at least 5 days before surgery. About 10% of our docs don't meet
this timeframe for various reasons. Maybe the patient didn't go in
for her biometer testing yet so we don't have the IOL power calcu-
lation. Maybe the doc's on vacation.
We have to have 2 of the lenses that the surgeon orders in stock
— 1 as the primary and the other as a backup in case we drop the
primary on the OR floor. Once we get the lens order form, we pull
the lens and wrap the form around the package. The nurse that
picks the lens signs the form to confirm that the lens we ordered
matches the lens that will be present in the OR for the case.
About 24 to 48 hours before surgery, we verify for a second time
that all the lenses we picked for the next day's cases match the lenses
that our surgeons ordered, that they're present (meaning, they're on
site in the facility) and that the laterality matches what's noted on the
OR schedule (we usually do 40 to 50 cases a day).
On the day of surgery, when the patient goes into the OR, a nurse
takes the picked lens with the lens order sheet rubber-banded around
it into the OR. She signs off and confirms that yes, the doctor ordered
this lens. Together the surgeon and nurse confirm that the lens is cor-
rect and then stamp and sign the form to indicate as much.
Then there's the final confirmation during the surgical time out. A
nurse confirms that the lens she's holding matches what the doc
ordered and everyone in the room — the anesthesiologist, surgeon,
surgical tech and RN — must agree.
Pulled the wrong IOL
It's hard to imagine an error slipping through, but it did. The lens
order came in on a Friday afternoon for a Monday morning surgery.
By some fluke in the schedule, the nurse that got the order on Friday
was also the nurse who would verify the lenses for the next day. She
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