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S H A R P S
S A F E T Y
distractions, observing the surgeon's movements and ensuring her
hands were clear of the neutral zone would have helped her anticipate
his next move.
Individual surgical teams must establish where the neutral zone —
comprised of a basin, towel, small instrument table or magnetic or
custom-made pad — is located, depending on patient positioning,
before each case. Announce the zone's location during pre-op briefings and how instruments will be passed through it.
Hands-free passing is ideal, during which communication is key.
Surgeons and techs should announce "sharp coming" or "sharp back"
— or whatever verbal warning works best for them, as long as it's
agreed upon at the start of the case — whenever they place items in the
neutral zone. When the passing of sharps directly into a surgeon's hand
is necessary — if he's peering through a surgical microscope and can't
break his field of vision, for example — alert him that the item is coming and place it using his preferred method.
The needlestick
A 68-year-old female patient needs an injection of subcutaneous heparin before a bilateral mastectomy procedure. The
heparin injection cartridge used by the nurse is not a safety device.
After giving the injection, the nurse places the needle cap on an
instrument table and inserts the needle into the cap. As the nurse
prepares to dispose of the syringe into a sharps container and
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J A N U A R Y 2013
