O C T O B E R 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 2 7
As part of that educational effort, provide them with laminated single sheets
that show common surgical positions and the pressure points that need to be
protected. We took staff education a step further by producing a short video
that features members of the surgical team demonstrating the steps of placing
patients in the positions most often used in our ORs. We show the video at staff
meetings as refreshers and use it to orient new staff to our positioning proto-
cols.
Here's another neat and effective way to teach recovery area nurses about the
importance of patient positioning: Have surgical nurses position them in the
positions most often used during surgery. The exercise will teach PACU nurses
about each position and give them a better understanding of where to check for
post-op skin issues and how to recognize pressure injuries. It also builds rapport
between the OR and PACU and improves the way they communicate about the
positioning needs of patients.
OSM
patient's arms tucked to their sides. Patients placed in Trendelenburg for extended
periods might experience breathing difficulties. Monitor their condition more fre-
quently than you would during procedures involving other positions.
• Lithotomy. Move the patient's legs up, out and into the stirrups slowly and
simultaneously. Pay special attention to the elderly and patients who have under-
gone total hip or knee replacements. Ensure the heels are adequately padded
and the buttocks remain on the surgical surface. Pad the head and arms as you
would for a patient in the supine position. When removing patients from the stir-
rups, lift the legs out simultaneously, bring them together, but lower them to the
table one at a time, so blood gradually drains from the legs instead of rushing
back to the heart.
— Charlene DiNobile, RN, MEd, CNOR, CNAA, CST
Ms. DiNobile (cdinobile@aol.com) is a professor in the surgical technology
department at the New England Institute of Technology in East Greenwich,
R.I. Elizabeth Lamonde, RN, CNOR, MSN, and Joyce Smith, RN, MBA, con-
tributed to the article.
