Educational Offerings

Preventing a fire in the operating room is a patient safety imperative as the consequences can be devastating to patients and staff alike. It is vital that the entire perioperative team be familiar with fire hazards and observe fire safety practices in the operating room. This educational activity will increase awareness of fire risks in the operating room and provide knowledge needed to develop and enhance fire safety initiatives.

Since first introduced as a glove-donning agent, powder has been a source of concern for the safety of both patients and healthcare professionals. The objectives of this educational program are to explain the history of glove powder, list the methods of powder dispersion, identify powder-associated complications, and describe considerations when using powdered gloves.

Microorganisms, agents of infection, are lurking in every healthcare setting, in patients and in caregivers. Transmission of microorganisms can occur during patient examinations, invasive procedures, respiratory care activities and all practices involving contact with body fluids. An effective practice that, when used diligently, significantly reduces the risk of transmission is known as aseptic technique. This program identifies possible transmission activities, the different types of aseptic technique and best practices for the acute care setting.

Hospital acquired pneumonia is the leading cause of healthcare acquired infections among mechanically ventilated patients in the ICU. The good news is that this ventilator associated pneumonia (VAP) can be prevented. This program describes the epidemiology of VAP, its microbiology and discusses the risk factors. Prevention strategies are explained and demonstrated.

Over the past decades, the use of closed-suction systems has become common in the care of the mechanically ventilated patient. This program will provide nurses, respiratory care practitioners, and other healthcare professionals with current information about safe and effective airway clearance with a closed-suction system.

Millions of surgical and medical procedures are performed annually in the United States. All of these procedures require contact by a medical device to a patient’s sterile tissue or mucous membrane. Therefore, it is imperative that the medical devices used for these procedures be appropriately cleaned and reprocessed to ensure optimal patient outcome. This educational program will describe risks associated with improper cleaning of reusable medical devices and identify basic components of cleaning solutions. Factors for the effective use of cleaning solutions will also be reviewed.

The prevention of suboptimal wound healing has been a major influence in the design of operating rooms, equipment, patient drapes and staff apparel. In this educational program, we will discuss how foreign debris interferes with optimal post operative wound healing and contributes to surgical site infection, inflammation, granulomas, adhesions, and excessive and/or poor quality scar formation. Ways to reduce this debris will be reviewed.

SARS, recent flu outbreaks and the threat of H5N1 Avian Flu crossing over to human-to-human transmission has highlighted the ease with which airborne viruses can be acquired and transmitted. This program will identify and discuss the airborne precautions guidelines, when those precautions are indicated and correct applications to avoid acquiring or transmitting an airborne infection. Special attention is placed on the proper identification and use of medical respirators, and the proper removal of protective personal apparel to avoid contamination and transmission of an infection.

Preventing wrong site surgery is a patient safety imperative. A clear understanding of this issue as well as the proactive measures needed to reduce the risk of surgical error is essential for today’s healthcare professional. In this educational program, contributing factors associated with wrong site, wrong procedure, wrong person surgery will be reviewed and measures to prevent these errors will be discussed. Actions to be taken if a surgical error occurs and essential ongoing activities to prevent errors will be addressed.

Despite significant advances in infection control practices, surgical site infections (SSIs) remain a substantial cause of morbidity and mortality. Patients who develop SSIs are 60% more likely to spend time in an ICU, five times more likely to be readmitted to the hospital and have twice the incidence of mortality. This program will present an overview of the impact of SSIs, review the risk factors and classification systems that indicate a patient’s susceptibility to an SSI and explore various perioperative infection prevention strategies, related to the patient, surgical environment, and members of the surgical team.

Unintentional perioperative hypothermia has been identified as a preventable patient health risk. Approximately 50% of all surgical patients experience hypothermia during surgery. The systemic effects of hypothermia prolong a patient’s recovery and length of hospital stay thus increasing the cost of medical treatment. This presentation will discuss the multiple causes of unintentional hypothermia, the effects of pre-medication and anesthesia, the complications associated with hypothermia, different methods to maintain normothermia, and the cost savings associated with maintaining normothermia.

This module reviews the functional requirements of peel pouches in sterilization: how to choose the right pouch for the appropriate sterilization method and how to properly pack, seal and label the pouches. Also discussed are proper methods of loading pouches into the sterilizing chamber, storing the sterile pouches, and proper opening and presentation techniques to maintain sterility of the contents.

This module discusses the two main packaging options in the hospital environment – pouches and wrap. Examples and rationale for the use of different materials and wrapping methods are provided. The factors that influence the most appropriate type of packaging are discussed. Also presented are the four questions to ask regarding aseptic opening of a sterile package.

This module describes the way wrap works as a microbial filter and defines the FDA’s sterilization wrap classification system which impacts the hospital’s ability to choose products. Also described are the most common ways of contaminating sterile packages and the three different barrier fabrics and their filtration capabilities.

This module defines decontamination, describes bloodborne pathogens, and identifies which are of special concern to health care workers. “Exposure incidents” are defined and the use of appropriate personal protective equipment (PPE) is described.

This module defines sterilization in terms of healthcare facilities, describes the four phases of a microbe’s life cycle, lists the factors which control the reproduction of microbes and identifies factors that can destroy them.

This module defines a wet pack, discusses the various causes of a wet pack and dispels common myths. Also discussed are time and cost considerations that should be included in calculations addressing the reprocessing of wet pack contents. AAMI Recommended Practices are reviewed as well.

This module discusses the different demands put on packaging systems from preparing the contents to presentation at the surgical suite. Policy recommendations for handling the various stages of the package’s cycle are provided. Wrap performance attributes required at each of these stages and options for test standards to compare and evaluate packaging performance at the various stages are discussed.

This module focuses on OSHA requirements for the return of reusable sharps. Included is an explanation of which instruments are classified as reusable, the definition of decontamination and a clarification of the requirements for reusable sharps containers. Considerations for establishing a facility policy for transporting and decontaminating reusable sharps is presented.

This module focuses on the analysis of the actual cost of processing a wrapped instrument tray through the sterile processing department. Calculations for compromised wrap, reprocessing labor, etc. are presented. Ultimately these calculations can be used to reduce total cost within the department. Participants will learn how to perform a cost of processing study and use the information to determine if costs can be reduced in one or more of three ways: 1) tray expiration/reprocessing costs, 2) price or amount of consumables used and 3) tray processing labor time optimization.

This module explores the low temperature technology alternatives to steam including ethylene oxide in its various forms, gas plasma, liquid chemical, and newer technologies in development.

This module describes proper loading of the steam sterilizer and the elements which are necessary to assure proper sterilization of the load.

This module describes tears, cuts, holes and abrasions that can compromise sterile package wrap and explores possible causes. Proper handling techniques which can prevent or mitigate wrap tearing are proposed. Discussions are specifically related to Kimberly-Clark wrap and are based on its unique material construction.

This module discusses two methods of wrapping, explores the continued rationale for using two sheets of wrap, and demonstrates the time-savings possible with simultaneous wrapping.

This educational module describes selection criteria for the purchase and use of wrapping material for hospital-wrapped items, and illustrates four common folding techniques including step by step directions.

Flash Sterilization continues to be a controversial topic. This ESP defines flash sterilization, lists reasons for the increased routine usage of this type of sterilization, details the criteria for how to do it properly, explains the concerns about routine flashing, and gives ideas on how routine flash sterilization may be reduced.

Millions of surgical procedures are performed annually. With this number of procedures, there is ample opportunity for contamination of the surgical site. This contamination may come from many sources including fiber and particulate matter. The Central Services Department is integral to the elimination of surgical site contamination. This program will address fiber and particulate contaminants, their impact on wound healing and the potential associated costs. Measures to minimize these contaminants will also be discussed.

Millions of surgical and medical procedures are performed annually in the United States. It has been documented that one medical procedure alone, a gastrointestinal [GI] endoscopy, is performed over 10 million times a year. All of these procedures, whether surgical or medical, require contact by a medical device to a patient’s sterile tissue or mucous membrane. Therefore, it is imperative that the medical devices used for these procedures be appropriately cleaned and reprocessed to ensure optimal patient outcome. This educational program will describe risks associated with improper cleaning of reusable medical devices and identify basic components of cleaning solutions. Factors for the effective use of cleaning solutions will also be reviewed.

Despite the best efforts of healthcare facilities to maintain a clean and safe environment, contact transfer of harmful microorganisms appears to be inevitable. Studies have shown that, in rooms of patients who were colonized or infected, 70% of environmental surfaces were contaminated with potentially harmful microorganisms, and 65 % of healthcare worker’s gowns were contaminated after delivering routine morning care to patients with MRSA. This educational program will review the current threat of healthcare-associated infections [HAI] and the major routes of microbial transmission with emphasis on contact transmission. Strategies used to prevent contact transmission of HAIs will also be discussed.

This program is designed to heighten awareness of workplace safety issues in the operating room and to specifically address potential biological exposures. Workplace safety issues, as identified by Association for perioOperative Registered Nurses [AORN], will be identified and reviewed in general. Specifically, the biological issues to which health care personnel are exposed will be identified and discussed. Measures that can be taken to prevent or avoid biological exposure will be introduced and, based on these measures; product selection criteria will be identified.

Artificial ventilation is a tremendous life saving technology. However, it is also fraught with patient risk including complications that have been associated with endotracheal tubes. Micro-aspiration, tracheal mucosal damage and ventilator-associated pneumonia are all potential problems linked to the endotracheal tube. In this educational program, we will identify complications associated with endotracheal tubes, explain why the ventilated patient is at risk for these complications and discuss strategies for reducing patient risk.

Surgical site infections (SSI) are a major postoperative concern for all members of the surgical team. The incidence of postoperative SSIs varies from facility to facility, from surgeon to surgeon, and more importantly, from patient to patient. This program will provide an overview of the impact of SSIs from the public health and cost standpoints. The patient risk factors of hypothermia and the patient and the pathogen source will then be discussed. The identification of patient-related SSI risk reduction strategies will also be presented.

Serious patient consequences have been attributed to surgical site infections including complicated recovery, required ICU care, extended hospital stay, need for readmission and, in some cases, death. These consequences come at a high cost to the patient, healthcare providers and to healthcare facilities. Measures to reduce surgical site infections are imperative in order to avoid these consequences. This program will address the impact of surgical site infections and the primary risk factors associated with their occurrence. Strategies to reduce surgical site infections will be reviewed and discussed.

Approximately 50% of all surgical patients experience hypothermia during surgery. Unintentional perioperative hypothermia may be caused by low ambient temperatures in the OR, an open exposed wound, administration or use of cool fluids, or general anesthesia. Patients may experience the systemic effects of hypothermia for several days after surgery that can affect their recovery and length of hospital stay. This presentation will discuss the causes of unintentional perioperative hypothermia, the effects of pre-medication and anesthesia on the body’s ability to maintain normothermia, the complications associated with hypothermia, the effectiveness of different methods to maintain normothermia, and the cost savings associated with normothermia as well as the latest clinical and scientific evidence that supports the newest developments in patient warming systems.

Ventilator-Associated Pneumonia (VAP) is a serious complication of mechanical ventilation that increases the risk of patient morbidity and mortality. It has been reported that patients on continuous ventilation are as much as 21 times more likely to develop pneumonia than non-intubated patients. The endotracheal tube interferes with patient defenses as well as with reflexes that would normally prevent direct pathogen access to the lungs. This educational program will describe why ventilated patients are susceptible to pneumonia and review strategies that will reduce the occurrence of VAP. Positive and negative aspects of VAP diagnostic procedures will also be discussed.