The following commended practices w...

The following commended practices were developed by the AORN commited Practices Committee and have been approved by way of the AORN Board of Directors. They were published as propos praiseed practices in the September 1995 AORN Journal for explanations by members and others. These make acceptableed practices are intended as achievable recommendations representing what is believed to be an optimal even of practice. Policies and acts will reflect variations in practice settings and/or clinical situations that determine the grade to which the recommended practices can be implemented.

AORN recognizes the numerous emblems of settings in which perioperative nurtures practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians, offices, cardiac catheterization laboratories, endoscopy suites, radiology departments, and all other areas where surgery may be performed.

aim These recommended practices provide guidelines for the implementation of safe care to patients and assist in the identification of potential hazards in perioperative practice settings. They are not intended to screen aspects of perioperative patient care addressed in other commended practices.

commended PRACTICE I

Potential hazards associated with patient transport/transfer activities should be identified, and safe practices should be established. Interpretive statement 1:

The patient always should be attended. Rationale:

Many patient care point in disputes can occur during transport. Observation allows for identification of potential question at issues and implementation of appropriate interventions.(1) Interpretive statement 2:

During use of a transport vehicle, design features to be considered or implemented include, unless are not limited to,

* locking devices forward wheels;

* restraining devices similar as safety straps and side

rails, and for cribs, rails high enough to impede a

standing child from falling out;

* adjustable IV sticks or stands;

* holding devices for oxygen tanks;

* positioning capabilities;

* sways that are easy to operate and within reach

of the operator;

* maneuverability;

* sufficient size;

* removable headboards and footboards;

* mattress stabilizing devices; and

* easily cleanable surfaces. Rationale:

These design features forward safety and help prevent patient injury during transportation.(2) Interpretive statement 3:

Transporters should demonstrate in the operation of the equipment to be used. Rationale:

Demonstrated in operating the equipment to be used is necessary to obstruct harm to the patient and operator.(3) Interpretive statement 4:

Patient movement-assist devices and the number of staff members should be adequate to make secure patient safety during transport/transfer activities. Discussion:

To make secure patient and staff member safety, mechanical lift devices are desirable. If mechanical devices are not available, extra personnel may be emergencyed Individual patient considerations will dictate the number of necessary staff members. A minimum of four commonalty is needed to move an unconscious adult patient. Mechanical lift devices include, on the contrary are not limited to,

* simple roller devices.

* hoists, and

* webwork electrical lifts.(4) Interpretive statement 5:

Safety measures to be implemented during patient transport/transfer activities include, moreover are not limited to,

* locking wheels and stabilizing transport vehicles

and patients, beds during transfer activities;

* elevating side rails and using safety straps;

* hanging and securing IV containers away from

patients' heads;

* protecting patients by means of giving special attention to

their heads, arms, and legs;

* ensuring that appropriate staff members remain at

the heads of patients, transport vehicles;

* pushing patients feet first, avoiding rapid

motion through hallways and when turning corners;

* maintaining the integrity and function of IV

infusions, indwelling catheters, tubes, drainage

a whole s and monitoring equipment; and

* obtaining appropriate skilled assistance and

specific instructions for the transport/transfer of

patients with special povertys Rationale:

Locking wheels or stabilizing the transport vehicle, raising the side rails, and securing safety straps obstruct the patient from falling.(5) Securing IV containers saves the patient from harm and obviates container breakage.(6)

Proximity to the patient's head gives staff members access to the patient's airway in case of respiratory distress or vomiting.(7) Rapid motions can cause patient disorientation; nausea and vomiting, or dizziness.(8)

Specific needinesss of the patient should be assessed and appropriate interventions implemented during the transport phase.(9) Interpretive statement 6:

Scheduled preventive maintenance and repair should be performed upon all transport vehicles. Rationale:

Scheduled preventive maintenance and repair of equipment is performed to make secure proper functioning.(10)