fering nerve or pressure
injuries, and everything
looks appropriate before
prepping can begin."
The workgroup also intro-
duced a requirement for the
circulating nurse to assess
the patient's positioning on
an ongoing basis during
cases, but that nurse doesn't
work alone. Everyone in the
OR is empowered and encouraged to voice concerns. "It's the commu-
nication in the room, and walking around making sure the patient's
position hasn't changed, especially after the bed has moved," she says.
"It's considered a total team effort to speak up if any part of the
patient's body shifted — or if someone thinks it may have shifted."
Once adopted, the enhanced positioning program was a success. It
reduced the facility's number of lateral positioning-related injuries to
zero. Ms. Rusch and her team moved on to updating protocols for
other positions — supine and prone are completed, with lithotomy
currently in the pipeline.
"We've definitely taken the lessons learned from lateral positioning
to what we're currently working on," she says. "It was a bit difficult to
figure out how to make a standardized approach work. We decided to
present the best evidence and best practices, and discuss tools we
have available to make those methods work."
Members of the surgical team have the autonomy to position
patients to the best of their abilities based on surgeon need, position-
ing aids and patient characteristics. For example, when placing
patients in the lateral position, some staff members use a beanbag,
5 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 0
• SOFT TOUCH Gel positioning aids offer safer support than foam-
based options.
