The CSPS endorses the following core principles with participation from all members of the multidisciplinary perioperative care team to achieve optimal patient outcomes: The CSPS endorses that a universal nomenclature must be used in the development of electronic medical records for documentation of perioperative care. (Adopted 02.03.07) IHTSDO SNOMED ASPF Data Dictionary Task Force AORN Perioperative Nursing Data Set The CSPS endorses that every reasonable effort be made to monitor critical physiologic functions of all patients based on patient needs, the type of procedure, and the anesthetic, including the perioperative team being able to hear audible physiologic alarms unobstructed by extraneous operating room noise. (Adopted 07.16.06; modified 07.15.07) ASPF ASA Standards for Basic Anesthetic Monitoring AANA Scope and Standards for Nurse Anesthesia Practice, Standard V The CSPS endorses that the Standardized Glossary of Times be used for Scheduling and Monitoring Diagnostic and Therapeutic Procedures of the Association of Anesthesia Clinical Directors. (Adopted 07.16.06) AACD’s Glossary of times used for scheduling and monitoring of diagnostic and therapeutic procedures The CSPS endorses that the following Transfer of Care principles should be adhered to: patient care is individualized, transfer of care data elements need to be communicated to the next caregiver through documentation and/or verbally, and implement patient briefing upon transfer of care to include patient’s name, name of caregiver, essential data, identify concerns and/or potential that may occur and what can be done about it. (Adopted 07.16.06) AORN Perioperative Patient 'Hand-Off' Tool Kit Joint Commission: Hand-off Communication AANA Postanesthesia Care Standards for the Certified Registered Nurse Anesthetist ASPAN Safe Transfer of Care (Not available on their website, but included in their Standards publication) The CSPS endorses that all measures will be used to ensure correct patient, correct site, and correct procedure surgery, including implementation of the Universal Protocol of the Joint Commission is recommended and support of the Time-Out prior to surgery or initiation of an invasive procedure. Consideration will be given to the use of the expanded Time-Out. (Adopted 07.15.07) AORN Position Statement on Correct Site Surgery AORN Correct Site Surgery Tool Kit ACS Statement on ensuring correct patient, correct site, and correct procedure surgery Joint Commission Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery AAOS Advisory Statement: Wrong Site Surgery AAO: Eliminating Wrong Site Surgery ICSI Safe Site Protocol for All Invasive High-Risk or Surgical Procedures The CSPS endorses that all measures to prevent sharps injuries will be used, inclusive of: double-gloving, use of blunt suture needles, hands-free technique or neutral zone, and the universal adoption of all sharps safety measures in perioperative care is recommended. (Adopted 07.15.07) CDC Virginia Health System NIOSH: Preventing Needlesticks and Sharps Injuries NIOSH: Use of Blunt-Tip Suture Needles to Decrease Percutaneous Injuries to Surgical Personne OSHA: Bloodborne Pathogens and Needlestick Prevention AORN Guidance Statement: Sharps Injury Prevention in the Perioperative setting ACS Statement on Sharps Safety ACS Statement on Blunt Suture Needles ENA Position Statement: Percutaneous Sharps/Needlestick Injuries Joint Commission Sentinel Event: Preventing needlestick and sharps injuries The CSPS endorses the implementation of all measures to prevent the retention of foreign bodies during surgical procedures which requires communication among all perioperative personnel and the consistent applications of reliable and standardized processes of care. (Adopted 07.15.07) ACS Statement on the Prevention of Retained Foreign Bodies after Surgery Joint Commission: Reducing the Risk of Unintentionally Retained Foreign Bodies VHA: Prevention of Retained Surgical Items ICSI Health Care Protocol: Prevention of Unintentionally Retained Foreign Objects in Surgery NoThing Left Behind The CSPS endorses the implementation of all measures to prevent fire in the operating room and during all phases of perioperative care, inclusive of the following: to control the fire triangle (air, heat, fuel, and electrical): control of oxygen sources, control of fuel or combustible material, appropriate drying of surgical prep solutions, and control of ignition or heat sources which includes electrosurgical devices and wires. (Adopted 07.15.07) AORN Fire Safety Tool Kit AORN Position Statment on Fire Prevention ASA Practice Advisory Joint Commission Sentinel Event: Preventing Surgical Fires ERCI Clinician's Guide to Surgical Fires: How They Occur, How to Prevent Them, How to Put Them Out The CSPS endorses that all efforts to prevent venous thromboembolism (VTE) should be implemented perioperatively to include appropriate VTE pharmacologic and/or non-pharmacologic (pneumatic compression devices) prophylaxis based on risk factors (SCIP measure). (Adopted 07.15.07) SCIP IHI Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy ICSI Venous Thromboembolism Prophylaxis Guidelines NQF National Consensus Standards for the Prevention and Care of Venous Thromboembolism (Including Deep Vein Thrombosis and Pulmonary Embolism) AACN Practice Alert: Deep Vein Thrombosis Prevention NICE: Reducing the Risk of Venous Thromboembolism in Inpatients Undergoing Surgery The CSPS endorses the implementation of all measures to prevent healthcare- associated infections as follows: Pneumonia: Prevention of ventilator-associated pneumonia, ventilator bundle, head of bed elevated, daily wake up, sedation vacation, assessment for weaning, ventilator weaning protocol, and stress ulcer prophylaxis (SCIP measure). Bacteremia: Prevention of catheter-related bacteremia. Surgical Site Infection: Appropriate antibiotic selection, timing and duration, hair clipping instead of shaving, normothermia, normoglycemia, and oxygen supplementation. (Adopted 07.15.07) SCIP CDC Infection Control Guidelines CDC Guideline for the Prevention of Surgical Site Infection, 1999 IHI IHI: Surgical Site Infections AAOS Advisory Statement: Recommendations for the Use of Intravenous Antibiotic Prophylaxis in Primary Total Joint Arthroplasty ICSI Health Care Protocol: Prevention of Surgical Site Infection ICSI Health Care Order Set: Antibiotic Prophylaxis for Surgical Site Infection Prevention in Adults AACN Practice Alert: Preventing Catheter-Related Bloodstream Infections AACN Practice Alert: Ventilator Assisted Pneumonia AARC: Care of the Ventilator Circuit and Its Relation to Ventilator-Associated Pneumonia AARC: Weaning and Discontinuing Ventilatory Support The CSPS has issued a Statement on Violence in the Workplace which is included here. It is the position of the CSPS that violence in the workplace must not be tolerated under any circumstances. (Adopted 10.09.07) Click here to read the statement Click here to download the statement OSHA Guidelines for Preventing Workplace Violence for Health Care & Social Service Workers OSHA Hospital eTool - Healthcare Wide Hazards Module-Workplace Violence NIOSH: Violence: Occupational Hazards in Hospitals ANA: Workplace Violence AORN Position Statement on Workplace Safety ENA: Violence in the Emergency Care Setting ICN: Abuse and Violence Against Nursing Personnel ICN Anti-Violence Tool-kit ICN Guidelines for Coping with Violence in the Workplace ICN: Workplace Violence in the Health Sector AACN: Workplace Violence Prevention AAOHN: The Occupational Health Nurse's Role in Preventing and Reducing Workplace Violence NYSNA Position Statement on Workplace Violence The CSPS endorses the development and implementation of evidence-based standards of practice. (Adopted 04.28.08)