Thank you for the Question: We ask patients to remove jewelry prior to going into surgery. There seems to be some controversy with if the patients should remove wedding rings or if it is alright to keep them in place. Some people feel that if the ring is far enough away from the surgical site, then is isnt much of a concern. The other argument is if the patient has an anaphylactic response and their hand swells resulting in possible damage to the ring finger. I think many of us have a hard time asking pts to remove their rings when the patient has been married for 50 years and has never removed them. We also get patients that claim that theyve had surgery before and were not every asked to remove them. There is a struggle with patient comfort and satisfaction over what is likely to be the best safest practice. What have you come across regarding rings? Answer: It really depends on the procedure. There are actually five reasons to remove jewelry but there are not any regulatory standards that insist upon it. So, the five things are guidelines First is interfere with radiology. If you are going to need x-ray or c-arm in that area, the jewelry will be big bright and in the way. If you dont need to imaging in that area, this is not a big deal so move on. Second is risk of accidental harm. This means we pull some piercing out or snag their ring and it cuts into their finger while we are positioning or moving the patient. This is the one of two reasons we might tape the jewelry during surgery. Covering with tape only keeps us from snagging it on something. It does not prevent burns. Third is the jewelry is in the surgical site. This one is a deal breaker. The jewelry has to go. Just the bacterial burden alone makes this a no no. Fourth is post-operative swelling. This is one is not a big deal for the 20 minute bunionectomy. But the CABG patient is going to have swelling and the rings have to go. Fifth is a risk of loss. This is another reason you might tape something. If it is a ring that has been on an arthritic finger for the last 57 years, this is probably not a concern. Some legal departments want the patient so sign a waiver just in case. The idea is to use these as guidelines or questions to ask yourself when caring for a patient. Remember we are to care for patients as individuals. We like to write policies about things that are all encompassing but really every patient is different and should be cared for in a way that is best for them. We need to be flexible, have guidelines but give the individual nurses the ability to care for the unique person in front of them.
Posted on: Thu, 13 Feb 2014 20:04:36 +0000
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