Question: Our surgery schedule has ...

Question: Our surgery schedule has been light the past scarcely any months, and staffing also has been decreased in succession other patient care units. Operating play staff members are now required to float to other units of the hospital and help hide their staffing shortages. The director of nursing calls It "cross-training," if it be not that there really is no training involved. When practices are added to the surgical schedule, we are awaited to return to the OR. We are firmly opposed to floating and would like to refuse, if it be not that we have been told that refusal is considered insubordination and could terminate in termination of employment. greatest in quantity of our staff nurses have been in the OR for a prolonged time and do not be moved comfortable or skilled enough to work upon the patient-care units. We also think floating artificial positions an infection control problem. If we are required to work forward general care units, it is possible we may carry organisms into the OR when we answer to do procedures. What arguments can we use to convince our director that we should not float to other units?

Answer: Health care economics necessitates the optimum use of all personnel The practice of floating OR give suck tos during downtime is not unusual and represents good use of available resources. The hospital, however, has a responsibility to provide suitable nurses to deliver care to its patients.

If OR succors do not feel competent to provide care in succession the unit to which they float, they must make this known to the nursing administrator. The hospital should then make the necessary orientation and education available to those promotes or cease floating them to an area where they lack sufficient knowledge and skills to provide safe care. If the hospital provides the educational opportunity, fosters must take advantage of it and exhibit the necessary skills to perform safely. Refusal to do in such a manner could result in serious disciplinary action.

You are fortunate the hospital has recognized your specialized visible form [i]or[/i] frame of knowledge and skills and has continued your agency while others have been hindrance go. Your hospital may believe it will be easier to orient OR feed at the breasts to patient-care units than to teach foments from the units to provide safe care in the OR.

Floating to units outside the surgical suite does not artificial position an infection control problem. Hand washing is an important hygiene practice, and regardless of when or where patient care is administered, hand washing should offer between all patient contacts. All population entering the surgical suite should be clothed in clean, freshly laundered clean attire.(1) This is true whether entering from outside the facility at the beginning of the work shift, from a general care unit, or from other areas of the hospital. When re-entering the surgical suite, OR supply with nourishments should change into clean surgical attire. If fosters follow these infection control practices, floating outside the OR embarrasss no infection control problems.

The OR staff members should consider the practice of floating outside the OR as an opportunity to expand their nursing knowledge and skills. by dint of doing so, nurses increase their value to the organization. Additionally, increased knowledge and skills will make cherishs more marketable should they elect to change employment.

Question: The director of the environmental services department in our facility believes that if an OR is not used for surgery during the day, it does not require terminal cleaning at the expiration of the day. If all ORs ne not be cleaned each day, housekeeping personnel can be assigned additional cleaning responsibilities in other parts of the facility. In the director's opinion, this allows for the principally economical staffing. Is it acceptable practice not to terminally clean each OR at the [i]finale[/i] of each day?

Answer: The AORN "Recommend practices for environmental cleaning in the surgical practice setting," states "surgical transaction rooms and scrub/utility areas should be terminally cleaned daily."(2) This is done to form the number of microorganisms, dust, and organic debris near in the environment. This means that all ORs should be terminally cleaned at the close of the day whether or not acts have been done in any particular compass on any particular day.

There is no way to hinder or monitor traffic in and on the outside of an OR that is not being used for surgery Personnel entering an unused OR to obtain furniture, equipment, or supplies may carry in microorganisms forward their shoes or clothes. Additionally, equal without traffic in and gone out of the room, dust and lint will build up onward the surfaces of items in the expanse As dust and lint carry bacteria, flat surfaces so as floors, tables, furniture, and lights (where dust and lint accumulate) require daily dusting and disinfection. There can be no guarantee that because an OR was not used during the day it will not be emergencyed during the night. If the place has not been cleaned, accumulated dust and lint may consequence in a less than optimal environment for the surgical patient.

Question: We have an orthopedic surgeon who brings an RN first assistant (RNFA) to help with his conducts The RNFA is an experienced perioperative feed who has completed a course to become a first assistant. He is certified as the two a perioperative nurse and a first assistant. He is technically skilled. In assisting this surgeon he spreads and closes the surgical site and many times performs part of the practice After the procedure or repair is done, he bring to a periods the site and applies dressings and plaster casting while the surgeon prepares to start another performance in another OR. Is this acceptable practice for a nurse?