An ambulatory surgical center (ASC) is a healthcare facility that focuses on providing same-day surgical care that includes diagnostic and preventative surgery. When looking at the ASC, it has transformed the outpatient surgical experience for millions of Americans by providing a more convenient surgical alternative. As much as 65% of all surgical cases performed take place in the outpatient ASC setting.  When considering same day surgery, it may appear a safer alternative to inpatient surgery; even though an estimated 1-6%  of outpatient surgeries ..read more

Ask the Expert at AORN 2024!   Dr. Heather D. Kooiker, DNP, MSN, RN, CNL, CNOR, CRNFA, is a Board-Certified Clinical Nurse Leader (CNL) who also holds Certifications in Perioperative Registered Nursing (CNOR), along with a Registered Nurse First Assistant Certification (CRNFA). Heather serves Baxter International as the Director of Global Medical Affairs for Patient Support Systems and Global Surgical Solutions. She is also a Professor of Nursing at Davenport University where she integrates Evidence Based Practice (EBP) and Research into the classroom, preparing the next generation of nur ..read more

The supine position is the most common surgical position with the patient lying on their back with the head, neck and spine in a neutral position.   This position is not without pressure injury risk as there is increased pressure and shear forces to the scapula, occiput, elbows, sacrum, coccyx, and heels. Today we are going to look at ways to mitigate the risk for pressure injuries (PI) to the heel, related to the supine position. When a patient lies supine, all the pressure of their lower legs and feet rest on the heel.  Heel PI represents approximately  ..read more

      One of the highly common surgical positions is supine. This approach involves the surgical team’s watchful eyes to oversee a patient that will lie on their back with their arms either tucked or untucked to provide direct anatomical and surgical exposure to any area from the head and neck to the anterior aspects of the lower legs and feet. Supine position may be requested for a myriad of surgical procedures including everything from a thyroid, chest, cardiac, general, urology, orthopedic, or podiatry procedure to name a few. Given the wealth of clinical indications for the ..read more

Essential goods are part of any great care or service. The operating room has countless examples of such materials. As perioperative professionals we know what is needed to provide the safest patient care.  Positioning patients safely and effectively is paramount to the success of all procedures. We often require more dedicated time and effort to position our patients than it takes to complete the entire surgical procedure. The lateral position involves multiple steps and items to achieve safety and success. A critical device for this position is the axillary roll. This device is a hot c ..read more

As perioperative professionals, the operating room team has a constant dedication and calling to the creation and maintenance of an environment that keeps our patient free from harm. As a vigilant guardian, the perioperative nurse is often at the forefront of this action. For positioning the perioperative patient, the nurse must use their senses to assess the patient’s well-being and current integumentary status as part of the pressure injury prevention assessment during all phases of care. A device that can assist with the prevention of pressure and be used in conjunction with current operat ..read more

Some surgical procedures require extreme positioning to ensure that the targeted surgical area is accessible to the surgeon and the surgical team. Extreme positioning requires extreme positioning devices which are manufactured to meet the need for surgical access first and foremost. Unfortunately, the devices and positions needed for optimal surgical access can increase the risk for an interoperative medical- device related pressure injury. The resultant pressure injury generally mirrors the pattern or shape of the device. One common position that fits the extreme high-risk description is the ..read more

One of the biggest responsibilities of the operating room (OR) team is to ensure patient safety.  There are many facets to patient safety in the OR.  Safe patient positioning is a critical facet since the patient is unable to tell you if they are in pain or uncomfortable.  The first step to improved outcomes related to patient positioning is to look to the evidence for guidance when choosing your positioning device.  There are extrinsic and intrinsic factors that contribute to the development of pressure injuries (PI) in the OR; one of the extrinsic factors is prolonged su ..read more

In the last blog we talked about compassion fatigue which is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events. It differs slightly from burnout but can co-exist. Compassion Fatigue can occur due to exposure on one case or can be due to a “cumulative” level of trauma. Burnout is a cumulative process, marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress, NOT trauma related. Even Mother Teresa understood compassion fatigue and burnout as she would ensure a mandatory ..read more

  The lateral surgical position is one of the most labor-intensive surgical positions that depends on brute force and team strength.  The lateral position is not only physically taxing on the staff, but also can be as hard on the patient; therefore, it is important to have an experienced clinical team member leading the way.  The surgeries that rely on the lateral surgical position vary by specialty and include lateral hip, thoracotomy, spine surgery, or kidney surgery. Many times, the lateral position is preferred over prone when possible for obese patients because th ..read more