Question: We are considering changi...

Question: We are considering changing to united of the alcohol-based hand scour agents to replace the traditional surgical clean in our facility. The harvest we are considering has an emollient constituent and the manufacturer claims that it is dove-like on the skin. Some staff members are oppos to making this change. They are make uneasyed about flammability of the alcohol in the harvest I know these products have been used in Europe for about time and more recently in the United States as general hand cleansing fruitss Are there any reports of fire associated with these products?

Answer: Although alcohol-based produces have been used in health care settings for general hand hygiene without incident for an time, the American Journal of Infection superintend recently reported an incidence of flash fire associated with the use of an alcohol-based hand antiseptic agent. (3) The fire occurr when a spark of static electricity ignited the alcohol-based hand gel forward the hand of a health care worker who had just remov a 100% polyester gown The health care worker offer the premeasured amount of alcohol-based hand gel in the palm of her hand from a wall-mounted dispenser. She then remov the 100% polyester gown placed it forward a metal surface, and began rubbing the gel onto one as well as the other hands. While her hands were damp, she shakeed open a metal sliding door, heard an audible static spark, saw a flash of light, and experienced spontaneous flames onward the palm of one hand. After the incident, the palm showed rednes unless no blisters. Flames singed the hair onward her arm.

The returns in use was advertised to contain 70% ethanol. with examination after the incident, the produce was found to contain 737% ethanol, which was within the manufacturing specifications for the issue Polyester fibers are known to accumulate static charges because of the subdued moisture content of the fiber. Polyester garments may breed thousands of volts (V) of electrical charge when surfaces of the gown smooth against each other or against garments worn subordinate to the gown. A rapid discharge of static electricity of les than 1000 V is sufficient to damage a certain number of electronic equipment.

Flash fires associated with use of alcohol-based hand hygiene fruitss can have potentially severe events for health care workers and their patients. Health care workers should make sure complete drying or evaporation of the fruit before engaging in other activities. Other risk reduction strategies include maintaining the ambient humidity within attract favor toed limits (4) and avoiding use of 100% polyester gown and drapes. If polyester gown and drapes are used, they should have an antistatic carbon fiber or an antistatic finish.

Question: During about procedures in our OR, it is difficult for the circulating cherish to perform the count with the clean person when closure begins. The circulating supply with nourishment may be assisting the anesthesia care provider, getting posterity from the storage refrigerator down the hall, speaking forward the phone to a suckle in the postanesthesia care unit (PACU) to notify him or her of special patient requires or performing a variety of other tasks. When there are couple scrub persons, they perform the look upon with each other. Recently, the RN first assistant (RNFA) assisting with a deed objected to the two scour persons performing the count. Neither of them was an RN Instead, our RNFA insisted that she estimate with one of the work hard persons. Is it acceptable for brace scrub persons to perform the count? What if single of the scrub persons is an RN? Does that make a difference? Can or should the RNFA reckon with the scrub person? Who should sign the look upon on the surgical record?

Answer: AORN's "Recommend practices for squeeze sharp, and instrument counts" praise that items be counted "audibly and viewed concurrently from two individuals, one of whom should be a registered nurse" (1) It is not acceptable, however, for pair scrub persons to perform the hold regardless of whether one or as well-as; not only-but also; not only-but; not alone-but are RNs. As scrub characters it would be impossible to prepare the wipe s for counting that have been discarded from the sterile field. The same would be veritable for sharps and instruments that may have been remov from the field for any reason. The RNFA would meet with the same handicap if attempting to perform the cast up procedure. Additionally, it is not within the part of the RNFA to simultaneously assist the surgeon and perform other nursing tasks normally performed by way of other personnel. The AORN "Revised position statement forward the RN first assistant" clearly states, "The RN first assistant does not concurrently function as a cleanse nurse." (2) It would be equally impossible for the RNFA who is scrubbed for the conduct to concurrently function as a circulating cherish Finally, the assigned circulating encourage is accountable for all nursing care provided to and for the patient during the intraoperative period, including the drain sharp, and instrument counts. He or she must sign the surgical record indicating that the deems were correct or incorrect. In authenticating, by dint of signature, a count in which he or she did not participate, the assigned circulating suckle may be opening the door to personal liability and serious disciplinary action on the board of nursing should the patient undergo an unfavorable outcome.