||Prevention of injury requires application of knowledge regarding effects of thermal sources during an operative or invasive procedure. Care must be taken to ensure patient care modalities are used in accordance to the intended functionality.
||Patient is free from signs and symptoms of injury related to thermal sources
||Prevention of injury requires application of knowledge regarding the appropriate utilization of items used during the operative or invasive procedure. Care must be taken to ensure removal of extraneous item from the procedural site before closure.
||Patient is free from unintended retained foreign objects
||Clinical processes support patient participation in identification of the correct procedure on the correct side including laterality and/or level. Care is individualized to address the unique needs of each patient.
||Patient's procedure is performed on the correct site, side, and level
||Prevention of patient harm requires application of knowledge regarding specimen management. The specimen(s) will be correctly obtained, identified, labeled, processed, stored, preserved and transported.
||Patient's specimen(s) is managed in the appropriate manner
||Caregivers convey information regarding patient current status to colleagues whenever transferring care to another caregiver. Confidentiality of information remains an integral component of patient privacy and will be maintained.
||Patient's current status is communicated throughout the continuum of care
||Performance of an operative or other invasive procedure requires the use of a variety of equipment (eg, IVs, tracheostomy tubes, pneumatic tourniquet, thermal blanket, and sequential compression devices). Prevention of injury requires application of knowledge regarding each item used during the operative or invasive procedure. Care must be taken to ensure the proper use, function, and coordination of these items so they serve their intended therapeutic purposes.
||Patient is free from signs and symptoms of injury caused by extraneous objects
||Prevention of electrical injury requires application of principles of electrosurgical safety, routine maintenance, and knowledge of potential hazards. Performance of the operative or other invasive procedure relies on many electrical devices, notably the electrosurgical unit (ESU). Electrical equipment must be used according to manufactures' documented instructions.
||Patient is free from signs and symptoms of electrical injury
||Prevention of positioning injury requires application of the principles of body mechanics, ongoing assessment throughout the perioperative period, and coordination with the entire health care team. Preexisting conditions (egg, poor nutritional status, extremes of age, vascular insufficiency, diabetes, impaired nerve function) may increase the patient's risk of injury. Other factors, independent of nursing care (egg, type and length of procedure, type of anesthesia) can contribute to the risk of positioning injury.
||Patient is free from signs and symptoms of injury related to positioning
||Prevention of laser injury requires application of laser safety principles, coordination with the entire health care team, and knowledge of hazards. Policies that address credentialing of personnel, laser safety, and maintenance must be in accordance with national regulatory standards and manufacturers' documented instructions.
||Patient is free from signs and symptoms of laser injury
||Hazards arise from the use of a variety of chemicals in the perioperative environment. Prevention of chemical injury requires application of knowledge of the proper use of each chemical compound. Preexisting patients conditions (egg, open wounds, skin condition, immune status, previous chemical exposure) can influence patient susceptibility to chemical injury. Length of exposure to a chemical may increase the likelihood of injury. These chemicals include, but are not limited to: cleaning solutions, skin prep solutions, pharmaceuticals (egg, irrigation solutions), methylmethacrylate, and tissue preservatives (egg, formalin).
||Patient is free from signs and symptoms of chemical injury
||Prevention of radiation injury requires the application of principles of physics and radiologic safety standards. Policies addressing education, credentialing, and radiologic safety and maintenance must be in accordance with national regulatory standards and manufacturers' documented instructions. Preexisting patient conditions (e.g., length of and /or previous exposure) can influence the patient's susceptibility to radiologic injury. Radiation exposure is limited to the target site.
||Patient is free from signs and symptoms of radiation injury
||Prevention of patient injury during transfer/transport requires application of principles of body mechanics, knowledge of transfer/transport techniques and equipment, and coordination of the entire health care team. Appropriate restraints or safety devices are used in accordance with regulatory standards and manufacturers' documented instructions. The condition of the patient will determine the qualifications and number of health care providers necessary during transfer/transport to ensure safety. Transfer/transport injuries may include skin damage from shearing, falls, fracture, or neuromuscular injury.
||Patient is free from signs and symptoms of injury related to transfer/transport
||Medications administered must be within the defined scope of nursing practice. Safe administration of medications during the perioperative period requires knowledge of the intended purpose and side effects of each medication and the patient's condition and current medication usage. Documentation should reflect name, dose, route, time, and effects of all medications administered.
||Patient receives appropriately administered medication(s)
||Adequate wound perfusion is necessary to promote optimal healing and maintain cellular function. Preexisting conditions (e.g., diabetes, vascular disease) and patient behaviors (e.g., smoking) can interfere with the adequate perfusion of both oxygen and nutrients.
||Patient's wound perfusion is consistent with or improved from baseline levels
||Adequate tissue perfusion is necessary to promote optimal healing and maintain cellular function. Preexisting conditions (e.g., diabetes, vascular disease) and patient behaviors (egg, smoking) can interfere with the adequate perfusion of both oxygen and nutrients.
||Patient's tissue perfusion is consistent with or improved from baseline levels
||Adequate gastrointestinal status is essential to maintenance of nutrition and elimination of waste products. Adequate gastrointestinal status is critical to absorption of calories, protein, fats, vitamins and minerals.
||Patient's gastrointestinal status is maintained at or improved from baseline levels
||Adequate genitourinary status is essential to renal function.
||Patient's genitourinary status is maintained at or improved from baseline levels
||Adequate musculoskeletal status is essential to functional mobility and the regulation of calcium and phosphorus ions in body fluids.
||Patient's musculoskeletal status is maintained at or improved from baseline levels
||The endocrine system with the secretion of hormones regulate cellular metabolism by influencing the rates of biochemical reactions to achieve homeostasis. Adequate hormone responses are critical to maintenance of physiologic equilibrium realized with homeostasis (egg, insulin secretion in response to hyperglycemia; epinephrine secretion during profound hypoglycemia; antidiuretic hormone secretion in the presence of increased osmolarity of the plasma; the instantaneous hypersecretion of pituitary adrenocorticotrophic hormone (ACTH) in response to many noxious stimuli; growth hormone to severe muscular exercise and of aldosterone to hemorrhage-induced hypovolemia). Several aspects are monitored throughout the perioperative period.
||Patient's endocrine status is maintained at or improved from baseline levels