the hallway. Once the patient is draped and the surgery starts, the
circulator should ungown and perform hand hygiene, so as not to
potentially contaminate the entire room.
One other thing: If you need supplies or instruments that aren't in
the OR, lean on your core techs outside of the room to track them
down.
• After surgery. When the procedure is complete, the circulator
prepares to transport the patient to the PACU. She wipes down the
chart and places it in a yellow bag or pillowcase. The circulator and
anesthesia provider must don fresh yellow gowns and gloves before
moving the patient to recovery. A scrub tech should stay by the
patient's side while the circulator retrieves the transport bed or
stretcher from the hallway. A PACU nurse should also be in a yellow
gown and gloves, ready to receive the patient in an isolation room or
bay. Remove the patient's chart from the yellow bag, wipe it down
and place it in an ante room. Staff who cared for the patient in PACU
should remove their yellow gowns and gloves, perform hand hygiene
and change their scrubs.
Worth the effort
To implement the Risk Zone system, we presented at staff meetings
and developed a poster that we showed to perioperative staff at our
annual skills fair. We encouraged every nurse and tech to advocate for
their patients and make sure to speak up when the protocol is violat-
ed — such as when a surgeon walks into the OR and positions the
patient without donning gowns and gloves.
We continue to evaluate and audit for compliance. Over the last year
and a half since we began the program, we've seen much improve-
ment. It was a big project to implement. I needed input and buy-in
from the entire perioperative team. All of us — pre-op, post-op, anes-
M A R C H 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 3 3