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aorn ipn 04 lecture notes nursing process and surgical attire overview with Complete Solutions UPDATED!!!

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aorn ipn04 lecture notes nursing process and surgical attire overview with Complete Solutions UPDATED!!!

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Module

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lOMoAR cPSD| 66549320




1

Scatter, leakage (radioation), ERAS, class I, II,III,IV, friction, shearing, positioning arms on
lower/higher in prone, checst/hop/kidney surgery (lateral recumbant?), transmission, nail
length?




Module 1
IPN04 The Nursing Process
● PNDS (Perioperative Nursing Data Set: standardized nursing language.
○ Supports EBP
○ Clear & universal language
○ Recognized by ANA as a unified medical language system, NLM & NIH.




● QSEN: Quality & Safety Education for Nurses
○ Preparing nurses with knowledge, skill & attitudes (KSAs) to improve
quality, safety & education ○ 6 competencies
■ Patient-Centered Care
■ Teamwork & Collaboration
■ Evidence-Based Practice (EBP)
■ Safety
■ Informatics
● Nursing Process

, lOMoAR cPSD| 66549320




2

○ Assessment
○ Diagnosis
○ Outcomes Identification
○ Planning
○ Implementation
○ Evaluation
○ Documentation
■ Occurs in ALL phases of the nursing process ●
Phases of Care
○ Preoperative
■ Collect data
■ Perform assessment
■ Develop nursing diagnosis
■ Develop a plan of care
○ Intraoperative
■ Implement a plan of care
■ Document care delivered
■ Coordinate interventions
■ Evaluate interventions ○ Postoperative
■ Evaluate modifications of
interventions
■ Identify complications
■ Communicate care given
● Standard Nursing Terminology
○ Promotes continuity of care
○ Promotes understanding and
improves communication. ● Documentation
○ The basis for future reference
○ Ensures quality of patient care
○ Evidence for court
○ Used for analytics
○ Personal experience record
■Document in each phase of care
● Preop
● Intraop
● Post-op
○ Standard Documentation Formats
■ SBAR

■ I PASS the BATON

■ SURPASS

■ SHARED

, lOMoAR cPSD| 66549320




3



● Patient Care Analytics
○ Documentation is used to organize & benchmark performance, justify staffing,
and improve the quality of care. (critical step to strategic planning within an
organization)
■ Time in/out of OR
■ start/end times
■ incision/closure times
■ Implant records
■ Research data




IPN10 Hand Hygiene
● Hand Hygiene vs Surgical Hand Antisepsis
○ Hand hygiene: general hand hygiene
■ Soap & water: 20 seconds, 70 deg F - 80 deg F
● Visibly soiled
● Infectious diarrhea
● Exposure to spores
● Most missed places: between fingers, fingertips, thumbs
■ Alcohol sanitizer
● 20 sec
● General hygiene use: before performing sterile task like
handling invasive medical equipment or wrapped sterile
packages.
■ Microbial
Contamination ●
Hands → patient
● Wash hands best to prevent healthcare associated infection.
(HAI) ■ Technique matters ●
■ Fingernails <2mm
■ Lotions can interfere with antiseptic products. Use the right
ones.
○ Surgical Hand Antisepsis: sterile field handwashing.
■ Scrub, gown, glove necessary to maintain sterile field
■ 4 steps to precleaning for surgical hand antisepsis
● Why?
○ Reduce transmission of bacteria from skin in
event of glove puncture during proccedure
○ Inhibit bacteria gorwth under the glove
○ Incrased antimicrobial efficacy of surgical
scrub
● 1: take your shit off

, lOMoAR cPSD| 66549320




4

● 2: don mask
● 3: if soiled, wash with soap & water
● 4:. Remove debri from under fingernails using disposable
nail cleaner & run under running water. ■Surgical hand
scrub (after precleaning)
● 1: use right product on hands/forearms
● 2: wash 4 sides of hands/fingers
● 3: scrub for right length of time (according to manufacturer)
● 4: no spashing on scrubs
● 5: throw away sponges
● 6: rinse hands/arms: fingertip → elbow
● 7: hold hands higher than elbows, away from scrubs.
Dont touch anything.
● 8: dry hands in OR with sterile towel & don gown/gloves ○
Dont rush drying. Keep hands away from body.
○ Dont let soak through the gown: it will
contaminat the sterile gown.
■ Surgical Hand Rub (if hands arent visibly soiled)
○ Manufacturer IFU is best reference for
appropriate use.
○ Suurgical scrub agents include all: persistent,
reduce mocroorganisms on the skin, & contain
non-irritatinf, antimicrobial preparations with
brad spectrum activity.
■ NOT SLOW ACTING
● 1: wash hands
● 2: clean subungual areas of hands & nails
● 3: rinse hands/forearms
● 4: dry hands & forearms
● 5: dispense rub product
● 6: apply fingertips → forearms
● 7: rub hands until dry
● 8: repeat if indicated by manufacturer


IPN06 Surgical Attire
● Surgical Attire
○ Scrub suit
○ Appripriate shoes
○ Name badge
○ PPE
■ Must be laundered in HC accredited facility
○ Tight-woven, low-linting
■ High level of cleanliness & hygeine
■ Promotes pt & worker safety

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