...Anesthesia is one of the most challenging and unique fields within the medical area. The field requires a lot of attention from those who practice anesthesia. Because of the high risks that are at stake, only a few are chosen. Those few are relied on heavily to complete their tasks while making it their main goal to successfully wake every patient after an operation. Due to the heavy responsibilities, stress could play a major role in the lives of those who may practice nurse anesthesia or may be currently enrolled in an anesthesia program. Soon, more stress could be added because of the educational requirements will be changing within the next few years. Although nurse anesthesia is one of the leading areas in the nursing field, those who...
Words: 1112 - Pages: 5
...AFT2 Task 3 / Tracer Patient A.1. Evaluation In reviewing the Surgical Patient Tracer Worksheet (SPTW), it was found that a deficiency was noted that stated “History and physical not done within 24 hours of admission (> 72 hours).” This meant that the laparoscopic hysterectomy related History and Physical (H&P) the patient received was used for the abdominal hysterectomy. Plus, it was more than seventy-two hours after being admitted to NCH for surgery that the patient received the H&P for the abdominal hysterectomy. In reviewing the Tracer document and other information, it became clear that there were three violations of Joint Commission Standards (JCS) for PC.01.02.03 which states: “The hospital assesses and reassesses the patient and his or her condition according to defined time frames.” (Joint Commission, 2014 August). The violations are as follows: 1) When bleeding was detected, the doctor made the determination that the less invasive laparoscopic hysterectomy the patient was scheduled to undergo would need to be changed to an abdominal hysterectomy. The tracer shows no evidence that neither the doctor nor anyone else associated with the surgery including the Anesthesiologist asked for a new H&P to determine the possible complications the bleeding might have on the choice of surgical procedure. The violation relates to JCS PC.01.02.03 Element of Performance (EP) 3 which states: “Each patient is reassessed as necessary based on his or her plan for care...
Words: 4479 - Pages: 18
...specialization in anesthesia. Anesthesia is described as an insensitivity to pain that is produced by drugs and given to patients by medical professionals before performing an invasive procedure. These types of advanced-practice nurses are referred to as Certified Registered Nurse Anesthetists (CRNAs). CRNAs work are expected to execute a variety of challenging tasks on a daily basis. They are directly under the supervision of a qualified anesthesiologist at all times while they perform preoperative, intraoperative, and postoperative...
Words: 742 - Pages: 3
... September 21, 2013 Perioperative staff, which includes pre-operative nurses, surgeons, anesthesia providers, operating room staff, and recovery room nurses should know what malignant hyperthermia (MH) is and how to handle it when it arises. “Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stresses such as vigorous exercise and heat” (Rosenberg, Davis, & James, 2007). Almost all patients that are MH susceptible have no characteristics of these changes without anesthesia. It is nearly impossible to diagnose susceptibility without either the exposure to the "trigger" anesthetics or by specific diagnostic testing, such as a muscle biopsy. Examples of key diagnostic features of MH include an unexplained elevation of expired carbon dioxide, muscle rigidity and rhabdomyolysis, hyperthermia, acidosis and hyperkalemia. If the patient is aware of a familial history of MH, and they inform the perioperative staff, they can be better prepared in the event that a crisis does occur. These changes can occur suddenly upon induction of anesthesia or during the surgical procedure, so the staff must be aware of what is happening and any changes with the patient and communicate with each other...
Words: 785 - Pages: 4
...the medical field. (Q)What is your specialized area? (A)My specialized area is registered Nurse Anesthetist. There are three types of anesthesia: General, Local, and regional. I am most interested in General anesthesia which puts the patient completely to sleep; although, I will have to study all three. (Q)What is your particular skill set? (A) My particular set of skills include 4 years combat lifesaver, and an enthusiastic and long lasting dream to be a anesthetist, the backing of most of my family being in the medical field (Q)How will you incorporate ExD? (A) I will incorporate ExD in my specialized research area by assigning: INDEPENDENT VARIABLE- MOTIVATION TO GO TO SCHOOL DEPENDENT VARIABLE- TIME (in years) TO EARN TITLE RN ANESTHETIST CONTROL – LACK OF MOTIVATION CONSTANTS – CRIMINAL RECORD, THE GOAL (anesthetist), MUST NOT DIE HYPOTHESIS – IF MY MOTIVATION TO GO TO SCHOOL IS ALTERED THE TIME IT WILL TAKE FOR ME TO EARN THE TITLE RN ANESTHETIST WILL BE ALTERED. (Q)How will you incorporate Mathematics? (A) I will incorporate mathematics in the form of the number of years of prerequisites plus the number of years in grad school. The amount of medication I would be administering to my patients vs the patients weight. The number of vacation days I can take in a year (Q)How will you incorporate Science? (A) I will incorporate science in being a registered nurse anesthetist with the use of biology, Chemistry,...
Words: 263 - Pages: 2
...patient mentally physically and spiritually and also to conduct a patient teaching to ensure the patient has all the information that they have the right to know. The nurse also acts as a witness to the signing of the informed consent. 2. The nurse must assess the needs of the patient pre-operatively this can include the need for information, education, the need for comfort, the need for spiritual guidance. The patient may need to use the bathroom; the patient may feel ill or need some calming techniques shown to them. 3. The nurse has the responsibility of ensuring the patient is ready for surgery. The nurses’ duties usually include placing the patient on NPO status, starting an IV line, prepping the intestinal tract and skin and administering the preoperative medicines. The nurse is usually following orders from the surgeon or guidelines of the facility they work in. The nurse also had the responsibility of ensuring that the patient feels as though they have all the information that they have rights to and that they have been well educated on the surgery. The nurse also can mentally and spiritually as well as emotionally prepare the patient for undergoing surgery. 4. The nurse administers patient teaching in regards to many things, patients usually have fears when it comes to the effects of surgery and anesthesia they may at times have questions about how the surgery will affect their home lives negatively....
Words: 1286 - Pages: 6
...patient mentally physically and spiritually and also to conduct a patient teaching to ensure the patient has all the information that they have the right to know. The nurse also acts as a witness to the signing of the informed consent. 2. The nurse must assess the needs of the patient pre-operatively this can include the need for information, education, the need for comfort, the need for spiritual guidance. The patient may need to use the bathroom; the patient may feel ill or need some calming techniques shown to them. 3. The nurse has the responsibility of ensuring the patient is ready for surgery. The nurses’ duties usually include placing the patient on NPO status, starting an IV line, prepping the intestinal tract and skin and administering the preoperative medicines. The nurse is usually following orders from the surgeon or guidelines of the facility they work in. The nurse also had the responsibility of ensuring that the patient feels as though they have all the information that they have rights to and that they have been well educated on the surgery. The nurse also can mentally and spiritually as well as emotionally prepare the patient for undergoing surgery. 4. The nurse administers patient teaching in regards to many things, patients usually have fears when it comes to the effects of surgery and anesthesia they may at times have questions about how the surgery will affect their home lives negatively....
Words: 1285 - Pages: 6
...Running head: OR EXPERIENCE Observational Experience in the Operating Room and Post Anesthesia Care Unit Bothayna Bader LaGuardia Community College Professor Rosenberg SCR 210 March 19th, 2013 Preoperative Phase The preoperative phase is the time period between the decision to have surgery and the beginning of the surgical procedure. For some patients, the preoperative period may last for months, during which testing and other procedures may be done. For an emergency, such as an appendectomy, the preoperative period may last only a few hours. During the preoperative phase, preadmission testing is done to assess health history, family medical history, and any known allergies to medications. During which time explanation of the surgical procedure and patient education is taking place. Patient education advises the patient on pre-surgical preparation such as bowel preparation, nutritional and fluid intake the day before the procedure and when to stop eating, and how to proceed with medication therapy the day before surgery. Diagnostic testing includes ECG monitoring, blood testing and vital signs. The trauma of surgery can greatly be relieved by psychological preparation of the patient before surgery, so during preadmission testing psychological evaluation is also taking place to assess the patient for any fears or anxiety related to the surgical procedure. The nurse should discuss techniques to aid physical recovery and ways to lessen the pain and anxiety that...
Words: 3682 - Pages: 15
...Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer Rationale: Mr. Gordon has drainage coming from his surgical incision, and his dressing needs to be changed. What assessments of the incision should Joan perform while changing? Answer: Rationale: Claudia asks Joan what she can do when she takes him home to help prevent...
Words: 3306 - Pages: 14
...hemorroidectomy. The role of the surgeon was to come in and perform the surgery. The anesthesiologist induced anesthesia, and monitored the patients heart and respirations and other vitals during the surgery. They also bring the patient out of anesthesia and extubate them. The circulating nurse job was to monitor during surgery and make sure the patient is safe, and to call the patients family during and after the surgery. The circulating nurse also goes to the pre-op holding area and assesses the patient prior to surgery and brings them into the OR. The surgical technicians job is to assist the surgeon during the procedure and hand him the required tools needed. They also count before and after the surgery to make sure all tools are present and accounted for. The PACU nurse role was to monitor the patient’s vitals and pain after surgery and to administer any medications. They also monitor the patient’s arousal after surgery and the surgical site for any possible complications. The first surgery I saw was a hernia repair. The surgeon made a 6-8 inch incision in the abdomen and repaired a recurrent hernia in the small intestine. He then put in a mesh to keep everything in place. General anesthesia was used for this procedure and the patient was intubated and tolerated/woke up well. Betadine skin prep was used and general draping techniques were used. In PACU the nurse observed the patients level of consciousness and pain level. She also monitored the drainage from the wound and...
Words: 410 - Pages: 2
...Trapped in the Dutch Anesthesia Market Executive summary The Dutch healthcare sector, where AA operates, is highly intervened and regulated Governmental price capping renders a pricing strategy based on Bouwman's model innefective. The PESTLE analysis points to several, sometimes concurring, threats from the outside. The SWOT analysis pointed to the need to redefine our mission as business. AA has gradually shifted from a clinical services company to a consultancy services company. Background information Anesthesia Associates Care (AA) operates in the Dutch medical sector, and it was first established in 2000 as an anesthesiology freelance practice in the city of Rotterdam. Although the author of this report works three to five days per week as a clinician, his function in AA also includes quality management and strategy. The Dutch medical sector where AA operates is highly intervened and regulated. The financing of hospitals and medical services is done by an oligopoly of insurance companies. The government, under advice from the insurers, imposes capped hourly wages for anesthesia services. Non-compliance with the price limitation is a criminal offence. Between 2002 and 2007 the demand for anesthesia locum tenens was so high that AA expanded to eighteen anesthesiologists and nine nurse anesthetists, while it expanded from Rotterdam to all corners of the Netherlands. Today, our client portfolio includes sixty-one Dutch university...
Words: 2923 - Pages: 12
...measures I observed at Inova was the role each physician, nurse, and other staff member played in the surgery. Each individual knew what was expected of him or her and was held accountable for one task or another. Within the pre-op room, the age, sex, race and other important information were listed on the patient chart along with the details of where each individual would stand or sit throughout the procedure. A short but concise rundown of the steps to follow during the procedure was written out on the whiteboard along with abbreviations for special equipment to be used. During the procedure, Darla explained each person’s duty and highlighted the role of the nurse who was in charge of making sure all medical supplies were accounted for at the end of the surgery. This included a magnetic board that held all the needles used during the procedure, all the gauze used during the procedure, tubes, tissues, etc. Next, she discussed the role of the nurse anesthetist who would keep monitoring the patient’s alertness levels to decide whether the patient needed another dose of anesthesia. In addition, Darla explained how the RN-First Hand nurses were able to physically help the surgeon perform the surgery because they had received special training that allowed them to do so. Another nurse came in to administer the cleaning of the pig valve in saline and made sure all the equipment needed was used and carefully put back in place. The nurse by the doctors side was in charge of handing each piece...
Words: 604 - Pages: 3
...AFT2 Task 1 Christian Fisher Western Governors University AFT2 Task 1 A. Compliance Status During the last Joint Commission survey two years ago, there were several areas of deficiency surrounding the use of moderate or deep sedation or anesthesia. These noted deficiencies gave Nightingale Community Hospital the opportunity to revamp and strengthen our procedures in all areas of peri-operative services. These include the Main OR, CVOR (Cardiovascular OR), Interventional Labs (Cardiac Catheterization and Interventional Radiology), and Endoscopy Suites. Significant process has been made especially in the area of the Time Out. A Time Out is the step by which all work in the particular surgical area halts and everyone in the suite actively participates in ensuring that for the current surgery we have: 1. Correct patient. 2. Correct side and site. 3. Correct procedure to be done. 4. Correct patient position. 5. Correct implants and equipment. All of the Peri-Op services procedural areas brought members of their teams to participate in brainstorming and development sessions in the area of the Time Out to ensure that it was robust and all encompassing. As well, some of these components and other important details should actually be completed prior to the patient’s arrival in the surgical suite. While the Time Out is an effective last act before a surgery proceeds, many other details should and must be completed long before that. This ensures the safety of the...
Words: 966 - Pages: 4
...1. The nurse completes the medication reconciliation for this patient. Explain the information gained in this procedure and the purpose of the medication reconciliation. (5 points) The medication reconciliation presented a panoramic view of the dose, route and frequency of the prescription the patient is currently taking. After it is performed it can be observed that the patient is taking 1200mg of Ibuprofen which is the max dose per day. Tylenol is prescribed 500mg every 6 hours PRN, patient need to be instruct not to exceed 3000mg per day. It is important to teach patient about the possible interaction between NSAID or acetaminophen and OTC cold medication. Hydrochlorothiazine 25mg twice a day, diuretics need to be monitor due to the interaction...
Words: 2116 - Pages: 9
...The anoxic encephalopathy is one of the post-operative complications that could be related due to anesthesia administration. The result of this complication is a lack of oxygen in the brain tissue. Although it takes less than 4 minutes to have a brain damage due to lack of oxygen, this occurs when the patient is away from the hospital care like home. Such thing should not happen while a patient is under the care of the healthcare professional. One of the first problems that could be noted, there was a lack of patient assessment, and that was the reason the patient Juan’s caregiver did not catch any sign and symptom of anoxic encephalopathy. Mr. Juan had signaled many times of some sort of post-operative complications. For example, he was unable...
Words: 353 - Pages: 2
