card would note 'beach chair position,'" she explains. "But that's all it
would say. As a nurse, I'd position patients how I'd want it done, but
that wouldn't be how the surgeon liked it. There were so many small
differences we had to manage."
Ms. Bachetti set out to develop surgeon- and procedure-specific edu-
cational tools that could be accessed easily in the OR. She gathered
all the surgical nurses and asked them which types of cases had the
most frequent positioning variations from surgeon to surgeon. Turns
out, it was shoulder and knee procedures.
Ms. Bachetti then approached the facility's orthopedic surgeons to
tell them about her project, and asked them about their specific posi-
tioning preferences, and their rationales for them. Once she collected
that information, she created PowerPoint slides for each surgeon and
the procedures they performed. But the idea wasn't to put them in a
binder; she wanted the information easily accessible to the surgical
staff.
She met with the hospital's IT department to develop a sharable file
on a web-based collaborative platform. Now OR staff members can
easily obtain positioning information through computers in the OR.
"Staff access a list of our orthopedic surgeons," says Ms. Bachetti.
"They click on a surgeon's name, and in his file are the procedures he
frequently performs — ACL, rotator cuff, shoulder arthroscopy.
Clicking on a procedure type displays the surgeon's digital preference
card, which includes pictures of how they want patients positioned
for the procedure."
Ms. Bachetti held in-services to educate the entire staff on the use of
the web-based tool. Positioning ambiguities? Gone. In fact, the suc-
cess of the program led orthopedic residents to create a website with
video instructions for each surgeon's steps for prepping, draping and
surgical approaches.
F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 4 5
