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One of the highly common surgical positions is supine. This approach involves the surgical team’s watchful eyes to oversee a patient that will lie on their back with their arms either tucked or untucked to provide direct anatomical and surgical exposure to any area from the head and neck to the anterior aspects of the lower legs and feet. Supine position may be requested for a myriad of surgical procedures including everything from a thyroid, chest, cardiac, general, urology, orthopedic, or podiatry procedure to name a few. Given the wealth of clinical indications for the supine position, intentional time must be afforded for the perioperative team to consider all areas of required surgical access, as well as the areas not exposed during the surgical intervention.

 By: Amos Schonrock, MAN, RN, ST, PHN, CSSM, CNAMB, CNOR, NE-BC, Perioperative Patient Safety Specialist

As perioperative professionals, the operating room team has a constant dedication and calling to the creation and maintenance of an environment that keeps our patient free from harm. As a vigilant guardian, the perioperative nurse is often at the forefront of this action. For positioning the perioperative patient, the nurse must use their senses to assess the patient’s well-being and current integumentary status as part of the pressure injury prevention assessment during all phases of care.

The annual Worldwide Pressure Injury Prevention Day is just around the corner on November 18, 2021.  Let’s not forget that perioperative pressure Injury prevention strategies decrease overall hospital acquired pressure injuries (HAPIs) in the non-reimbursable CMS “never event” category.  Awareness around perioperative pressure injuries and the focus on patient risk identification, including environmental and extrinsic risk factors, is gaining traction within the surgical and medical device community. As a result, skin injury prevention bundles, hospital policies, and safety strategies are being researched and recommended throughout the healthcare industry.

The lateral surgical position is one of the most labor-intensive surgical positions that depends on brute force and team strength.  The lateral position is not only physically taxing on the staff, but also can be as hard on the patient; therefore, it is important to have an experienced clinical team member leading the way.  The surgeries that rely on the lateral surgical position vary by specialty and include lateral hip, thoracotomy, spine surgery, or kidney surgery. Many times, the lateral position is preferred over prone when possible for obese patients because the bulk of the patients panniculus can be displaced off the abdomen.  To help improve patient outcomes, this blog will discuss the risk and interventions that are involved with placing a patient in the lateral position.

Hospital Acquired Pressure Injuries (HAPI, formally pressure ulcers) can result in a lifetime of pain, suffering and even possibly death for the patient. HAPI rates are reported to the National Database of Nursing Quality Indicators (NDNQI) which is the, “Only national, nursing quality measurement program that provides hospitals with unit-level performance comparison reports (NDNQI, 2010b, p. 2). Healthcare leadership can use the information provided by the NDNQI to establish organizational goals for improvement at the unit level and mark progress in improving patient care and the work environment.