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# SFGH OR BULLETIN BOARD

#### HIGHLIGHTS OF WEEKLY IN-SERVICE NOTES: May 1

• Marc Steuer-Orientation to the Difficult Airway Cart
• There is a new smaller difficult airway cart that lives in the OR 1 Ante Room
• This cart has not replaced the other two difficult airway carts that live in the Ante Room between OR 4 and OR 5
• The code for all the carts is 1-3-5
• The fiber scope is not included on the new cart. It is kept in the scope cabinet in the OR 1 Ante Room
• The cart is clearly labeled with all its contents
• If an Airway Emergency <u</u>arises:
• Be sure to grab a difficult air way cart
• Be sure that the CN and the D1 are aware of the airway situation
• Start thinking about what surgeons are available to help with the situation
o Gen surg is staffed 24/7, ENT is only here specific days of the week
• Assist anesthesia as necessary, ask for additional help if needed, and start to gather equipment for an emergency trach (if the situation becomes urgent).

#### ANNOUNCEMENTS

• LEANING OUT!  Many changes have occured and it is difficult to adjust to them so keep on supporting and helping one another locate supplies. Of course there is always room for improvement and it is a working process so continue to voice your thoughts on the suggestion board posted on the Ante RM door (btwn RM 1 & 8). Thank you for being patient as new changes are put into effect!                                                                                                                                                                                                                           --Updated 5S Board will soon be updated to include core 5S responsibilities as well
• Skeleton Rebid Plan:
o The tentative skeleton has been created. It is currently being reviewed by union representatives.
o Once it has been approved, it will be posted for staff to review in an “open comment” period for approximately 2 weeks.
o Then staff will be brought in according to the seniority list posted in the break room to choose shifts.
• Halogen! SFGH online e-learning is due end of May. Please complete by due date.
• New GRADS!! New hires have started their new grad program in April and May! Let us welcome them with our big hearts!
• Do you like to save ! Here is your chance! As city employees, you will recieve 30% off when you purchase See's Candies. Just present your Department ID or Disaster Service Worker ID card. This only applies to specific locations. For more info call (800) 347-7337 or visit www.seescandy.com/QualityDiscountStore/shoplocations

#### FAST FACTS

• Are you interested int earning your CNOR certificate? Here is your chance! Register online at aorn.org/PrepFor CNOR to recieve various study opportunities like test strategies, AORN recommendations and perioperative standards based on lastest evidence-based practices, and test questions.

-- Recieving your CNOR certificate means it is a professional achievement that demonstrates you are competent and

have the knowledge and skills in perioperative nursing

-- "Gain credibility and recognition from colleagues and patients, achieve personal and professional goals"

**financial investment can be reimbursed by SFGH educational fund

• EVIDENCE-BASED PRACTICE: Baed on evidence, 2% chlorhexidine gluconate bath cloths are effective in reducing surgical site infections. Because of our patient population, it extremely important for them to use the wipe on their surgical wound prior to incision. Let's collaborate with pre-operative nurses to ensure our patients have used the chlorhexidine gluconate cloths pre-operatively, whether it occured at home or in surgical center.                                                                                                                                                      -- You can check out the article at: www.aornjournal.org/article/S0001-2092(13)00221-4/fulltext
• What actions should be taken when a scrubbed person sneezes during an operative or other invasive prodecure?                                                                                             ANSWER: step away from sterile field to sneeze, remove sterile gown, leave the room to discard your mask, wash your hands, don a new mask, and scrub back in                              -- AORN recommends to remove your masks when it becomes wet or soiled because your mask filtering decreases when it is compromised by moisture                                          -- A sneeze contains an average of 73,000 bateria particles that compromize your mask and increases surgical site infections in our patients
• Is there a particular lenth of time after which a surgical mask should be changed?                                                                                                                                            ANSWER: There are no AORN recommendations; however, a research study was conducted to discover at what hour does surgial mask become non-effective. Researchers had      the participants read out loud for 2 minutes, pause, and repeat the reading at 15 minute intervals. The researchers took air samples at 1, 2, 4, and 6 hours. They found masks became compromised at the fourth hour and the microbacterial barrier decreases. Therefore, based on this research study, it is important to change your surgical mask after continiously wearing it for four hours.
• Take a Look! Here is a webpage from AORN for opportunities for further education and CE units: www.aornjournal.org/article/S0001-2092%2813%2900366-9/fulltext                             -- there are opportunties for conferences, webinars, specialty education, etc.

#### COMMENTS, ANNOUNCEMENTS, QUESTIONS & INNOVATIVE IDEAS YOU WANT TO SHARE

• Here are a few of your suggestions to post on the wiki page: shortage of supplies, equipment problems, mistakes or lessons learned so others will not do the same, staff requesting to cover shifts, helpful hints for specific services and cases to give an idea about the sugery or surgeon's preference, oppotunities for CE units

-- These are all great suggestions that are important to post so utilize the wiki page as a communication tool to disseminate information. This section's purpose is for you to post             any pertinent information related to the OR so it is up to you on how to utilize this website. Please take a moment to add information about the suggested topics you wrote on               the evaluation form. THANKS!

-- Other topics like updates with LEAN, CE units, AORN articles will soon be posted. Please stay tune!

•  * * * *Remember this is a ultimately a webpage used to benefit yourselves as lifelong learners and for professional development. It is a page that includes both announcements and in-service meeting highlights, as well as, a communication tool for every one of us to access. The web page will bring about collaboration among us, the nurse educators, and manager. For instance, we are able to support one another by contributing ideas and improvements for the OR to work more efficiently. This multimedia environment will increase motivation, strengthen morale, and build trusting and positive relationships among co-workers. As a result, there is an increase in quality care provided to our surgical patients. This also addresses team building that is nurse focus to empower one another with knowledge.* * * *