Regan’s answer omits JCA H guideline In the February AORN Journal, the answer to the question about releasing a patient from an ambulatory surgery center without a sponsor following general anesthesia was incomplete. While Regan’s response in “OR nursing law” was correct in general, it did not refer to the specific regulations regarding this criteria in the JCAH Manual for the Accreditation of Hospitals. On page 66 of the manual, the regu- lation states, “Any patient who has received other rhan local anesthesia shall be examined before discharge and shall be accompanied home by a designated person. . . . ” At Southwest Texas Methodist Hospital, San Antonio, we have supplemented this with an addendum: I‘ . . .if an appropriate sponsor is not available at the time of the discharge examination and the patient has passed the discharge criteria for ‘street readiness,’ he will be sent home in a taxi-cab.’’ It is imperative that this be well documented. If the patient demands to go home without a sponsor before meetingthe dischargecriteria, note that the patient left against medical ad- vice. Anne Dean, RN President San Antonio AORN Chapter €0 aeration form may be lesser evil The Journal‘s March “The experts research” column discussed the use of consent forms for release of aerated ethylene oxide sterilized items. Further elaboration by AORN experts would be helpful. The real question is: “What should a sterilizer operator or central service supervisor do when a surgeon or OR supervisor demands an article before the aeration cycle is 100% complete?” I suggest that many surgeons and many OR supervisors are quite familiar with aeration characteristics and hazards of ethylene oxide. In addition, the surgeon or OR supervisor is in a far better position than is the sterilizer operator to decide how desperately the item is needed. The consent form (or a dated memo to the releaser’s superior) seems to be a simple and widely used method for the user to accept responsibil- ity in an emergency situation. Manufacturer’s aeration recommendations and Association for the Advancement of Medi- cal Instrumentation provide a wide safety mar- gin. A modest reduction of the aeration time might present a small hazard to patients and possibly a very slight hazard to personnel, but dogmatic refusal to release objects, which your article seems to recommend, could present a far more hazardous legal and practical situation. It seems to me that a carefully drawn consent form is a logical compromise. Robert F Smith President Diack Incorporated Beulah. Mich Medical libraries in danger The article in the February 1983 AORN Jour- nal, “New draft of Medicare regs specify RNs must circulate,” provided your readers with excellent information, as usual. In addition to the good news about the OR nursing practice 1144 AORN Journal, May 1983, Vol37, No 6

Regan's answer omits JCAH guideline

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Regan’s answer omits JCA H guideline

In the February AORN Journal, the answer to the question about releasing a patient from an ambulatory surgery center without a sponsor following general anesthesia was incomplete.

While Regan’s response in “OR nursing law” was correct in general, it did not refer to the specific regulations regarding this criteria in the JCAH Manual for the Accreditation of Hospitals. On page 66 of the manual, the regu- lation states, “Any patient who has received other rhan local anesthesia shall be examined before discharge and shall be accompanied home by a designated person. . . . ”

At Southwest Texas Methodist Hospital, San Antonio, we have supplemented this with an addendum: I ‘ . . .if an appropriate sponsor is not available at the time of the discharge examination and the patient has passed the discharge criteria for ‘street readiness,’ he will be sent home in a taxi-cab.’’

It is imperative that this be well documented. If the patient demands to go home without a sponsor before meeting the discharge criteria, note that the patient left against medical ad- vice.

Anne Dean, RN President

San Antonio AORN Chapter

€0 aeration form may be lesser evil

The Journal‘s March “The experts research” column discussed the use of consent forms for release of aerated ethylene oxide sterilized

items. Further elaboration by AORN experts would be helpful. The real question is: “What should a sterilizer operator or central service supervisor do when a surgeon or OR supervisor demands an article before the aeration cycle is 100% complete?” I suggest that many surgeons and many OR supervisors are quite familiar with aeration characteristics and hazards of ethylene oxide. In addition, the surgeon or OR supervisor is in a far better position than is the sterilizer operator to decide how desperately the item is needed. The consent form (or a dated memo to the releaser’s superior) seems to be a simple and widely used method for the user to accept responsibil- ity in an emergency situation.

Manufacturer’s aeration recommendations and Association for the Advancement of Medi- cal Instrumentation provide a wide safety mar- gin. A modest reduction of the aeration time might present a small hazard to patients and possibly a very slight hazard to personnel, but dogmatic refusal to release objects, which your article seems to recommend, could present a far more hazardous legal and practical situation. It seems to me that a carefully drawn consent form is a logical compromise.

Robert F Smith President

Diack Incorporated Beulah. Mich

Medical libraries in danger

The article in the February 1983 AORN Jour- nal, “New draft of Medicare regs specify RNs must circulate,” provided your readers with excellent information, as usual. In addition to the good news about the OR nursing practice

1144 AORN Journal, May 1983, Vol37, No 6