Normothermia Management | 179 | ||
| Physiology Of Temperature Regulation | 180 | ||
| Perioperative Hypothermia Risk Factors | 181 | ||
| Hypothermia And Complications | 184 | ||
| Prevention Of Hypothermia | 187 | ||
| Principles Of Warming Safely | 191 | ||
| Conclusion | 192 | ||
| References | 193 | ||
| Chapter 16: Electrosurgery | 195 | ||
| Historical Background | 195 | ||
| Electrosurgery | 196 | ||
| Conclusion | 202 | ||
| References | 203 | ||
| Unit III: Workplace Safety | 204 | ||
| Chapter 17: Workplace Safety Issues and Trends | 204 | ||
| Workplace Safety Issues | 204 | ||
| Aorn Position Statement On Workplace Safety | 206 | ||
| Strategy To Improve Safety | 210 | ||
| Conclusion | 211 | ||
| References | 212 | ||
| Chapter 18: Hazards from Surgical Smoke | 214 | ||
| Hazards Of Surgical Smoke | 214 | ||
| Smoke Evacuation Recommendations | 216 | ||
| Smoke Evacuation Practices | 217 | ||
| Compliance With Smoke Evacuation Recommendations | 219 | ||
| Conclusion | 220 | ||
| References | 220 | ||
| Chapter 19: Bloodborne Pathogens | 222 | ||
| History | 222 | ||
| Pathogen Prevalence | 222 | ||
| Bloodborne Pathogen Transmission | 224 | ||
| Injury Pattern | 224 | ||
| Engineering Controls And Work Practices | 225 | ||
| Recommendation For Management Of Occupational Exposure | 228 | ||
| Conclusion | 233 | ||
| References | 233 | ||
| Chapter 20: Laser Risks and Preventive Measures for the Staff | 234 | ||
| History Of Lasers | 234 | ||
| Laser Physics | 235 | ||
| Effects On Biological Tissue | 238 | ||
| Laser Safety | 239 | ||
| Standards Of Practice | 241 | ||
| Laser Safety And Training Programs | 247 | ||
| Specialty Procedures | 249 | ||
| Laser Rentals | 250 | ||
| Conclusion | 251 | ||
| References | 251 | ||
| Chapter 21: Preventing Back Injuries | 252 | ||
| Perioperative Back Injuries—Perspectives And Challenges | 252 | ||
| Barriers And Hazards | 253 | ||
| Algorithms | 259 | ||
| Three Realms Of Prevention | 259 | ||
| Lift Teams—Combining All Preventive Controls Into One Package | 268 | ||
| Implementing Safe Patient Handling Programs | 269 | ||
| New Initiatives | 270 | ||
| Conclusion | 271 | ||
| References | 271 | ||
| Chapter 22: Latex Allergy | 273 | ||
| What Is Natural Rubber Latex? | 273 | ||
| History Of Gloves And Nrl | 274 | ||
| Manufacturing Process | 276 | ||
| Latex Reactions | 279 | ||
| Preventing Latex Reactions | 286 | ||
| Patient Management | 286 | ||
| Environmental Management | 287 | ||
| Patient Assessment For An Nrl Allergy | 288 | ||
| Conclusion | 290 | ||
| References | 290 | ||
| Chapter 23: Minimizing Radiation Exposure | 291 | ||
| Types Of Ionizing Radiation | 291 | ||
| Radiation Exposure | 292 | ||
| Biological Effects Of Ionizing Radiation | 292 | ||
| Radiation Dose Limits | 294 | ||
| Monitoring Radiation Dose | 296 | ||
| External Radiation Protection | 297 | ||
| Internal Radiation Protection | 298 | ||
| Radiation Safety Precautions For Modalities Using Ionizing Radiation | 299 | ||
| Radiation Therapy | 302 | ||
| Conclusion | 304 | ||
| References | 304 | ||
| Chapter 24: Infectious Disease Exposure | 306 | ||
| Historical Background | 306 | ||
| Chain of Infection | 307 | ||
| Basic Components of an Infection Prevention and Control Program | 309 | ||
| Standard and Transmission-Based Precautions | 310 | ||
| Specific Illness Considerations in the Operating Room | 316 | ||
| Bioterrorism and Emerging Infections | 317 | ||
| Sterilization and Quality Assurance | 327 | ||
| Staff Training | 330 | ||
| Maintaining a Safe, Clean Work Environment | 330 | ||
| Conclusion | 331 | ||
| References | 331 | ||
| Chapter 25: Dealing with Disruptive Behaviorin the Perioperative Setting | 333 | ||
| Defining Disruptive Behavior | 333 | ||
| Core Issues Of Disruptive Behavior | 335 | ||
| Work Model For Disruptive Behavior | 339 | ||
| Conclusion | 342 | ||
| References | 342 | ||
| Unit IV: Looking Ahead | 343 | ||
| Chapter 26: Safety in the Perioperative Setting | 343 | ||
| Vendor Qualifications | 344 | ||
| General Hospital Policies, Protocols, And Procedures | 347 | ||
| New-Product Protocols | 347 | ||
| Physician And Vendor Relationships Relative To Medical Supplies And Equipment | 348 | ||
| Staff And Vendor Relationships | 349 | ||
| Infection Control Considerations | 349 | ||
| Patient Consent | 350 | ||
| Managing Vendors In The Operating Room | 350 | ||
| Pros And Cons Of Vendors In The Operating Room | 350 | ||
| Conclusion | 351 | ||
| References | 351 | ||
| Chapter 27: Using Human Factors to Balance your Operating Room | 353 | ||
| The Operating Room As A Microsystem | 353 | ||
| Human Factors | 354 | ||
| Balance Theory | 354 | ||
| Directions For Future Research | 360 | ||
| Conclusion | 360 | ||
| References | 361 | ||
| Appendix A: Sample Surgical Count Policy and Procedure Perioperative Patient Care Services Policy And Procedure | 362 | ||
| Purpose | 362 | ||
| Responsibility | 362 | ||
| Policy | 362 | ||
| Procedures | 363 | ||
| Documentation | 365 | ||
| Statement Of Collaboration | 365 | ||
| References | 365 | ||
| Appendix B: 2007 guideline for isolation precautions: preventing transmission of infectioUs agents in health care settings | 366 | ||
| References | 366 | ||
| Index | 393 |