Transcript Patient Identification

Patient Transfer & Transport
Concorde Career College, Portland
ST210
Patient Identification
Right Patient for the Right
Procedure by the Right Doctor
Patient Preparation
• Patient’s physical, emotional status
is assessed and recorded
• Vital signs assessed and recorded
• Patient is wearing a clean gown
– Undergarments removed
Patient Preparation (continued)
• Jewelry removed
– Wedding band taped in place if facility
policy allows
– Religious symbol can be carried;
removed before anesthesia
• Dentures, removable bridges
removed
• Contact lenses, eyeglasses, hearing
aids removed
Patient Preparation (continued)
• Eye, extremity, breast prostheses
removed
• Wig, hair piece removed
• Hairpins removed to prevent scalp
injury
• If ordered by physician, antiembolic
stockings are applied to lower
extremities
Patient Preparation (continued)
• Be sure patient has voided and if not,
have them do so
– Time is recorded on preoperative
checklist
• Patient’s personal property must be
safeguarded
– Give to family member for safekeeping
– Place valuables in facility safe
Preoperative Medications
• If ordered, preoperative
medications are given
– Antibiotic
– Preanesthetic medications
• After receiving preoperative
medications; the gurney is placed
in lowest position with side rails
raised
• Patient cautioned to remain in
gurney
Identification
• Check surgery schedule to gather
necessary information
– Patient’s name
– Facility identification number
– Surgeon’s name
– Surgical procedure
Identification (continued)
• Prior to taking patient to OR
– Introduce yourself and state your purpose
– Compare patient’s name to surgery schedule
• Ask patient to state their name
• Check patient’s ID/wristband
• Check nameplate on end of gurney
– Confirm name of surgeon
– Confirm surgical procedure and side of surgery
– Check for allergy wristband if necessary
Identification (continued)
• Check chart for completeness
– Name on outside
– History and physical
– Results of diagnostic examinations
– Signed consent
– Allergy status
• Be sure preoperative checklist is
complete and signed by RN
• Transport patient
Patient Transportation
Safe Transportation To and
From the OR
Stretcher (Gurney)
• Most common means of transporting
adult and adolescent patients
– Occasionally used as OR table (i.e.
cataract extraction
Ward Bed (Patient’s Bed)
• Uses
– Traction prevents transfer to gurney
– Large patient
– Unconscious patient
– Postoperative traction or stability
devices will be needed
• Following orthopedic procedures (i.e. total
hip)
Crib
• Uses
– Patient is less than 5 years old
– Sides are high to contain patient
– Sides can be padded to prevent patient
injury
– Side rails can be lowered to deliver
preoperative and postoperative patient
care
Wheelchair
• Uses
– Patients who will have local or no
anesthesia
– Patients undergoing a diagnostic
procedure such as cystoscopy or
sigmoidoscopy
– DO NOT use wheelchairs for patients
who are sedated
Parts of a Standard Gurney
• Swivel wheels
– Seem to have a mind of their own
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Wheel locks
Frame
Shelf
Mattress - Velcro® attachment to
frame
• IV pole
• Side rails - adjustable
• Safety straps (seat belt)
Procedure and Safety Rules
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Clean sheets, pillow with pillow case
Warm blanket(s)
IV pole
Introduce self and state purpose
Identify patient
Review chart
Procedure and Safety Rules
(continued)
• Verify patient allergy status
• Be sure patient has recently voided
– Leave room as patient gets up from bed
to go to the bathroom unless they need
assistance
– Remember, hospital gowns are not very
flattering; tend to be more embarrassing
for females
– Ask patient, when done to climb back
into bed and cover up
Procedure and Safety Rules
(continued)
• Explain all procedures to the patient
to alleviate anxiety
• Lay warm blanket over bed covers
• Pull down bed covers, maintain
patient dignity
• Place gurney next to patient’s bed
• LOCK THE WHEELS!!!!
Procedure and Safety Rules
(continued)
• Move IV bag, Foley catheter, etc to
gurney
– Place IV pole at foot end of gurney to
prevent injury to patient’s head should
the item fall
• Policy at many facilities requires two
individuals to be in attendance when
patient transfers to the gurney
– One person steadies gurney with body
– Second steadies bed to keep from
separating
Procedure and Safety Rules (continued)
• Assist patient as needed
• Keep patient covered, if possible
• Raise the side rails; be certain
patient’s body parts are out of the
way (i.e., fingers)
Procedure and Safety Rules
(continued)
• Instruct patient to keep hands,
fingers, elbows inside of side rails
during transportation
• Ask patient if they would be more
comfortable with head of gurney
raised
• Ask patient if they would like a pillow
under their knees
• Push patient from head end so their
feet go first
Procedure and Safety Rules
(continued)
• Walk at a moderate pace that allows
for control of gurney at all times
• Rapid movements may cause
dizziness and nausea for patient,
especially if they have received
preoperative medications
• Inform patient when you will be
going over bumps, rough areas,
inclines, declines
Procedure and Safety Rules
(continued)
• If you approach a door that must be
opened and secured, lock gurney
wheels before doing so
• When entering elevator, go in head
first so feet are facing doors
• Conversation on a case-by-case
basis; situational; comes with
experience
• Family or friends may accompany
patient
Procedure and Safety Rules
(continued)
• Monitor patient for unusual physical
signs (labored breathing, unusual
restlessness, clutching chest, etc)
• Monitor patient’s emotional state
• If transporting baby, pediatric, or
adolescent patient, parent(s) or legal
guardian should accompany patient
Procedure and Safety Rules
(continued)
• Pediatric patient transported in crib
– May be active
– Let parents help ensure patient safety
during transportation
– Watch for potential head injuries
– Take your time
– Pad the sides of the crib if necessary
– Child may bring favorite toy
Transfer to Table
• Properly identify patient
• OR table and gurney locked
– Mattress secured to OR table
• Minimum of 2 people assist an awake
patient during transfer
• Person on “gurney side” helps patient
move to OR table
• Person on “OR table side” prevents
patient from falling off the narrow table
Transfer to Table
• Minimum 4 persons to move
unconsciousness, obese, or weak
patients
– Move on the count of three
– Anesthetist controls timing
– Anesthetist controls head and neck at
all times
– Surgeon is responsible for stabilizing
un-splinted fractures during move
Transfer to Table
• Anesthetized patient is moved slowly
to allow circulatory system to adjust
• Body parts not to extend beyond
table edges, rest on metal parts, or
unpadded surfaces
• Body exposure kept to minimum
– Prevent hypothermia
– Maintain patient’s dignity (especially
awake patient)
Transfer to Table
• Protect arms
– Prevent accidental IV removal
– Avoid hyperextension of arm board
• Be sure patient does not have
crossed legs
– Uncrossed to avoid neurovascular
compromise
Transfer to OR Table
• Lab Demo