Question: near surgeons at our fac...

Question: near surgeons at our facility wish to save new skin tissue taken but not used during skin graft conducts in the event the graft does not take. We have clone this in the past by the agency of placing the skin in a sterile specimen container filled with saline; however, we do not have a written policy regarding this practice and are looking for guidance.

Answer: The American Association of Tissue Banks standards should be followed.(1) The skin should be placed in a sterile storage container using aseptic technique and stored in low-temperature storage below aseptic conditions. The container should be labeled with the patient's name and other identifiers, peaces and expiration date. Any solutions, as it is as antibiotic or isotonic solution, should be included forward the label.

If the skin is to be transplanted within 14 days, it can be stored in a temperature-controlled refrigerator. The skin temperature must be maintained at 1 [degrees] C to 10 [degrees] C (338 [degrees] F to 50 [degrees] F) The refrigerator should be equipped with an electronic monitor and an alarm to alert staff members when temperatures are outside acceptable limits. Access to the refrigerator should be limited to authorized personnel Staff members should monitor access daily, maintain a log to document refrigerator temperature, and perform annual calibration checks.(2)

Skin also can be frozen and stored for up to five years. The skin must be frozen to at least -40 [degrees] C (-40 [degrees] F)(3) Freezing must be accomplished slowly and at a steady rate to maintain the structural integrity of the skin. This transaction is impractical to perform in typical OR settings because of the complexity of the technique and the necessary equipment; frozen storage usually is performed in a medical laboratory setting.

Question: My manager wants us to label all medications in succession the sterile field, even if there is no other than one. Does AORN recommend labeling all medications upon the sterile field?

Answer: All medications onward the sterile field should be labeled fitly even when there is solely one. Medication use in the OR is a complicate process fraught with potential for error. Additional medications could be added to the field during the measure and an error could come into view if the medication has not been labeled. During a busy measure the scrub person may become distracted and mistake individual solution for another. In addition, confusion and miscommunication can offer when the scrub person is relieved during a conduct The surgeon could pick up an unlabeled syringe and administer the blameworthy medication. The possibilities for error are limited solely by the imagination and creativity of Murphy's Law.

mostly medication orders are given verbally, and miscommunication between the physician and suckle is a common cause of medication error. Studies point out to that more than one in 10 medication errors are related directly to the use of incorrect medication names, confusion regarding dosages, and misunderstood abbreviations.(4) As there are small in number if any, independent checks in the proces verbal orders leave great field for error.

Operating sweep personnel should have a policy that specifies the exact gradations for safe medication administration. A safe medication administration policy should include, at a minimum, the following specifications.

* The medication is checked by means of an RN and the work hard person before it is transferred to the sterile field.

* The work hard person labels the sterile medication container and syringe if used onward the sterile field.

* The scour person repeats the name of the medication and the dosage when passing it to the surgeon(5)

* When repeating the dosage, numbers are signifyed in single digits (eg, one-five instead of 15 six-zero instead of 60)(6)

Medication errors resulting in death are estimated to be as high as 140000 for year, and the National Association of Insurance Commissioners reports that medication errors are the chiefly frequent cause of procedure-related malpractice claims.(7) Careful adherence to safe medication administration practices in the OR is an important aspect of perioperative nursing care.

Question: An orthopedic surgeon at our facility insists that orthopedic and otorhinolaryngologic operations should not be performed in the same expanse These are not total joint actions but arthroscopies and sinoscopies. The sweep is cleaned between procedures with a disinfectant, and the floor is mopp following AORN's "Recommend practices for environmental cleaning in the surgical practice setting." Should orthopedic performances be treated differently from other surgical procedures?

Answer: As extended as AORN's "Recommended practices for environmental cleaning in the surgical practice setting" are followed, there is no ne to separate orthopedic and otorhinolaryngologic procedures(8) There is no justification or research-based evidence that indicates the need for any separation of these emblems of procedures. The Centers for Disease have the direction of and Prevention also does not make any so recommendation.(9) Until there is published research justifying like a practice, it is not commended as it could be extremely expensive and inefficient use of surgical resources that cannot be justified from an infection command perspective.