Question: Our housekeeping departme...

Question: Our housekeeping department uses universal household bleach to clean the floors in the ORs. Is household bleach an acceptable cleaning agent for this?

Answer: Household bleach (ie, sodium hypochlorite) is a chlorine blend that is an effective, low-level broad-spectrum disinfectant with bactericidal, fungicidal, tuberculocidal, and virucidal effects(1) Although it is an inexpensive disinfectant suitable for use in the OR, it has several drawbacks. It is corrosive upon metal surfaces and may damage expensive equipment. Chlorine has a disagreeable odor and may be a respiratory irritant. Sodium hypochlorite may dissipate rapidly below certain conditions, and if inadvertently combined with other chemicals, it may quick in emergencies a potential health risk to employee and patients.(2) Sodium hypochlorite may be preferable for fault cleaning floors and walls, thus diminishing its adverse consequences Other agents may be more suitable for cleaning between steps and terminal floor cleaning. An acceptable cleaning consequence for the surgical environment should be

* labeled for hospital use,

* a low-foaming detersive disinfectant,

* effective against a broad image of microorganisms,

* menstrum in tap water,

* residue exempt with no residual water deposits,

* nontoxic and nonirritating to patients and health care workers, and

* odorless.(3)

Question: I am the OR supervisor at a small, rural hospital, and we are having difficulty with appropriate patient identification. Many staff members have became familiar with patients who have been to the facility commonly and they have became lax about applying identification arm bands, checking armbands, and verbally identifying patients. I am worried that an error may come into view and I am looking for supporting information to improve compliance with suitable patient identification.

Answer: Inadequate patient identification may lead to the inappropriate surgery or procedure performed forward the wrong patient, which is considered a sentinel circumstance requiting review by the Joint Commission in succession Accreditation of Healthcare Organizations (JCAHO).(4) Familiarity with patients should not replace reliable processe for becoming patient identification. Eliminating basic identification proceedings sets a dangerous precedent and detects patients to increased risks for receiving the improper treatment. Proper patient identification is an essential first pace to providing safe patient care and preventing errors. The following strategies should be considered when developing policies and performances for correct patient identification.(5)

* Involve the patient and his or her family members in identifying the patient and correct procedure

* Use appropriate communication techniques for identified language barriers.

* Use a designated system (eg, armband) for identifying the patient.

* Use a verification checklist to note verbal identification with the patient and family members; review of the medical documents (eg face sheet, history, physical examination); documentation of informed consent; and verification that the designated identification way contains correct information.

* Require verbal confirmation of the correct patient and proceeding in the OR by each member of the surgical team.

* Monitor compliance with the protocol for quality control

A comprehensive approach is requireed to prevent patient misidentification. Everyone involved in providing patient care povertys to follow facility protocols and fitly identify the patient.

Question: The anesthesiologists at our facility are proposing a plan they believe will cut short turnover time. They are requesting that sterile supplies far a following procedure be opened and protected in a separate room while a proceeding is in progress and then be transported to the assigned stead when the procedure is integral I am opposed to this practice and believe it is not upright aseptic technique, but I am meeting a apportionment of resistance from the anesthesiologists. What is AORN's position regarding transporting spread sterile supplies to another room?

Answer: An spread sterile setup should not be transported to another space Maintaining the sterility of the sterile field during transport, although it is guarded is nearly impossible. Transport of the secreteed table from one room to another requires that it pass without of an environment with positive ventilation that provides airflow from clean to les clean areas. Additionally, air rifes created during transport carry dust, lint, and other particles that can migrate beneath the loose fitting table defend contaminating the sterile supplies.(6) The perceived time and costlinesss saved by opening and preparing the sterile setup in another space is quickly eradicated by the risk of postoperative infection. A sterile field should be expanded as close to the time of use as possible and monitored continuously.(7) There are many avenues to improve efficiency and save time; however, compromising quality aseptic technique is counterproductive and enjoins the patient at unnecessary increased risk for infection.