Outpatient Surgery Magazine

Going Green for the Greater Good - March 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1218927

Contents of this Issue


Page 89 of 124

Turning up the heat In my quest to right the trend on SSIs, I collaborated with nursing, surgical and anesthe- sia leaders to develop a colon bundle for our facility. Active patient warming, which occurs throughout the entire surgical episode, is a major component of the bundle. To ensure our staff follows standardized warming protocols, I created a guideline for pre- venting IPH (you can access it here: osmag.net/forms). Here are some of its key ele- ments: • Know the risks. There are several factors that exacerbate the risk of IPH and pre- venting it starts with the patient assessment. Staff need to be aware of hypothermia's risk factors (note them in your warming policy) and pay extra attention to patients who exhibit them. Pediatric patients and geriatric patients are most at risk. People with a low BMI (17 or below) and patients on psychotropics, antidepressants and thyroid supple- ments are also susceptible. Procedure type and anesthesia technique also play a role. For example, patients undergoing procedures requiring placement of a pneu- matic tourniquet are more at risk for IPH. Those who receive spinal anesthesia or regional blocks are at double the risk because the blocks impact the sympathetic vasoconstrictor and vasodilator systems, which affects the body's thermoregulation. • Temperature monitoring. Standardized temperature monitoring methods should be explicitly spelled out in your warming policy. You might have noticed some staff members take oral temperature readings and others opt for an axillary measurement — perhaps for the same patient. These methods simply aren't equitable and are an inconsistent method of temperature taking could impact the effectiveness of your warming practices. It's essential to get buy-in for a standardized monitoring method by including it in your guidelines. For example: "Tympanic measurement is our standard. We'll use it pre-op, intra-op and post-op." If your facility decides upon a different standard, that's fine. Pick one and stick with it. If you're unable to use that method due to the patient's health status or procedure type, have a designated backup method in place. Mistakes are often made with temperature maintenance. All too often, a patient gets 9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 2 0

Articles in this issue

Links on this page

Archives of this issue

view archives of Outpatient Surgery Magazine - Going Green for the Greater Good - March 2020 - Subscribe to Outpatient Surgery Magazine