Outpatient Surgery Magazine - Subscribers

Tell Your Patients to Drink Up - Outpatient Surgery Magazine - March 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1091431

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Page 73 of 132

Staging spaces Our positioning process starts long before we flip our patients over from the stretcher onto the OSI table with a Jackson frame we use for procedures that require prone positioning. Prior to surgery, our nursing staff meets with all patients in a staging area — one of the 22 holding rooms located adjacent to our 24 ORs — to find out any limita- tions or restrictions that may affect the patient's positioning. Individuals with high BMI are at a greater risk for injuries, especially pressure ulcers, because they put more weight and pressure on their pressure points during surgery. In general, the heav- ier the patient, the greater the pressure. And the greater the pressure, the shorter the time period the patient can endure the procedure. That's why it's so critical to get the positioning right from the start. When patients enter the staging area pre-surgery, we're looking for any type of apparent skin tears or redness that we need to make our entire OR team aware of before surgery. Again, we're extra careful with those high BMI patients, where we double-check for tiny tears underneath areas like the panniculus or under the breasts. While we obviously know about patients' past shoulder or neck sur- geries, we get into the specifics about their range of motion during this consult. We use this pre-op patient meeting to find out things that wouldn't necessarily show up in their EMR by asking questions like Do you have any — even very minimal — shoulder or neck pain? The info we get via observation and consultation helps, but demon- stration is paramount to our positioning success. Before every proce- 7 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 9 • FEET FIRST From the foot of the patient's bed, all members of the OR team will methodically do a final check of the patient's position. Lehigh Valley Health Network

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