Clinical Site Resource Manual. Northport Medical Center- DCH

Transcription

1 Clinical Site Resource Manual Northport Medical Center- DCH 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. Map / 4 D. Pictures of Personnel / 5 E. Faculty Anesthesiologist / 6 F. Faculty Nurse Anesthetist / 6 G. Anesthesia Technicians / 6 H. Rotation Requirements / 7 I. Additional Information / 8 J. Clinical Objectives / 9 K. Demographics of Clinical Site / 11 Section 2 FORMS USED AT LE BONHEUR CHILDREN S MEDICAL CENTER A. Preanesthetic Evaluation Form / 15 B. Anesthetic Record / 16 2

3 Nurse Anesthesia Program School of Health Related Professions University of Alabama at Birmingham Northport Medical Center-DCH - Clinical Orientation Handout - Location Hospital: Directions to Clinical Site (from the RMSB Building) 2700 Hospital Drive Northport, AL Anesthesia Department / Operating Room Anesthesia Office: See Map Head west on I-20/59 toward Tuscaloosa, take exit number 73 McFarland Blvd. /Hwy 82. Turn right and follow Hwy 82 North past DCH hospital and into Northport. Northport Medical Center will be on the left side of the road, look for the signs. 1st floor hospital 205 / / (FA) Anesthesia Lounge:: Main OR Desk: Steve Straughn, CRNA Nurse Anesthesia Resident Manager: 1 st floor hospital 1 st floor hospital (beeper) willowpt@bellsouth.net Description of Clinical Site Northport DCH is a 204 bed hospital and became part of the DCH Health System in It was established as a facility for Tuscaloosa and the surrounding area. The OR is busy as 4335 cases were done in DCH Health System provides highquality, compassionate community-based health services to the communities we serve through our employees, physicians and volunteers in a financially responsible manner. The types of surgical cases performed include: 3

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5 Steve Straughn, CRNA Nurse Anesthesia Resident Manager Billy Parsons, CRNA Chief CRNA 5

6 Department of Anesthesia Clinical Faculty Physicians Chief of Anesthesiology: Staff Anesthesiologists: Dr. Carter Dr. Booker Dr. Rock Nurse Anesthetists Chief Nurse Anesthetist: Nurse Anesthesia Resident Manager: Assistant Nurse Anesthesia Resident Manager: Staff Anesthetists: Billy Parsons, CRNA Steve Straughn, CRNA Stephanie Hust, CRNA Gordon Walker Kenny Dodd Art Nelson Elliott Schwartz Cheryl Hines Jan Fountain Rick Collins Karen McCurnin 6

7 Rotation Requirements 1. Nurse Anesthesia Residents are expected to be dressed at 0615 and are expected to work until 1600 unless otherwise indicated or approved by the float CRNA 2. In case of illness, a call or must be made/sent to the UAB Nurse Anesthesia Program office. Call the Northport Medical Center Anesthesia Surgery department by The # is Professional behavior is expected at all times 4. Scrubs, mask, cap, and new show covers are required in the OR. Lab coats are to be worn when leaving the OR suite. Remove mask, cap, and shoe covers when leaving the OR. 5. Lockers may be found in the male/female dressing rooms 6. The next day s schedule will be posted on the door of the anesthesia workroom each afternoon. Steve Straughn, Stephanie Hust, or Billy Parsons will choose an assignment for the students for the following day. 7. SRNA s are expected to report to NMC prepared to perform the assigned case/block and to answer questions concerning the procedure or drugs to be used. 8. The SRNA should set up their room and anesthesia cart according to the instructions of their clinical instructor or standard protocol. Make sure your room and cart are fully stocked prior to starting the first case of the day. After performing routine machine and equipment checks, make a notation on each anesthesia record (graphics sheet) indicating the equipment checks were done. 9. After setting up the assigned room, the SRNA should report to the holding room to see their patient and start IV s. The student should also discuss the plan of care with the CRNA at this time. 10. The SRNA s location while on duty should be known at all times by the CRNA assigned to that room or the float CRNA 11. CRNA s will be responsible for all narcotics. SRNA s will be given narcotics on a case by case basis as to limit confusion and repeat dosing. Students should make the CRNA aware of any narcotics given. 12. NMC Anesthesia department does not employ an anesthesia tech. Each CRNA/ SRNA is therefore responsible for turning over their room after each case. Make sure your cart and machine are clean, stocked, and ready for the next case. 13. SRNA s will be expected to make postop visits to all patients for whom they performed a regional block. The student should see the float CRNA prior to beginning their first case to discuss which postops the student will see. 14. Each CRNA may have their own expectations concerning the performance of the SRNA. Students and CRNA s should discuss any such expectations. 15. Regional anesthesia reference books may be found in the anesthesia workroom. Please DO NOT take these books home. Students may, however, make photocopies from these books as needed. The following pages from the Atlas of Regional Anesthesja by David Brown are recommended for review. Pg Upper extremity blocks. 7

8 Pg Interscalene blocks Pg Axillary Blocks Pg IV regional blocks Pg Lower extremity blocks Pg Cervical Plexus blocks Pg Neuraxial Anatomy Pg Spinal Anesthesia Pg Epidural Blocks 1. The cafeteria is located on the first floor. Additional Information 2. Student parking is available in the lots behind the hospital. 8

9 Clinical Objectives 1. Assess each patient preoperatively and obtain an adequate history and physical. Categorize each patient according to ASA guidelines. Write a legible and informative pre-op note. 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 this plan with the attending MDA and/or CRNA before the case is to begin. Develop a back up or 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 modifications 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, normal CO 2 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 communicate effectively with members of the anesthesia care team and ancillary staff. 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 communicate pertinent information to the appropriate MDA and/or CRNA 9

10 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. 10

11 Demographics of Clinical Site Maximum # students clinical site is able to accommodate 2 Maximum # junior students clinical site is able to accommodate 0 Maximum # senior students clinical site is able to accommodate 2 Hands-on Regional Experience Commonly Occasionally Rarely Never Spinals Epidurals Axillary blocks Supraclavicular blocks Bier blocks Other (ankle, digital) Nurse Anesthesia Resident Inserts Central Lines Internal Jugular Vein Subclavian Vein Antecubital Vein Pulmonary Artery Catheter Arterial Lines Commonly Occasionally Rarely Never 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 11

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