OR Policy Help............

  1. Hi all-

    Before I reinvent the wheel and start from scratch I was wondering if you had a hospital policy you could share or even some information on:

    ***joint hardware removed in the OR

    ***Allowable abscences in a year before corrective action begins

    ***Local Cases in the OR...........do you require a hep lock or a IV be placed before going to the OR?

    I have done the usual AORN checking already but didn't come up with a lot. Any information that you know of or how you practice at your facility is greatly appreciated..........I know it is a lot to ask!!

    Stacey
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  2. 6 Comments

  3. by   TracyB,RN
    hardware... goes to path for gross exam... patient can't have it back, either. BOGUS!!
    absences... depends on the reason.. usually 5 occurence in 1 yr is verbal, next is write up, next step suspend, next step... seee ya
    Haven't done a local case in sooo long... i couldn't tell ya.. but i think our patients need at the very least a hep lock.
  4. by   umakemesmile
    Hardware is sent with pt. if they want it. After it has been disinfected and sterilzed. Only sent to Path. if MD deems it so.

    Absenteism? HA!! here there are no worries for the repeat call in's. Officially, 3 call in's per quarter is supposed to be when action is taken.

    We do local's with no IV's.
  5. by   IsseyM
    Anything removed from our patients-supposed to go to Path but it doesn't always happen. Surgeon's will provide the patient with hardware if they request it.

    We can call in 3 times within a 3 month period. Basically we could call in once a month without getting written up. More than that you're supposed to get a verbal, 2nd time you get written up and 3rd time suspended or terminated. I haven't seen any of this happen to the regular people who call in. I've only heard a couple of people receive verbal warnings. The wrong people get away with alot of crap. If i were to do half of what some of them do, i'd be fired on the spot!

    All of our patients coming into the OR, even under local must have a running IV.
  6. by   lindaloo51
    Hardware that is removed is steilized and given to the patient if they request it. If it is defective, it documented on an occurence form, sterilized and given to OR supervisor for whatever action is necessary.

    Call ins are given a verbal at 4 per 12 month period, written at 4 or 5, written with counseling at six and 3 day suspension at 7. This does not count if you cover yourself with FMLA paperwork. Then it is only counted as 1 occurence.

    All patients coming to the OR have IV access. Endoscopies have 2 staff(Circulate and scrub), all other procedures have a circulator, scrub and a monitor nurse.
  7. by   ewattsjt
    This is just for my facility and I am sure you will see varying answers on this question.

    Hardware is supposed to be thrown away…some docs demand it be cleaned, sterilized and sent with the patient if they ask. The idea of not giving it back is the same as not using the same screw on different patients (microbes love hardware). Most patients will not only show it off but let their friends handle it…YUCK!!!

    Absenteeism is one I am not that familiar with. It does run for a rolling calendar year (if I miss tomorrow; it starts a year from then). I do know that after three continuous self sick (unapproved days) you must have a doctor slip and if 5 continuous, you must apply for FMLA. Those will only count as one day/are combined as one absence. I may be wrong on this part…third day is a verbal warning, fourth day is counseling with suspension and fifth is fired. All vacation, holidays and time off goes into one bank and it doesn’t matter how much you have if you were not approved off.

    Local…It depends on the extent of the case. Most of the time since it has come to surgery, it will be an IV. There are a few exceptions though.
  8. by   callbabe
    Quote from TracyB,RN
    hardware... goes to path for gross exam... patient can't have it back, either. BOGUS!!
    absences... depends on the reason.. usually 5 occurence in 1 yr is verbal, next is write up, next step suspend, next step... seee ya
    Haven't done a local case in sooo long... i couldn't tell ya.. but i think our patients need at the very least a hep lock.
    I agree with the above, our policys are similar.
    IV access is only used with conscious sedation, and most surgeons do not even do anymore. Because they have to be ACLS trained. We do alot of MAC ( monitored anes care)

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