Position Matters
This position places patient flat on their back with their face upward.
What is SUPINE position?
The number of "sharp" items (scalpel, local syringe/hypo, trocars) that can be passed at once in a sharps pan
What is ONE!!
This must be checked before using any sterile item on the field
What is package integrity and expiration date?
A rep is too close to the sterile table and is pointing at equipment on the sterile table with their bare hands
What is ask them to stay a foot away from the sterile field and to use a laser pointer and never reach over a sterile field
This must be verified before surgery to ensure correct patient, procedure and site
What is informed consent?
This position involves the patient lying face down.
What is PRONE position?
AORN says you should do this before donning and doffing sterile and/or unsterile gloves and is the single most effective method to prevent SSIs
What is proper hand hygiene (washing hands with soap and water OR using a Purell type hand antiseptic minimally if no visible debris on hands)?
The prep solution is still wet and the surgeon asks to drape
What is delay draping until the prep is completely dry to reduce fire risk
The surgical count is incorrect at preliminary counts
What is notify the doctor and team immediately, recount, and if still incorrect, look for the missing item (and/or get an xray)
This record tracks implants with lot numbers, serial numbers and manufacturer details.
What is tissue is the implant log?
In this position the patient lies on their side, often with positioning devices such as a bean bag, pillows or other appropriate positioners .
What is the lateral position?
According to AORN, this must be performed before any procedure begins and involves (ideally be interactive!) the entire surgical team
What is the surgical time-out?
Either full hand scrub with a nail pick, sponge brush/solution OR Nail pick w/Avaguard.
What is the first scrub of the day?
A team member sees a break in sterile technique
What is without questioning, make the correction (ie change OR gloves/attire, remove the "offender" instrument/equipment, cover the contaminated area w/impervious drape)
This must be documented when a specimen is sent to pathology
What is patient name & birthdate, specimen identification, date and time specimen was explanted from patient?
This position is a variation of supine where the patient's legs are elevated and supported in stirrups
What is the Lithotomy position?
AORN recommends this action if there is any doubt about the sterility of an item or field
What is considering it contaminated?
Required for surgeries involving a body cavity or large open wound (ie. open abdominal surgeries, vaginal hysterectomies and hip revisions).
What is using the situate detection wand or mat at closing of incision?
A specimen is passed off the field without a label or confirmation
What is stop the process and verify specimen labeling with the surgeon before sending?
This time out is done upon the patient entering the OR room, usually initiated by the RN circulator, confirming the anesthesia plan and documented by anesthesia.
What is the anesthesia time-out?
In this position, the patient is seated upright at an angle.
What is Fowler's position or Beach Chair position?
Sterility is compromised once you do this in any procedure other than those performed on a hand table
What is sitting on or reaching for anything lower than waist level? pg 1021
OR cap, mask, scrubs, non-linting jacket, safety goggles, gloves, protective eye wear, shoe covers (if shoes don't remain at the hospital)
What is proper surgical attire?
You notice there is a clear liquid in a medication cup on the sterile field that is not labeled and you did not see it being poured into the cup
What is do not use it and have it removed from your field immediately?
Omitting this detail on the "supplies/implant" section of the EMR can lead to the patient being charged twice for this item.
What are breast implants brought in by surgeon for a cosmetic surgery? (documented as 'doctor-supplied')