Nifa Study Guide Q And A

NIFA STUDY GUIDE Q AND A

Thexcnumberxconexcpatientxcsafetyxcissuexcidentifiedxcinxcaxcsurveyxcofxcperi-
operativexcnursesxcisxcpreventing:xc-xcanswer--Wrongxcsite/procedure/patientxcsurgery

Reprocessingxc(flashing)xcinstrumentsxcinxcthexcORxcisxchighxcriskxcbecause:xc-xcanswer--
ORxcpersonnelxcnotxcproperlyxctrainedxctoxcreprocessxcinstruments

Toxcsafelyxctransferxcandxcpositionxcpatientsxcinxcaxcmannerxcthatxcpreventsxcshearing,xcpersonne
lxcshouldxcusexcaxcmechanicalxcliftingxcdevicexcforxcaxcsupine-to-
supinexctransferxcofxcaxcpatientxcweighingxcmorexcthan:xc-xcanswer--157xclbs

_______________xcshouldxcbexcthexcprimaryxcdecisionxcmakersxcforxcwhatxcequipmentxcandxcsu
ppliesxcarexcpurchasedxcandxcstockedxcinxcthexcdifficultxcairwayxcmanagementxccart.xc-xcanswer--
Anesthesiaxcpersonnel

Properxcspecimenxcmanagementxctechniquesxcpreventxcerrorsxcandxcincludexcallxcofxcthexcfollowi
ngxcEXCEPT:xc-xcanswer--
Receivingxcspecimensxcfromxcthexcsurgicalxcfieldxcthenxcaffixingxcpatientxclabelxctoxceach

PreventingxcsurgicalxcfiresxcisxcaxctopxcpriorityxcforxcallxcORxcpersonnelxcandxcmembersxcofxcthexcsu
rgicalxcteamxcshouldxcperformxcallxcofxcthexcfollowingxcdutiesxcEXCEPT:xc-xcanswer--
Performxcaxcweeklyxcfirexcriskxcassessment

Peri-
operativexchypothermiaxcisxcanxcimportantxcissuexcforxcallxcanesthetizedxcpatientsxcbecausexcofxca
llxcofxcthexcfollowingxcEXCEPT:xc-xcanswer--Increasesxcriskxcofxcrenalxcfailure

RecommendationsxcforxcpreventingxcretainedxcsurgicalxcitemsxcincludexcallxcofxcthexcfollowingxcE
XCEPT:xc-xcanswer--Utilizingxcaxcmultidisciplinaryxcteamxctoxcresolvexcincorrectxccounts

Selectxcthexcappropriatexcorderxcforxcadministeringxcbloodxcandxcbloodxcproducts.xc-xcanswer--
Verifyxcinformedxcconsentxcforxcblood,xcverifyxcpatientxcidentificationxcandxcbloodxctypexcandxcunitx
cnumbersxcagainstxcbloodxctagxcandxcrequisitionxcslipxcwithxcsecondxclicensedxcperson,xcsignxcslip

s

Weighingxcspongesxcisxcaxcvaluablexctoolxcforxcmeticulousxccalculationxcofxcbloodxcandxcfluidxcloss
xcwhenxcconductedxccorrectlyxcandxcusedxcinxcappropriate xccircumstances.xcSelectxcthexcrespons

excthatxccorrectlyxcreflectsxcthexcbestxcpracticexcinxcweighingxcsponges.xc-xcanswer--
Keepxcaxcrunningxctotalxcbloodxclossxccalculatedxcfromxcavailablexcspongesxcduringxcprocedure

Laparoscopicxcproceduresxcthatxcemergentlyxcconvertxctoxcopenxcproceduresxcplacexcthexcpatien
txcatxcriskxcforxcunintentionalxcretainedxcforeignxcobjectsxc(RFOs).xcWhatxcnewxcandxcevolvingxcrisk
xcreductionxcstrategyxccouldxcpreventxcRFOsxcandxcfrustrating,xctime-

consumingxcmiscountxcadventuresxcatxcthexcendxcofxcthesexcprocedures?xc-xcanswer--

, Replacingxcorxctaggingxcspongesxcandxclaparotomyxcinstrumentsxcwithxcradiofrequencyxcidentific
ationxc(RFID)xcchips

Axcfemalexcpatientxcwithxcend-
stagexcpancreaticxccancerxcwasxcadmittedxcfromxchospicexcforxcaxcceliacxcplexusxcblockxctoxctreatxc
intractablexcpain.xcShexchadxcaxcWhipplexcprocedurexc18xcmonthsxcearlierxcandxcenjoyedxcaxcgoo
dxcqualityxcofxclifexcuntilxc3xcweeksxcago.xcShexcwantedxctoxcbexcablexctoxccompletexc"gettingxcherxct
hingsxcinxcorder"xcandxcsayingxcgood-
byexctoxcherxcfriendsxcandxcfamilyxcwhilexcenjoyingxcherxclastxcdaysxcpain-
free.xcThexcpatientxcinsistedxcthatxcherxcDoxcNotxcResuscitatexc(DNR)xcstatusxcNOTxcbexcrescinde
d.xcShexcwasxcconsciousxcandxccompetentxcandxcknewxcwhatxcwasxcbestxcforxcherself.xcThexcpatie
ntxcwasxctakingxcfullxcadvantagexcofxcwhatxcprovisionxcforxcherxccare?xc-xcanswer--
PSDAxcandxcadvancexcdirectives

Axcpatientxcwasxcpresentedxcwithxcthexcpreparedxcinformedxcconsentxcformxcduringxcthexcdiscussi
onxcwithxcherxcsurgeonxcconcerningxcherxcscheduledxcvaginal-
assistedxclaparoscopicxchysterectomy.xcShexcdemonstratedxcandxcverbalizedxcthatxcshexcunders
toodxcallxcofxcthexctenetsxcofxcthexcprocedure,xcrisks,xcexpectedxcoutcome,xccomplications,xcandxcp
roceduralxcprocess.xcBeforexcshexcsignedxcthexcconsentxcform,xcshexcinformedxcthexcsurgeonxcth
atxcshexcdidxcnotxcwantxcanyxcmedicalxcstudentsxcorxcsurgicalxcresidentsxcperformingxcanyxcpartsxc
ofxcthexcprocedurexcotherxcthanxcassistingxcandxcdidxcnotxcwantxcanyxcphotographsxcofxcherxcbodyxc
taken.xcThexcsurgeonxcagreed,xcandxcshexccrossedxcoutxcthosexcportionsxcofxcthexcformxcandxciniti
aledxcthemxcbeforexcshexcsigned.xcThexcpatientxcwasxcexercisingxcher:xc-xcanswer--
rightxctoxcinformedxcconsent.

Earlyxcon,xcduringxcthexcpreliminaryxcspongexccountxconxcclosurexcofxcaxcrepairxcofxcaxcrupturedxcab
dominalxcaorticxcaneurysm,xcthexccirculatingxcnursexcwasxcunablexctoxcaccountxcforxc2xclapxcspong
es.xcHexchadxcmeticulouslyxcmaintainedxcaccountabilityxcforxcallxcspongesxcandxcinstrumentsxcdis
cardedxcfromxcthexcsterilexcfieldxcandxcbaggedxceachxcspongexccarefully.xcHexcimmediatelyxcturne
dxcandxcaddressedxcthexcentirexcteamxcinxcaxcclearxcvoice.xcSelectxcthexcappropriatexccommunicati
onxcthatxcthexccirculatingxcnursexcmustxcemployxcduringxcthisxccountxcdiscrepancy.xc-
xcanswer--"Wexchavexcaxccountxcdiscrepancy.xcWexcstartedxcwithxc70xcspongesxcandxcfindxconlyxc6

8.xcWexcarexcmissingxc2xclapxcsponges.xcEveryone,xcpleasexccheckxcyourxcareas.

ThexcORxcisxcaxcdanger-
pronexcareaxcforxcbothxcpatientsxcandxcstaff.xcProvidingxcaxcsafexcenvironmentxcofxccarexcforxcthexc
patientxcinvolvesxcidentifying,xcmitigating,xcandxcmanagingxcthexchazardsxcinherentxcinxcsurgicalxc
care.xcChoosexcthexcanswerxcbelowxcthatxccompletesxcthexcblanksxcinxcthisxcsentence:xcThexcriskxc
ofxcthexcsurgicalxchazardxcofxc_________________xccanxcbexcmitigatedxcthroughxc___________
____________.xc-xcanswer--
wrongxcpatient,xcwrongxcsite,xcandxcwrongxcsidexcsurgery;xcsitexcmarkingxcandxcpresurgicalxcchec
klists

Axcpatientxcwasxctransferredxctoxcthexcpostanesthesiaxccarexcunitxc(PACU)xcbyxcthexcanesthesiaxc
providerxcandxcperioperativexcnurse.xcAxchand-
offxcreportxcwasxcgiven,xcusingxcsituation,xcbackground,xcassessment,xcrecommendationxc(SBA
R)xcformat,xctoxcthexcacceptingxcPACUxcnurse.xcThexcfirstxcelementxcofxcinformationxcthatxcshouldx
cbexcpresentedxcinxcthexchand-offxcreportxcis:xc-xcanswer--

patientxcidentificationxcandxcprocedurexcperformed.