Body jewelry isn’t a good accessory for surgery
Body jewelry isn’t a good accessory for surgery
Patient safety requires removal in many cases
Same-day surgery managers are accustomed to responding to trends as they develop and spread throughout our communities. Some trends are related to new surgical techniques and equipment, while other trends are related to nonclinical developments.
A growing use of herbs and tattoo removal are two areas in which same-day surgery programs have had to develop policies or programs in recent years. (For information about herb use and surgery, see Same-Day Surgery, September 2001, p. 97. For information on tattoo removal, see SDS, August 1999, p. 89.) Another area in which there is increasing need for policies and guidance is related to body jewelry.
A lot trickier than earrings
"Asking a patient to remove earrings from pierced ears almost never presents a problem, but asking patients to remove jewelry from other parts of their body more often creates resistance on the patient’s part," says Beth Ackerson, RN, MSN, CNOR, perioperative director for the Health Alliance of Greater Cincinnati in Fort Thomas, KY. Sometimes a patient is afraid the jewelry will be difficult to put back in the body, while others are afraid that the jewelry will be damaged or lost, says Ackerson. "Some of the jewelry is very expensive, so we treat it carefully," she adds. "Whenever possible, we give the removed jewelry to a family member, but if there is no family member, we give it to security to lock in the hospital safe," Ackerson explains.
Most same-day surgery programs utilize their existing policies related to jewelry removal and apply it to body jewelry. "We use our existing policy and address each case individually," says Willie M. Tarr, RN, director of perioperative services at St. Joseph Hospital in Bellingham, WA. Recently, a patient who was undergoing a procedure on her back refused to remove her navel jewelry, so Tarr’s staff explained the risk of electrosurgical burns when metal is left in the abdomen. After emphasizing their concern for her safety, Tarr’s staff was able to convince her to remove it, he says.
Avoid surprises
"Anesthesiologists always remove tongue jewelry or other jewelry that might interfere with airway management," says Ackerson. "Sometimes they don’t discover the piercing until they start to intubate the patient," she says. These discoveries of surprise piercings happen even after staff members have asked patients about piercings, says Ackerson.
Although she doesn’t know if the patients neglected to tell them about the piercings because they didn’t want the staff to know, didn’t understand the patient safety implications, or because they honestly forgot, Ackerson’s staff now ask about piercings in several ways. "We ask if they have body jewelry anywhere on their body and may ask specifically about tongue piercings," Ackerson says. "When patients tell us about body jewelry, we ask them to remove it," she says. If the patient seems reluctant, the nurse explains the safety issues related to infection, electrosurgical burns, and the risk of jewelry breaking and falling into the body, she adds.
Use the proper tools for removal
Because some body jewelry requires special tools for removal, Ackerson suggests that same-day surgery programs invest in the proper tools such as ring-opening pliers to remove captive bead rings. (For vendor information, see "Sources and resource" at the end of this article.) "We keep the tools on hand because we want to make sure the removal is also safe for the patient," she says.
Although neither Ackerson nor Tarr have had to cancel a procedure because a patient refused to remove jewelry, they both say they would do so. Tarr points out, "The patient’s safety is our primary concern, and if we believe the jewelry represents a risk, we wouldn’t proceed."
Sources and resource
For more information about body jewelry policies and practices in same-day surgery programs, contact:
• Beth Ackerson, RN, MSN, CNOR, Perioperative Director, Health Alliance of Greater Cincinnati, 85 N. Grand, Fort Thomas, KY 41075. E-mail: [email protected].
• Willie M. Tarr, RN, Director of Perioperative Services, St. Joseph Hospital, 2901 Squalicum Parkway, Bellingham, WA 98225.
For information about body piercing and body jewelry, contact: Association of Professional Piercers, PMB 286, 5446 Peachtree Industrial Blvd., Chamblee, GA 30341. Telephone: (888) 515-4APP. E-mail: [email protected]. Web: www.safepiercing.org.
To purchase tools to remove body jewelry, contact: Anatometal, 411 Ingalls St., Santa Cruz, CA 95060. Telephone: (888) ANOMETAL or (831) 454-9880. Web: www.anatometal.com. (Click on "tools and accessories.")
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