Chapter 30 Workplace Issues and Staff Safety

Chapter 30  Workplace Issues and Staff Safety

MULTIPLE CHOICE

1. What one factor describes the high incidence of musculoskeletal disorders among surgical technologists and perioperative nurses?

1. Pulling a large, heavy piece of equipment rather than pushing it
2. The cumulative effect of repeated patient handling events
3. The growing high obesity rate and heavier patients and care providers
4. The cumulative effect of pushing, pulling, and carrying heavy instrument sets and

   rolling carts

ANS: B
The high incidence of MSDs among nurses is the cumulative effect of repeated patient handling events, often involving unsafe loads. Nurses and surgical technologists often lift, transfer, or reposition patients on OR beds and transport vehicles, and assist with
prepping with their arms outstretched or their bodies bent forward in awkward postures and positions, increasing the risk for injury.

REF: Page 1258

2. The lifting equation provides a mathematical equation to determine the recommended weight limit (RWL) and lifting index (LI) for selected two-handed manual lifting tasks. Essentially, what is the recommended maximum weight limit for one person in a patient handling task? What is the best option when the weight limit exceeds the recommendation?

1. 25 lb; bend from the knees, not the waist
2. 32 lb; use good body mechanics
3. 37 lb; wear a support belt
4. 35 lb; use assistive lift devices

ANS: D
The concept behind the lifting equation is to start with a recommended weight that is considered safe for an ideal lift and then to reduce the weight as the task becomes more stressful. In general, the revised equation yields a recommended 35-lb maximum weight limit for use in patient handling tasks. When the weight to be lifted exceeds this limit, assistive devices should be used.

REF: Page 1261

3. Wet floors are a common hazard causing slips, trips, and falls (STFs). Select a prevention strategy that is a best practice for preventing STFs from spills on wet floors.

1. Transport liquids in covered containers with lids in place.
2. Place bright yellow low-profile pop-up signs in areas where STFs are most likely

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 30-2

to occur.
c. Position highly visible yellow absorptive pads in areas where STFs are most likely

to occur.
d. Use a dripless, brush-free gel solution for surgical patient skin preps.

ANS: A
Anticipatory planning to avoid wet spots can reduce the rate of falls. Providing lids for all cups or other open containers being transported helps to avoid spills.

REF: Pages 1261-1262

4. A STF hazard is present when the scrub person stands on a lift, or foot stool, to reach an acceptable height for ergonomic comfort with the sterile field. Whether the scrub person uses one stool, stacked stools, or a “runway” of stools, the danger exists that a fall could occur. What classification of cause and prevention factor does this situation represent?

1. Proper footwear
2. Unobstructed pathways
3. Uneven floor surface
4. Lighting

ANS: C
Hospitals should ensure that there are no uneven floor surfaces, including thresholds, on floors. While 36% of same-level incidents occurred because of floor contaminants such as wet floors, the remainder (64%) of the falls on the same level occurred at transition areas, such as from dry to wet, on uneven floor surfaces, or from one type of floor surface to another. Hospitals should ensure that there are no uneven surfaces, including thresholds, on floors.

REF: Page 1262

5. A sharps-safe area on the sterile field between the scrub person and the surgeon—where sharps can be transferred to the surgeon from the scrub person and returned to the scrub person after use—is referred to as the:

1. sharps zone.
2. hands-free zone.
3. neutral zone.
4. safety zone.

ANS: C
The “neutral zone” has been defined as a location on the surgical field where sharps are placed in a predesignated sterile basin or tray or on a magnetic pad, from which the surgeon or assistant can retrieve them. After use, the items are returned to the neutral zone, and the scrub person retrieves them. This technique eliminates hand-to-hand passing of sharps between the surgeon and the scrub person, so that no two individuals touch the same sharp at the same time.

REF: Page 1265

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 30-3

6. Select the appropriate nursing action that supports hands-free instrument passing and sharps safety.

1. Create a neutral hands-free area between the scrub person and surgeon with a basin or magnetic mat.
2. Use a hands-free area for sharps and all small clamps or sponges.
3. Announce the transfer of the sharp or clamp as soon as possible after it is placed.
4. During the hand-off report, ask the relief scrub person if he/she will want to use

   the hands-free technique for passing sharps.

ANS: A
A magnetic pad or basin may be used to create the neutral zone; if a basin is used, it should be placed on the field and not held by the scrub person. Dedicate the neutral zone to sharps only; these include suture and hypodermic needles, scalpels, and other sharp instruments. Place only one sharp at a time in the neutral zone. Announce the transfer of a sharp before placing it in the neutral zone (such as “knife down”). Include identification of the neutral zone during hand-off communications to relief scrub persons.

REF: Page 1265