We get busy. We forget. But not really – it’s only that protocol and procedures in the OR are so much a part of our daily routines. And is there anything really new about the newest guidelines for perioperative practice* issued just six months ago by AORN?  

 * Be sure to ask the head of education for your facility for a copy

New name, same purpose:

Previously titled Perioperative Standards and Recommended Practices, the purpose of the now named Guidelines for Perioperative Practice remains basically the same: to provide guidance for achieving excellence in perioperative patient care and workplace safety.

Topic areas to note:

  • Support surfaces in the OR
  • Cleaning and maintaining patient safety products
  • Specific concerns for each surgical position

As providers of OR support surfaces, at Action Products we took special note of the report, included in the Guidelines, of a quasi-experimental study to determine peak pressures when using each of three different support surface arrangements:

  • an OR bed mattress alone
  • a polyurethane convoluted foam overlay on the OR bed mattress
  • a viscoelastic dry polymer gel overlay on the OR bed mattressaction akton polymer gel overlay

 “The viscoelastic gel overlay was the most effective surface for preventing pressure injury.”  In fact, the researchers found, “the use of viscoelastic gel overlay during procedures lasting 90 minutes or longer decreased the incidence of postoperative pressure injury by .51% and resulted in an overall cost savings of $46 per patient.”

 The Guidelines emphasize the importance of cleaning all materials, devices and equipment in accordance with manufacturers’ specific instructions.

  • Perioperative team members should select, clean, inspect, and maintain
  • positioning equipment, devices, and support surfaces and should ensure
  • they are repaired or replaced when dam­aged, defective, or obsolete. 

Action Products recommends using spray-wipe-rise cleaning protocol.  Gas sterilization, autoclaving, machine washing or drying, or soaking are not recommended.

The 2017 AORN Guidelines state that Trendelenburg, lithotomy, and lateral are acceptable positions, but emphasize that patients should be in any of these positions for the shortest time possible; proper positioners should be selected for each specific surgery. 

Perioperative personnel should use additional pressure-redistributing padding to support the patient and redistribute pressure from bony prominences and other pressure points….Implementing repositioning interventions to reverse neurological conduction changes identified by neurophysiological monitoring may prevent peripheral nerve injury.

At Action Products, pressure relief and shear reduction in the operating room are the top drivers in the design and composition of our many positioning products. We were gratified by AORN’s including text on restricting the use of towels and blankets for positioning, a caution we have long been offering our clients..

Have you reviewed and implemented the 2017 AORN guidelines?