Barrier Material Selection (Procedure-Specific) for Certified Perioperative Nurse (CNOR)

Barrier Material Selection (Procedure-Specific)

Guidelines:

• Appropriate barrier material selection is choosing the right preventative interventions to protect the patient.
• The goal of appropriate barrier material selection is patient safety and is dependent on the nurse’s assessment, knowledge, and team communication.
• Procedure-specific protective barrier materials
  • Lead aprons and drapes
  • Eye goggles
  • Laser shields
  • Gowns/Gloves

Considerations:

• Anatomy and Physiology
• Surgical Procedure
• Regulatory Guidelines
• Principles of patient/personnel safety
  • Surgical smoke safety
  • Hazardous waste management
  • Chemical, fire, laser, radiation
• Instruments, supplies, and equipment related to surgical procedure

Nurse’s role:

• Follow the Nursing Process:
  • Assessment
  • Identify Risks
  • Outcome Identification and Communication with surgical team
  • Planning for appropriate barrier material selection
  • Implementation of appropriate barrier material
  • Continual evaluation
• Also important: Knowledge of regulatory guidelines, manufacturer’s IFU, principles of patient/personnel safety

Pitfalls:

• Head/Neck/Upper Chest Surgeries
• Oropharyngeal surgeries
• Laser surgeries
• Radiology in surgeries
• Consider both patient and personnel safety

Examples:

• Your next case is a patient having a laser tonsillectomy. As you “plan” for the case and prep the OR, what are some of the priority actions that will keep the patient safe?
  • Laser standby
  • Team communication
  • Moist gauze
  • Saline on backtable
  • Eye protection per manufacturer’s IFU
  • Appropriate signage/window covering per manufacturer’s IFU
• What are the risks identified during your assessment that lead to the planning of these
  actions?
  • Risk of fire
  • Risk of eye injury related to laser, surgical procedure site and type
  • Risk of personnel injury related to laser

Linchpins (Key Points):

• Patient Safety is the priority
• Team communication is key
• Know manufacturer’s IFU
• Prepare adequately