Summary
Samenvatting VMV6- Verpleegkundige methodiek en vaardigheden 6
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Deel Operatiekwartier
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jolienpaeye
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Inhoud1 Het operatiekwartier...........................................................................................................................4
1.1 Achitectonische en fysische normen............................................................................................4
1.1.1 De sluiszone of niet kritische zone:........................................................................................4
1.1.2 De reine zone of semi-kritische zone.....................................................................................4
1.1.3 De aseptische zone of kritische zone.....................................................................................4
1.2 Functionele normen.....................................................................................................................5
1.3 Organisatorische normen.............................................................................................................5
1.3.1 Medische staf........................................................................................................................5
1.3.2 Verplegend en ander personeel.............................................................................................5
1.4 Specifieke bijkomende eisen........................................................................................................5
1.5 Klimatologische eisen...................................................................................................................6
2 Het operatieteam................................................................................................................................6
2.1 Anesthesist...................................................................................................................................6
2.2 Anesthesieverpleegkundige..........................................................................................................6
2.3 Chirurg..........................................................................................................................................7
2.4 Assisterende verpleegkundige......................................................................................................7
2.5 Instrumenterende verpleegkunde................................................................................................7
2.6 Omloopverpleegkundige..............................................................................................................7
3 Inrichten en apparatuur......................................................................................................................7
3.1 Standaarduitrusting van een operatiezaal....................................................................................7
3.2 Specifieke apparatuur...................................................................................................................8
3.2.1 Diathermie.............................................................................................................................8
3.2.2 Laparoscopie........................................................................................................................11
3.3 Röntgendoorlichting...................................................................................................................11
3.4 Artroscopiepomp........................................................................................................................11
3.5 Da Vinci robot.............................................................................................................................12
3.6 Bloedleegteapparaat..................................................................................................................12
3.6.1 Materiaal:............................................................................................................................12
3.6.2 Werkwijze:...........................................................................................................................13
3.6.3 Risico’s bij bloedleegte........................................................................................................13
3.6.4 Contra-indicaties voor bloedleegteapparaat.......................................................................13
3.6.5 Diathermie en bloedleegte..................................................................................................13
3.7 Andere........................................................................................................................................14
4 De patiënt in het operatiekwartier....................................................................................................14
Pagina 1 van 29
, 4.1 Voorbereiding van de operatiepatiënt........................................................................................14
4.1.1 Preoperatief onderzoek.......................................................................................................14
4.1.2 Preoperatief nuchter zijn.....................................................................................................14
4.1.3 De acute operatiepatiënt.....................................................................................................14
4.2 Omgaan met de operatiepatiënt................................................................................................14
4.2.1 Communicatie met de operatiepatiënt................................................................................14
4.2.2 Pre-operatieve stress en angst............................................................................................14
4.2.3 Privacy van de operatiepatiënt............................................................................................14
4.2.4 Begeleiding van kinderen in het OK.....................................................................................15
5 Hygiëne, steriliteit en infectiepreventie in het OK.............................................................................15
5.1 Klimaatbeheersing......................................................................................................................15
5.1.1 Temperatuur regeling..........................................................................................................15
5.1.2 Luchtverversing....................................................................................................................16
5.2 Standaardvoorzorgsmaatregelen...............................................................................................16
5.2.1 Medewerkers en mobiliteit.................................................................................................16
5.2.2 Kledijvoorschriften...............................................................................................................16
5.2.3 Kledijvoorschriften volgens de verschillende zones.............................................................17
5.2.4 Persoonlijke hygiëne............................................................................................................17
5.2.5 Chirurgische handontsmetting.............................................................................................17
5.2.6 Zich steriel aankleden..........................................................................................................18
5.2.7 Steriele jas verwijderen.......................................................................................................18
5.3 Hygiëne bij de operatiepatiënt...................................................................................................18
5.3.1 Preoperatief wasssen...........................................................................................................18
5.3.2 Proper linnen.......................................................................................................................18
5.3.3 Preoperatief ontharen.........................................................................................................18
5.3.4 Preoperatief ontsmetten.....................................................................................................19
5.4 Afdekken van de operatiepatiënt...............................................................................................19
6 Positionering......................................................................................................................................20
6.1 De operatietafel..........................................................................................................................20
6.2 Houdingen..................................................................................................................................20
6.2.1 Algemene aandachtspunten bij positioneren......................................................................20
6.2.2 Rugligging of supinatiehouding............................................................................................21
6.2.3 Buiklig of pronatiehouding...................................................................................................21
6.2.4 Zijlig of laterale houding......................................................................................................22
6.3 Risico’s en complicaties door positioneren.................................................................................22
6.3.1 Decubitus.............................................................................................................................22
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, 6.3.2 Zenuwbeschadiging.............................................................................................................23
6.3.3 Luxaties................................................................................................................................23
6.3.4 circulatiestoornissen............................................................................................................24
6.3.5 Brandwonden......................................................................................................................24
7 Chirurgisch instrumentarium.............................................................................................................24
7.1 Auteursnaam vs. Bijnaam...........................................................................................................24
7.2 Terminologie...............................................................................................................................24
7.2.1 Onderdelen van instrumenten.............................................................................................24
7.2.2 Anatomisch vs. Chirurgisch..................................................................................................24
7.2.3 Basisprincipes bij instrumenten...........................................................................................25
7.3 Overzicht basisinstrumentarium.................................................................................................25
7.3.1 Ontsmetten..........................................................................................................................25
7.3.2 Incideren..............................................................................................................................25
7.3.3 Hemostase...........................................................................................................................26
7.3.4 Presenteren.........................................................................................................................26
7.3.5 Prepareren/herstellen/implanteren....................................................................................27
7.3.6 Sluiten..................................................................................................................................27
7.4 Hechtingsmateriaal.....................................................................................................................27
8 Veilige heelkunde..............................................................................................................................28
8.1 Voor de inductie van de anesthesie (sign in)..............................................................................28
8.2 Voor de incisie (time-out)...........................................................................................................28
8.3 Voor de patiënt de operatiezaal verlaat (sign out).....................................................................29
8.4 Nieuwe tendens..........................................................................................................................29
Pagina 3 van 29
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