Patient transfer policy from the room to operations

Policy: organizing procedures and securing the transfer of the patient from the patient's room to the operating room

Purpose: to adjust the workflow during the transfer of the patient from the patient's room to the operating room

Working procedures:

1.    The department nurse informs the operational nurse of the receipt of the summoned patient (hour and date ) .

2.    Inform the anesthesia consultant to discuss the case, review the medical file, re-evaluate the patient and document the evaluation in the medical file

3.    The patient is transferred to the concerned operating room after the approval of the anesthesia consultant by the knowledge of the worker and handed over to the operating nursing

4.    The operations nurse reviews the file and makes sure of the patient's personality and his knowledge of the quality of the surgical intervention, the place of intervention and the surgeon's name 

5.    The medical team follows the instructions to maintain the patient's safety before performing the operation according to the form prepared for this, explaining:

- Re-confirm the patient by asking the patient for the Triple name and reviewing the data match with the bracelet and patient file 

- Confirm the type of operation planned to be performed

- Confirm the position of the planned operation

- Confirm the name of the surgeon.

In charge: 

- Department nursing-operating room nursing

- Consultant anesthesiologist-surgical consultant or his representative    

- The room worker

Models: safe surgery model

References: Egyptian accreditation standards.

Preparation	review	The trust

Pre-anaesthesia patient assessment policy

 

Policy: patient assessment for anesthesia and sedatives .

Purpose: evaluation of the patient for anesthesia and sedatives before anesthesia for surgeries and interventions to ensure patient safety .

Working procedures:

1.    The day before the surgery, the anesthesiologist reviews the patient's file, signs the examination, and reviews the laboratory and diagnostic tests in order to assess his health condition and make sure that the patient is medically fit for anesthesia and record this in the patient's file (see AP.2.1 )

2.    After the examination of the patient, the anesthesiologist takes the patient's consent to anesthesia, indicating the type of anesthesia planned to be used /sedatives in accordance with the possible condition / complications and the expected results, and this is recorded in the declaration of consent to perform a surgical intervention and both the anesthesiologist and the patient sign the declaration in the prepared declaration form

3.    The anesthesiologist re-evaluates the patient immediately before surgery in the operating unit in the patient preparation area to make sure that the patient is fit for anesthesia and make sure that the necessary precautions are taken for the patient and recorded in the patient's medical file .

Responsible: anesthesiologist.

Models:  

 - Patient evaluation form before anesthesia .                         - Confirmation of the patient's consent to surgical intervention .

References:

    Egyptian accreditation standards.

Preparation	Review	The trust

Patient follow-up policy during anesthesia 

Policy: follow-up of the patient during anesthesia .

Purpose: to ensure patient safety during anesthesia

Working procedures:

- All patients receiving total, partial or analgesic anesthesia are regularly observed in the operating room by an anesthesiologist.

- Monitoring is an essential part of the proper handling of the patient during surgery.

- Basic follow-up criteria during anesthesia

1.    Blood circulation: it is necessary to ensure the regularity and safety of the patient's blood circulation during all stages of anesthesia 

- An electrocardiogram is performed continuously for each patient receiving anesthesia and this is followed up from the beginning of anesthesia until the readiness to leave the anesthesia site.

- Venous blood pressure and heart rate of each patient receiving an anesthetic are monitored at least every five minutes with an assessment of the readings.

- Circulatory functions are constantly assessed for each patient receiving an anesthetic by one of these methods: pulse palpation - hearing heart sounds, remote monitoring of blood pressure inside the veins, monitoring the peripheral pulse with ultrasound or by measuring the oxygen percentage.

2.    Body temperature :the body temperature should be kept under control during all periods of anesthesia

- There is a ready-made means of continuously measuring the patient's body temperature when changes in body temperature occur, are expected or suspected to occur, and the temperature is then measured.

3.    The vital functions of the patient are constantly monitored by follow-up devices throughout the anesthesia process and this is recorded in the patient's follow-up form during anesthesia in the medical file and includes the following points:

* Pulse speed.

* Regularity of the pulse.

* Blood pressure.

* Respiratory rate.

* The level of oxygen saturation.

* Medicines and liquids that have been given to the patient.

* Giving blood and its derivatives.

· The drug used.

* Unforeseen events or complications that have occurred to the patient, if any.

· The patient's condition at the end of the operation.

* Start and end time of anesthesia.

* Signature of the anesthesiologist. 

In charge:

- Anesthesiologist.

- Nursing operations .

Models:

- Patient follow-up form during anesthesia .

References:

- Egyptian accreditation standards.

Preparation	Review	The trust

Patient follow-up policy after recovery from anesthesia 

Policy: patient care after the procedure

Purpose: observation of the patient until he is fully awake

Definition: admission of all patients receiving any type of anesthesia to the recovery room for a predetermined period of time in order to ensure their safe and proper care after receiving the anesthetic

Actions:

1.    In case of total anesthesia

· All patients receiving total anesthesia should be monitored regularly for reactions.

* Vital signs should be recorded every 15 minutes, as well as the degree of consciousness, until he leaves the recovery room.

2.    In case of partial anesthesia

* All patients receiving partial anesthesia should be monitored in the same way as patients with total anesthesia.

· They should stay in the recovery room until vital signs stabilize and sensation and the ability to perform functions return to the injured limb.

3.    In case of local anesthesia

* All patients receiving local anesthesia should be monitored in the same way as patients receiving total anesthesia

* They can be discharged if the vital signs are stable, the level of pain tolerance is acceptable and as directed by the surgeon or anesthesiologist.

4.    Post-operative pain relievers

· In the case of patients receiving hypnotic pain-killing drugs after the operation, the patient is observed in the recovery room after taking the drug until the vital signs become stable and the level of pain tolerance is also acceptable, and then transferred to the patient's room in the Department

As directed by the surgeon and anesthesiologist.

In charge :

- Anesthesiologist.

- Recovery nursing .

Models :

- A sample of patient follow-up after anesthesia (awakening) .

References :

- Egyptian accreditation standards

Preparation	Review	The trust