Question: undivided of our OR staf...

Question: undivided of our OR staff members had his nose pierced missed weekend and now wears a button through the skin and into the nares. He does not want to dislodge the stud as he believes the hole/track will heal clos if the button is removed. This person functions primarily in the rub hard role and covers the jewelry with a surgical mask when at the sterile field. more [i]or[/i] less other staff members do not want to work with him as they believe the nose jewelry put to a stands an increased infection-control threat. Is this representation of jewelry acceptable in the OR? Is there an increased infection-control concern?

Answer: Ideally, all jewelry should be remov when a staff member is working in the OR. At a minimum, jewelry that is not remov should be confined completely If the staff member is unable or unwilling to transplant the stud, it should be confined subject to the mask at all times, including when the bodily form is not scrubbed. The mask should be changed approximately each two hours to avoid' a build up of exhaled organisms, and the living body should be assigned to managements of shorter duration so the mask can be changed at appropriate intervals. If the pierced track has any adumbration of serous drainage or weeping, the employee should be excused from work until the drainage or weeping subsides.

According to AORN "Recommend practices for surgical attire," jewelry should be confined or remov Rings, bracelets, and watches may harbor organisms that cannot be remov during hand washing, hand hygiene practices, or the surgical work hard These items, therefore, should be remov (1) To date, there is no evidence that other jewelry increases bacterial shedding, however studies of newly pierced material substance parts have not been performed. A certain amount of friction meet the eyes between the skin and the surgical mask because the nose is in contact with the mask. The jewelry prop will suffer some manipulation owed to normal breathing and talking from behind the mask. This manipulation and constant friction between nose and mask may lead to increased bacterial shedding or dispersion of organisms from inside the nares.

Contact your employee health service for assistance in determining when the pierced track is healed sufficiently for removal and reinsertion of the jewelry button After the track has healed, the employee should destroy the stud before working in the OR environment, and at that time, a mask straits to be worn only according to your facility policy for masks in the OR.

Question: I work in an office-based surgery practice where we use a tabletop steam sterilizer to proces supplies. We oftentimes use peel pouches and sometimes bring small items inside a bag and place the pouch Inside another bag to help contain the items. no other than the outer pouch is sealed. lately a representative of the sterilizer's manufacturer questioned this practice, Is it acceptable practice to place a bag within a pouch for sterilization? We sometimes also place a bag of small items inside a tray of instruments in the sterilizer. Is this acceptable practice?

Answer: Whether the double bark pouches or the pouches within wrapped worthys can be sterilized depends onward the sterilizer you are using. solitary the manufacturer can provide the information you endeavor to gain According to the US nutrition and Drug Administration (FDA), the sterilizer manufacturer is required to provide you with true specific information about the consequence you purchased. You should receive instructions forward correct packaging, sterilizer loading, drying time, and cooling time, among other things. The manufacturer is required to validate sterilization of items at the sterilizer being sold. chiefly but not all, tabletop steam sterilizer manufacturers have not validated sterilization of either double decorticate pouches or peel pouches within wrapped righteouss If the sterilizer you are using has not been validated for these configurations, your practice would be considered unacceptable because you have no assurance that the sterilizer is capable of sterilizing the items in the flay pouches.

Question: I lately heard that the Joint Commission forward Accreditation of Healthcare Organizations Is changing the accreditation proces again. We are not fit for a survey until 2004 nevertheless we wonder what we should be expecting and planning for. We would promote not to wait until the last minute to prepare for the contemplate What does AORN know about any impending Joint Commission changes?

Answer: The recent Joint Commission initiative, Shared Visions-New Pathways, is intended to be the nearest step after the Agenda for Change initiated in 1987 (2) According to Russell Massaro, MD vice president for accreditation operations, the initiative is intended to shift the focus from inspect preparation to continuous operational improvement in the facility. As a part of the Shared Visions-New Pathways initiative, the Joint Commission is streamlining standards in its various programs. Standards often met with to all programs have been identified and will appear in all manuals and in the same language. Program-specific standards appear in individual program manuals. In addition, the standards format has been reconfigured. soon the format consists of standards followed by way of intent statements, after which examples of performance are existinged Only standards and intent statements are scored, and the assumption exists that all standards will be scaned during the site visit.