Clinical Site Resource Manual. Flowers Hospital

Transcription

1 Clinical Site Resource Manual Flowers Hospital Nurse Anesthesia Program School of Health Related Professions The University of Alabama at Birmingham

2 TABLE OF CONTENTS Section 1 CLINICAL SITE RESOURCE MANUAL A. Location and Directions / 3 B. Phone and Fax Numbers / 3 C. Pictures of Personnel / 4 D. Faculty Anesthesiologist / 5 E. Faculty Nurse Anesthetist / 5 F. Anesthesia Technicians / 5 G. Rotation Requirements / 6 H. Additional Information / 7 I. Clinical Objectives / 7 J. Demographics of Clinical Site / 9 Section 2 FORMS USED AT FLOWERS HOSPITAL A. Preanesthetic Evaluation Form / 10 B. Anesthetic Record / 11 2

3 Nurse Anesthesia Program School of Health Related Professions University of Alabama at Birmingham Flowers Hospital - Clinical Orientation Handout - Location Hospital: Directions to Clinical Site (from the RMSB Building) 4370 West Main Street P.O. Box 6907 Dothan, AL Take I-65 South toward Montgomery to I 85 N exit 171 toward Atlanta. Merge onto US 231 and follow 94.3 miles. Turn right onto US 231S/ Ross Clark Circle and go 1.5 miles. Turn right onto US 84W/ West Main Street and look for the hospital on the right. Anesthesia Department / Operating Room Anesthesia Office: Main OR Desk: Tim Woodall, CRNA, MS Nurse Anesthesia Resident Manager: 1 st floor hospital ext (FA) 1 st floor hospital ext ext 8597 Tim.Woodall@TriadHospitalsInc.com ( ) Description of Clinical Site Flowers Hospital has served the healthcare needs of the Wiregrass for over 50 years. The facility is not only an important resource for the Dothan Community, it also functions as a major referral center for the Tri-state area of south Alabama, southwest Georgia, and northwest Florida. By combining responsible personnel, modern equipment and supplies, effective management, sophisticated support services, up-to-date professional education programs and a staff of over 240 physicians, Flowers Hospital is able to assure its patients quality health care. 3

4 PICTURE Tim Woodall, CRNA Nurse Anesthesia Resident Manager Flowers Hospital 4

5 Department of Anesthesia Clinical Faculty Physicians Director of Anesthesiology: Staff Anesthesiologists: Segars, Dr. Larry Cecchini, Dr. Tony Duerson, Dr. Doug Fletcher, Dr. Ken Hughes, Dr. Lee Jones, Dr. Steve Osborne, Dr. Andy Manager of Anesthesia: Anesthesia Coordinator: Nurse Anesthesia Resident Managers: Staff Anesthetists: Woodall, Tim Grubbs, Nola Harrell, Diane Seay, Glynn Ward, Frankie Averett, Pam Benson, Tina Chancey, Steve Cherry, Cyndy Clark, Lisa Clark, Robert Cook, Bonnie DeHaven, Jan Doyle, Mary Henry, James Jewell, Robert Lowther, Kathy Madison, June Miller, John Mitchell, Teri Neal, Jody Neal, Joel Orr, Cathy Simmons, Robin Skinner, Shirley Smith, Neva Van de Perre, Wilma Anesthesia Technicians Anesthesia Technicians: Ragland, Barbara Edwards, Josephine Graham, Nelson 5

6 Rotation Requirements 1. An in-depth anesthesia orientation will be provided on the first day of your clinical rotation. 2. You should be on duty, dressed in scrubs, and check your case assignment by Come earlier if you need more time to be prepared for a 0700 case. 3. Scrub suits, mask, cap, and new show covers are required in the O.R. Lab coats are to be worn over scrubs at all times when leaving the O.R. suite. Mask, cap, and shoe covers are to be removed when leaving the O.R. Suite. 4. Ask the Nurse Anesthesia Resident Manager (NARM) for a locker at the beginning of the rotation. 5. Report to the Daily Coordinator to receive your assignment for that day. 6. Assignments are to be determined based on clinical need, as well as your ability to make wise choices of your own. First year students will have assignments made for them. Second year students will be allowed some freedom in choosing assignments. If choices are unacceptable, assignments will be made for you. The large white board located at the O.R. desk contains the scheduled cases for the day. 7. After the first day, you will be expected to prepare for your first case of the day. a. the day before surgery, obtain a pre-anesthetic evaluation (PAE) form for your assigned patient. b. Fill out the appropriate anesthesia care plan; discuss plan with the CRNA/MDA responsible for the patient prior to the beginning of each case. c. Do any reading that may be pertinent to the case the night before so that you will be prepared for your first case. 8. Narcotics will be obtained from the locked narcotic cabinet; key is held by the day s coordinator. 9. Set up the anesthesia cart and room according to the instructions of your clinical instructor for the day. 10. You are expected to discuss each anesthetic care plan with the attending MDA and/or CRNA before the beginning of each case. 11. Your location while on duty must be known by the clinical instructor or the NARM AT ALL TIMES. 12. Professional behavior is expected at all times. 13. In case of illness, a call MUST be made to the hospital AND to the Nurse Anesthesia Program to report your absence. You must speak to someone in the Anesthesia Department. Call between to notify of your absence. Tell them to write that you are sick on the student call calendar. 14. The clinical rotation is a service rendered to the patients from the private sector of the community. Expedient turnover time for the anesthesia team is expected. It is your responsibility to set up your cases in a timely manner. If you have difficulty doing so between cases, discuss the problem with your attending MDA and/or CRNA. They will advise you on ways to decrease turn over time. Courtesy to all staff and patients are expected at all times. 15. Each student will be assigned a mail slot in the lounge to store daily evaluations. 6

7 16. Work with many different CRNA s. You will learn a lot from each one of us. Clinical Objectives 1. Assess each patient preoperatively and obtain an adequate history and physical. Categorize each patient according to ASA guidelines. Reveal significant pre-operative information to the MDA and CRNA responsible for that particular patient. 2. Develop an anesthetic plan for each patient you will be administering anesthesia to and discuss the plan with the attending MDA and/or CRNA before the case is to begin. Develop an alternative anesthetic plan for each patient you will be administering anesthesia to. 3. Assess medication needs for each patient, correctly and effectively write pre-op orders with appropriate medication and dosages identified. Discuss pre-op orders written with appropriate MDA and/or CRNA. 4. Set up the assigned operating room, anesthesia equipment, and anesthesia cart prior to admission of the patient into the operating room. 5. Start an appropriate sized intravenous catheter for IV fluid administration. 6. Prepare the patient for anesthesia induction, which includes: A. Applying appropriate monitors for that particular patient B. Selecting appropriate drugs and dosages for induction C. Having appropriate equipment immediately available for the induction of the patient D. Assessing the physical and emotional need of the patient before induction and implementing the necessary modification if needed. 7. Calculate each patient s estimated fluid deficit and appropriate fluid replacement for surgery. 8. Demonstrate the ability to manage an airway. 9. Demonstrate the ability to intubate an anesthetized patient using standard equipment. 10. Demonstrate the ability to maintain proper ventilation, oxygenation, and normal CO2 levels. 11. Demonstrate vigilance in monitoring the patient during the complete anesthetic process. 12. Demonstrate the ability to interpret information received from the monitoring equipment. 13. Demonstrate the ability to correctly assess monitoring equipment malfunction. 14. Demonstrate the ability to communicate effectively with members of the anesthesia care team and ancillary staff. 15. Demonstrate the ability to assess anesthetic problems that may arise during a case and effectively 7

8 communicate pertinent information to the appropriate MDA and/or CRNA. 16. Demonstrate the ability to safely maintain a patient under anesthesia. 17. Identify the factors that would necessitate crystalloid versus colloid administration and effectively communicate this information to the MDA and/or CRNA. 18. Develop an anesthetic plan for the emergence of a patient under anesthesia and communicate this plan to the MDA and/or CRNA. 19. Demonstrate the ability to safely extubate a patient that has been intubated for surgery and is anesthetized. 20. Assess the patient s physical status and determine the care plan that is needed for the patient in the recovery room. 21. Demonstrate the ability to effectively communicate with the recovery room personnel. 22. Correctly identify the recovery room protocol for emergencies. 23. Correctly identify the chain of command should an anesthetic emergency develop and effectively communicate pertinent information to the appropriate person. 24. Demonstrate the ability to accurately and effectively perform a post op visit to obtain pertinent information on each patient anesthetized by the student. 25. Communicate any adverse reactions or anesthetic problems that the patient may have had to the appropriate MDA and/or CRNA. 26. Demonstrate professional behavior at all times during the clinical rotation. 8

9 Demographics of Clinical Site Maximum # students clinical site is able to accommodate 6 Maximum # junior students clinical site is able to accommodate 3 Maximum # senior students clinical site is able to accommodate 3 Hands-on Regional Experience Commonly Occasionally Rarely Never Spinals Epidurals Axillary blocks Supraclavicular blocks Bier blocks Other (wrist, ankle, digital) Nurse Anesthesia Resident Inserts Commonly Occasionally Rarely Never Internal Jugular Vein CVL Subclavian Vein CVL Antecubital Vein CVL Pulmonary Artery Catheter Arterial Lines Clinical experience includes: Commonly Occasionally Rarely Never Mask inductions for adults Maintenance of GA via a face mask Placement and management with LMA Nurse Anesthesia Resident Administers Drugs During Induction Commonly Occasionally Rarely Never Taking In-house call is an option Yes No Afternoon Night mwh 9/21/2003 9

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