NASC CRNFA key terms

A formal pause immediately before incision in which the whole team verbally confirms patient identity, procedure and site, consent, allergies, antibiotic timing, imaging needs, and anticipated critical events.

A standardized safety framework requiring preprocedure verification, site marking, and a time-out to prevent wrong-patient, wrong-procedure, and wrong-site surgery across all operative settings.

A structured three-phase checklist completed at sign-in, time-out, and sign-out that standardizes communication and reduces preventable morbidity and mortality in operating rooms.

The internalized commitment to aseptic technique and patient welfare that guides practice even when no one is observing, forming the ethical foundation of infection prevention.

Practices that keep pathogens from entering a surgical wound, including sterile field maintenance, proper gowning and gloving, and controlled movement within the room.

The designated area of sterile drapes and equipment that may be touched only by sterile personnel or sterile instruments, and that becomes contaminated when contact with nonsterile items occurs.

Passage of microorganisms through a barrier material when it becomes saturated with fluid, requiring the drape or gown to be replaced rather than merely dried.

A standardized scrub of hands and forearms with an antimicrobial agent for a prescribed contact time, reducing resident and transient flora before sterile gowning and gloving.

A system categorizing medical devices as critical, semicritical, or noncritical based on the risk of contact with sterile tissue, mucosa, or intact skin, which determines the required level of reprocessing.

A validated process that destroys all microbial life, including bacterial spores, on an item, verified through physical, chemical, and biological monitoring rather than appearance alone.

A preparation of highly resistant spores used to confirm that a sterilization cycle achieved the conditions needed to kill microorganisms, providing the strongest routine evidence of process effectiveness.

A process that eliminates all microorganisms except high numbers of bacterial spores, appropriate for semicritical devices such as flexible endoscopes that contact mucous membranes.

An infection occurring within a defined postoperative window at or near the incision, classified as superficial incisional, deep incisional, or organ space, and tracked as a quality metric.

Evidence-based perioperative process measures, including timely prophylactic antibiotic administration and discontinuation, appropriate hair removal, glucose control, and normothermia, used to reduce surgical site infection.

Maintenance of core body temperature near 36.5 degrees Celsius or higher throughout the perioperative period, reducing wound infection, bleeding, and cardiac events associated with unintended hypothermia.

A pharmacogenetic hypermetabolic crisis triggered by volatile anesthetics and depolarizing muscle relaxants, marked by rising end-tidal carbon dioxide, rigidity, hyperthermia, and acidosis, treated with dantrolene.

Administration of agents such as neostigmine with an anticholinergic, or sugammadex, to restore muscle strength after paralysis and confirm safe extubation.

Continuous measurement and waveform display of exhaled carbon dioxide that confirms endotracheal tube placement, airway patency, ventilation, and adequate cardiac output during anesthesia.

A drug-induced depression of consciousness in which the patient responds purposefully to verbal or light tactile stimulation while protective airway reflexes and spontaneous ventilation remain intact.

A dose-related neurologic and cardiac syndrome from local anesthetic absorption or inadvertent intravascular injection, presenting with perioral numbness, seizures, or dysrhythmias and treated with lipid emulsion.

Injection of large volumes of dilute local anesthetic with epinephrine into subcutaneous tissue to provide anesthesia and hemostasis, requiring vigilance for cumulative dose limits and toxicity.

Assessment of whether epinephrine-containing local anesthetics are safe for a given patient, weighing risks in peripheral digits and in patients with significant cardiovascular or ischemic disease.

The patient's voluntary authorization of a specific procedure after receiving and understanding information about its nature, risks, benefits, alternatives, and the consequences of declining.

A written statement of a patient's preferences for future care, such as a living will or durable power of attorney for health care, that guides decisions when the patient cannot speak.

The legally authorized boundaries of a professional's role, defined by state nurse practice acts, licensure, certification, facility policy, and the individual's demonstrated competence.

A perioperative team member who provides continuous, competent aid to the surgeon, including exposure, hemostasis, tissue handling, and wound closure under the surgeon's direction.

The systematic counting of sponges, sharps, and instruments before, during, and after a procedure, with resolution of any discrepancy and documentation before the patient leaves the room.

A sponge, instrument, or other material unintentionally left in a patient after a procedure, a never event that requires disclosure, documentation, and follow-up care.

Placement of the patient to optimize surgical access while protecting pressure points, nerves, eyes, and airways, maintaining alignment, and preventing shear and falls.

A head-down tilt of the operating table used for pelvic and abdominal access, which increases venous return and airway pressure and requires secure padding and support.

Elevated pressure within a closed tissue compartment that compromises perfusion, causing pain out of proportion, paresthesia, and pallor, and requiring urgent intervention.

Risk-stratified use of mechanical devices and pharmacologic anticoagulants to prevent deep vein thrombosis and pulmonary embolism after surgery.

Knowledge of regional tissue planes, vascular supply, innervation, and organ relationships that guides safe dissection, retraction, and hemostasis in the operative field.

Control of bleeding through mechanical means such as pressure, ligation, and electrocautery, or through pharmacologic and topical agents, maintaining a clear field and stable blood volume.

Practices that prevent electrosurgical injury, including intact return electrode contact, lowest effective power, avoidance of flammable solutions, and management of smoke.

Control of the fire triad in the operating room by keeping oxidizers away from ignition sources and fuel, and by coordinating team readiness for airway fires.

A structured transfer of essential patient information between care teams, using a standardized format, read-back, and opportunity for questions to reduce communication failures.

Assessment and support of ventilation and oxygenation after anesthesia, including head positioning, suctioning, monitoring, and readiness to intervene for obstruction or hypoventilation.