ing," says Ms. Nolan. "Before we even think about going to get the
patient, we go over all aspects of the case. Confirming the patient's
weight is a big part of the discussion because it determines the size of
the bypass circuit we use and how much blood we give the patient.
All of our drug calculations are also based on weight."
Typically, perfusionists set up their pumps the day before a case
based on the patient's most current weight, which is noted in the med-
ical records. The nursing staff also has the patient's weight in their
records and compares it to the weight recorded in pre-op on the day
of surgery. If the updated weight is different than what's been noted
in the medical record, even by only 1 kg, a nurse informs the rest of
the care team during the regularly scheduled pre-op huddle.
Ms. Nolan recalls a few instances where discrepancies in a patient's
weight were caught during the pre-op check and says the briefings
have enhanced patient safety. She also acknowledges there's room for
improving the process. A scrub nurse, circulating nurse, perfusionist,
anesthesia fellow and anesthesia attending are all present during the
huddles, but many surgeons have not been able to attend. The sched-
uled times — 7 a.m. on Mondays, Thursdays and Fridays and 8 a.m.
on Tuesdays and Wednesdays — are not ideal for them due to their
workflow.
Ms. Nolan hopes this will change in the future because she
believes input from every member of the surgical team is essential.
"Each discipline focuses on different aspects of patient care and
brings different expertise to the table," says Ms. Nolan. "It's some-
times difficult to consider a case from a different viewpoint. Nurses
might not see things the same way an anesthesiologist would
because they don't have that training."
Transparency among colleagues also remains an issue, according to
Ms. Nolan. Some members of the care team have conversations or
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