Medical Ethics In The Operating Room a Reminder

Medical Ethics In The Operating Room Medical EthicsIn The Operating Rooma Reminder

Medical Ethics In The Operating Room Objectives • A reminder to us all • Why ethics ? • Examples of some existing problems. • Examples of some practical solutions. • Conclusions & Suggestions.

Medical Ethics In The Operating Room Why Ethics ?

Medical Ethics In The Operating Room Why Ethics ? • In medicine we deal with confidential issues(related directly to people’s lives, history, behavior, body, health & disease). • Patients put their trust in medical professionals & expect high ethical standards.

Medical Ethics In The Operating Room Why Ethics ? • Health providing teams are expected to know&maintain a high level of ethical standard. • Most ethical issues are standard. • Some special ethical issues are related to: • religion, culture, …etc • Deficiencies in practical application of known ethical standards exist.

Medical Ethics In The Operating Room Why Ethics ? • Ethical issues are always of concern to the public. • Any breach of ethical standards leaves harmful effects shaking the confidence in the system. ( media controls the public opinion)

Medical Ethics In The Operating Room

Medical Ethics In The Operating Room Current Situation

Medical Ethics In The Operating Room Current Situation • Written ethical standards: • ? not widely applied in all hospitals. • ? not known and/or not fully applied to all personnel using the Operation Room.

Medical Ethics In The Operating Room Role of Hospitals

Medical Ethics In The Operating Room Role of Hospitals • Provide the best medical treatment as well as ethical standards. • Leading hospitals & institutes should: • Apply the highest ethical standards, • Teach them to the future generations of medical personnel.

Medical Ethics In The Operating Room Some Ethical IssuesIn OR

Medical Ethics In The Operating Room Some Ethical Issues in The OR • Exposure of body. • Dress. • People gathering and traffic. • Noise. • Comments and behavior. • Honesty. • Consent.

Medical Ethics In The Operating Room I. Exposure of body

Medical Ethics In The Operating Room Exposure of body • Parts of body should not be exposed to others ( governed by religion ) • men : from umbilicus to knees. • ladies : all body. • Exceptions are allowedwhen necessary according to a definiteneed. • Exposure of some body parts is often necessary, depending on procedure.

Medical Ethics In The Operating Room Exposure of body - Examples • Preparation for anesthesia • Chest auscultation & inspection. • Insertion of folly catheters.

Medical Ethics In The Operating Room Exposure of body - Examples • Patient’s transfer to & from: • Operating table, • Recovery, • The ward.

Medical Ethics In The Operating Room Exposure of body - Examples • Positioning of patient. • Application of tourniquet. • Cleaning & draping. • Removal of draping & tourniquet. • Application of cast.

Medical Ethics In The Operating Room Exposure of body Whenever exposure is necessary, it should be : • Limited to parts needed only. • In the presence of limited number of people. • For the shortest period of time.

Medical Ethics In The Operating Room Exposure of body –when necessary • Limited to parts needed only. Often over exposure takes place !

Medical Ethics In The Operating Room Exposure of body - when necessary • In the presence of limited number of people. Often too many people around (Drs. / Nurses / Technicians / Students/ workers) Often unnecessary

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Medical Ethics In The Operating Room Exposure of body - when necessary • For the shortest period of time. • Not to call in the cleaners early(to save time). Do we really apply this ?

Medical Ethics In The Operating Room Suggestion A sign “Female patient” or “Do Not Enter” outside of the operating room.

Medical Ethics In The Operating Room II. Dress

Medical Ethics In The Operating Room Dress - patient • A single piece, • Does not expose selected parts only, • Does not cover well behind, often torn strip ends, • Ladies: • Sleeves short, • Head, face and neck cover not adequate. • Not good for both sexes, Not descent by any standard !

Medical Ethics In The Operating Room Dress - patient • Underwear  by some policies should be removed ( even if operation is at neck ! ). • Problems with patient’s underwear : • uncleanliness / metal parts / nylon ? • Solution: • ensure and allow clean underwear. • Provide proper disposable underwear .

Medical Ethics In The Operating Room Suggested Patient’s Dress

Medical Ethics In The Operating Room Suggested Patient’s DressCriteria • Should provide adequate cover according to local standards (religion). • Should provide adequate local (selective) exposure. • Should allow quick & practical wide exposure in emergency situations. • Should look descent.

Medical Ethics In The Operating Room Suggested Patient’s Dress

Medical Ethics In The Operating Room Dress - staff • Lady staff Drs., nurses, students. • Does not meet required standards regarding : • Design, • Width & length, • Areas covered( head & body) , • Practicality. ( ask our lady colleagues ! )

Medical Ethics In The Operating Room New Staff’s DressSuggested and designed by our lady colleagues

Medical Ethics In The Operating Room Suggested Staff’s Dress • Proper head cover. • Proper neck cover. • Proper forearm cover. • Buttons on side. • Wide. • Comfortable.

Sleeves can be rolled up above elbow for draping. Fixed by press button on strips pulled from inside. Medical Ethics In The Operating Room Suggested Staff’s Dress

Medical Ethics In The Operating Room Lady Surgeons Scrub Area

Medical Ethics In The Operating Room Scrub Area Man Lady

Medical Ethics In The Operating Room Scrub Area

Medical Ethics In The Operating Room III. People’s gathering & traffic

Medical Ethics In The Operating Room People’s gathering and traffic • Often too many people in the corridors, receiving area & OR  causes inconvenience to patients & staff. • Problem related to : - behavior of staff & students. - limited space. (Both should be discussed & improved)

Medical Ethics In The Operating Room People’s gathering & traffic Traffic at the receiving area

Medical Ethics In The Operating Room IV. Noise

Medical Ethics In The Operating Room Noise • Patients coming to OR are worried need privacy, silence & reassurance. • Noise should be kept to minimum.

Medical Ethics In The Operating Room Noise Discussions & stories should be in staff rooms only, away from patients !

Medical Ethics In The Operating Room V. Comments & Behavior

Medical Ethics In The Operating Room Comments & Behavior • Jokes & laughing: • Loudly, • In front of patients, • In a language not known to them ! • Before anesthesia, • During procedure with local/spinal anesthesia.

Medical Ethics In The Operating Room Comments & Behavior • Comments & remarks on patient’s: • Disease, • Body shape or weight, • Behavior …etc. That would not be said if patient is awake

Medical Ethics In The Operating Room Comments & Behavior • Patients might see instruments before anesthesia: • Scissors, • Drills, • Scopes, • Saws .. etc

Medical Ethics In The Operating Room a Reminder