Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress ePosters 87 Main theme: The operating room nurses shoulder duty and responsibility, independently and in the team, but they need more structural support and knowledge Themes Subthemes Follow routines whenever possible Ensure the use of the WHO checklist for safe surgery Follow and question guidelines Experience that routines about the time in the lithotomy position vary or are missing Take responsibility for positioning Take the time to position the patient in the lithotomy position Choose leg supports that are better for the patient in the given time Use materials and equipment that reduce the risk of pressure Balance between flexibility and strict routines Try to handle changing conditions wisely during surgery Deviate from the lithotomy position during certain operations Develop and participate in teamwork Ensure that the team around the patient works efficiently Share experiences with colleagues Recognize the need for expanded knowledge Too limited knowledge of factors causing complications after the lithotomy position Awareness of the risks related to certain procedures Conclusion: If attention to the lithotomy position would be better acknowledged in the checklist and included the whole team, it would probably solve some of the problems, since teamwork has been described as important for problemsolving. http://doi.org/10.1002/nop2.1971 466 Wet surgical instrument boxes: an attack on patient safety + ANTONIO SALMERON GRACIA1, Emiliana Sabuco Tebar2, Irene Salmeron Matas3, Vicente Sabuco Tebar4, Miguel Culiañez Berenguer5 1HOPITAL G.U.J.Mª MORALES MESEGUER, QUIRÓFANO, MURCIA, Spain, 2HOSPITAL G. U. REINA SOFIA, PREVENTIVA, MURCIA, Spain, 3SAFETYNET PRIMARI CARE, CLINICAL NURSE MANAGER, DUBLIN 1, Ireland, 4HOSPITAL GENERAL DE ELCHE, QUIRÓFANO, ELCHE, Spain, 5DOMUS Vi RIBERA, GERIATRIA, BILBAO, Spain Background: Two incidents were reported, related to the presence of moisture in sterile surgical instruments Objectives: Evaluate the factors involved in the presence of humidity in containers of sterilized material. Methods: The following actions were carried out: Review of indicators of the sterilization process, verification of the weight of the containers, evaluation of the correct loading of the sterilizer, review of the packaging method, revision the documentation of preventive maintenance of the 2 autoclaves and technical review of the 2 autoclaves involved in the incidents. Results: After the evaluation of the incidents, the following results were found: Incident 1: compliant items: indicators of the sterilization process, weight of containers ≤ 10 Kg, evaluation of the correct loading of the sterilizer and preventive maintenance of the autoclave; packaging method: internal biological barrier plus rigid container with reusable filter (500 cycles), the commercial house does not provide a certificate of the number of sterilization cycles of the reusable filter and the technical review by company, the incident was caused by a low vacuum level caused by a specific drop in pressure in the water line. Incident 2: compliant items: Weight of containers ≤ 10 Kg, Indicators of the sterilization process, evaluation of the correct loading of the sterilizer, technical review of the company; Non-conforming items: instrument packaging method. Conclusion: After studying the incident, the following improvement actions were proposed: 1) request traceability of reusable filters or incorporate containers with single-use filters. 2) Periodically monitor and record pressures of the autoclaves. 3) Consider renewing the autoclaves, for a period of use > 15 years. 4) Modify the wrapping of perforated containers: 1 layer of absorbent paper under the container and wrap with a 200-gauge biological barrier layer and a second 400-gauge layer. 5) Continuing training for operating room and sterilization staff.
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