care in positioning strategies."
They're instructed on all pressure points, she says, and are care-
ful to apply preventive dressings to those areas. "We also flag high-
risk patients based upon risk assessment and skin assessment,
upon admission to the perioperative area," she says. "A high-risk
designation triggers high-risk nursing interventions pre-, intra- and
post-operatively."
That kind of teamwork is essential for dealing with high-risk and
obese patients, agrees Ms. Cramer. "You need more manpower and
resources available for lifting, shifting, and moving, and also more
padding and more protective barriers are usually indicated."
Another hint: If you're dealing with heavier patients, don't forget to
verify your table's weight limit, says Carol Giese, MSN, RN, CNOR,
CSSM, director of surgical services, at the Christus St. Michael Health
System in Texarkana, Texas. "And assess for impingement immediate-
ly after positioning," she adds.
Finally, keep in mind that when a spine patient gets to recovery, the
PACU staff won't know the position that the patient had been put in
during surgery. It wouldn't hurt to relay the information.
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