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NEWS & INFORMATION
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Source To Surgery - May 1996, Vol. 4 Issue II
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Latex Precautions in the O.R.
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Pam Werner, RN, CNOR, OR Manager, Surgery Memorial Hospital at Oconomowoc,
Wisconsin, USA
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It's 3 o'clock in the afternoon and you have just learned that the patient scheduled for
surgery at 7:30 a.m. tomorrow has a latex sensitivity, what are you going to do? I found myself
in this situation as an O.R. manager, about five years ago. It certainly put to the test all the
assessment, planning and implementation skills that a nurse uses. It also sent up the red flag that
said, "There is a special need out there for a specific patient population, how are we going to be
ready for this and future patients?" So, let's get started.
In preparation for caring for this first patient, many lessons can be learned to help in the
future. The critical assessment question is, "What am I going to do to this patient that might
expose him/her to latex?a To that end, the operating room, recovery room, and any other area
where the patient may be, all need to be scrutinized. While meeting the short-term goal of caring
for the first patient, the long-term goal, the quality improvement opportunity, is to develop an
overall plan to address the future latex-sensitive patients. While the overall plan should be
addressed with multi-disciplinary groups, the purpose of this article is to address latex precautions in the O.R.
In the O.R. there already exists a means to choose and/or pick the items needed to provide
for the patient's surgical procedure, referred to here as a pick list or pick sheet. Utilize this ready
source of information to prepare for the patient, call the companies that manufacture the
products you use and begin to develop lists to determine items safe to use and ones to be
avoided. It is helpful to organize your lists, at least for use in the O.R. in some logical manner
(see example). Utilize your material services personnel to make those inquiries to all companies
that provide you with the "stock" items in your hospital. The O.R. presents a special challenge to
complete these informative lists because there are so many "non-stock" items. From personal
experience, five years ago, companies were not as aware of this situation as they are now. Most
companies are now responding to customer needs by labeling their products more clearly and
providing customer service, by phone, that is knowledgeable and informed. Once items have
been identified, a system needs to be developed so that latex-free items can be easily identified
from those containing latex. A latex-free cart or special labeling of drawers or storage areas may
be an efficient way to draw staff's attention as to the contents of products and packages.
Developing lists and getting products organized is but one part of the process, the more
difficult task of education is ongoing. The process of patient identification, from the time of
scheduling through discharge, requires educating all staff to ask certain key questions related to
latex allergies. Physicians' offices need to know of a patient's sensitivity to latex so that
information can be made available to admitting, pre-admission areas, O.R. personnel and all
other hospital personnel that may come in contact with the patient. Any admissions areas; O.R.
scheduling, admitting, the Emergency Department, especially if they are computerized, should
customize the screens that deal with allergies so that latex allergies can be noted as soon as
possible and the appropriate steps taken to identify the patient, i.e., special colored armbands, or
colored stickers on charts and forms, or key words on the O.R. schedule. All staff need to be
informed of the progress of plans for care of patients with latex allergies and given the
opportunity to contribute to the overall process in the department. Pick lists or
preference cards can be edited and/or developed for high risk populations; i.e.,
newborns with myelomeningocele or patients with atrophy of the bladder.
Physicians need to be brought in on decisions regarding the choice of non-latex
products, or at least be informed when a change is being made.
The success of your planning and implementation can be measured by the
number of identified latex allergic/sensitive patients that do not have any reactions
during their surgical intervention.
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