OR Manager - November 2018 - 12

Patient safety
Intraoperative
positioning
Continued from page 1
back to the care unit, " adds Colleen
O'Neill-Orsini, BA, RN, OR staff nurse.
" We were taught to check incisions to
make sure they were clean, dry, and
intact, but we didn't focus on areas of
the body that could have been affected
by intraoperative positioning, " she says.
" A patient could have been in a lateral
position for 6 hours, but we didn't know
we should be checking the hips and
other pressure areas. "
Ana Velez, RN, staff nurse, noted
that when she worked in the care unit,
her patients would leave the floor for
the OR and then a few hours later they
would come back, and she had no idea
what happened to them during all of
The " Bridge Nurses. " Standing, left to right: OR staff nurses Susan Rubin, RN; Hyonchu
Kim, RN; Nicole Washington, RN; Courtney Sparango, RN; Ana Velez, RN;
and Colleen O'Neill-Orsini, BA, RN. Lying on table: Reagan Rose, BA, RN, CNOR,
perioperative nurse educator. Source: Temple University Hospital, Philadelphia.
Used with permission.
Pre- and post-education survey
of positioning practices
Nurses at Temple University Hospital, Philadelphia, crafted these survey questions to assess
the knowledge base of care unit nurses responsible for many postoperative patients.
1. How knowledgeable are you of the potential risk of pressure ulcers/injuries related
to positioning in the operating room?
2. How knowledgeable are you of postoperative pain related to surgical positioning?
3. How knowledgeable are you of referred pain related to surgical interventions,
such as insufflation of CO2 gas?
4. How knowledgeable are you of the various surgical positions associated with the
different procedures that a patient may have in the operating room (ie, gynecology,
thoracic, cardiac, etc)?
5. How knowledgeable are you of lithotomy positioning during surgical procedures
and its impact on nursing considerations/physiological complications for postoperative
care?
6. How knowledgeable are you of supine positioning during surgical procedures
and its impact on nursing considerations/physiological complications for postoperative
care?
7. How knowledgeable are you of lateral positioning during surgical procedures
and its impact on nursing considerations/physiological complications for postoperative
care?
8. How knowledgeable are you of prone positioning during surgical procedures and its impact
on nursing considerations/physiological complications for postoperative care?
9. How knowledgeable are you at recognizing that a patient may experience pain at
a site different than their surgical site following a procedure?
Source: Temple University Hospital, Philadelphia. Used with permission..
12
OR Manager | November 2018
those hours. " When I started learning
about what happens to patients during
surgery, I began feeling really bad that
I hadn't known these things before, but
I thought it was only me, " says Velez.
" Then we all started talking about it and
found we were all feeling the same way,
and decided we wanted to do something
about it, " she says.
They saw an opportunity to help increase
unit nurses' awareness of what
takes place in the OR and to enhance
patient care on the postsurgical units by
educating the nurses on how to prevent
postoperative complications, such as
skin breakdown or injury, nerve injury,
musculoskeletal pain, and compartment
syndrome, says Rose. " The whole
Periop 101 group, which we call our
'Bridge Nurses,' was really passionate
about the idea of starting a project to
educate the unit nurses, " she says.
Pre-, post-education surveys
The Bridge Nurses spearheaded the
project and came up with an idea of
how to measure any benefit and change
in the care unit nurses' knowledge as a
result of the education.
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OR Manager - November 2018

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