Implant Verification and Availability for Certified Perioperative Nurse (CNOR)
Included In This Lesson
Outline
Implant Verification and Availability
Guidelines:
- The perioperative nurse is responsible for verifying correct implants are available
- Nursing Process
- Comprehensive Surgical Checklist
- Surgeon Preference Card
- Knowledge of surgical procedure
- Knowledge of instruments, supplies, devices related to surgical procedure
- Surgical team communication (briefing/time-out)
- Verification of sterility or expiration date
Considerations:
- TJC Universal Protocol: National Patient Safety Goals *Prevent wrong site, wrong procedure, wrong person surgery
- 3 key steps:
- Conducting a pre-procedure verification process
- Marking the procedure site
- Performing a time-out
- Pre-procedure verification process includes identifying the items that must be available for the procedure. This includes any required blood products, implants, devices, and special equipment.
- Also included on the comprehensive surgical checklist and is part of the nursing process with assessment and planning.
Nurse’s role:
- Utilize safety tools and processes, every patient, every time
- This includes surgical checklist with universal protocol, briefing, time-out, debriefing.
- Pre-procedure verification process is vital to patient safety
- Correct patient, correct procedure, correct implants and related equipment, devices, and supplies available, correct imaging displayed, relevant documentation (H&P, consent, preanesthesia assessment), etc.
- Verification of implant availability and sterility prior to procedure
Pitfalls:
- Must follow healthcare organization’s policies and procedures
- Implant ordering, sterilization processing, storage, handling
- HCIR presence in OR
- Related equipment/devices/supplies
- Documentation/log
- Follow manufacturer’s IFU
- Expiration date/sterilization
- Storage
- Related equipment/devices/supplies
- Pre-procedure verification and team communication is essential
Examples:
- You are assigned to an OR doing back-to-back neurosurgery cases with the same surgeon using a craniotomy set and micro plating system and implants. A third urgent/emergent neurosurgery case with a different surgeon is added on to follow. You know that your facility only has 2 craniotomy and microplating system sets. As part of your pre-procedure verification process, what are some priority actions?
- Verify that the instrumentation and implant set from the first case are being expedited for re-sterilization
- Brief with surgeon on instrumentation required for add-on case
- Communicate estimated time for instrumentation and implant availability
- Coordinate with HCIR for refilling implant tray
- Document!
Linchpins (Key Points):
- Use safety tools and checklists to prepare and plan
- Pre-procedure verification is vital to patient safety
- Team communication is a must
- Document, Document, Document
Transcript
References
- Rothrock, J. (2019). Alexander’s Care of the Patient in Surgery (16th ed.). Elsevier Health Sciences.
- Association of perioperative Registered Nurses (AORN): Guideline Essentials (website), 2022, https://www.aorn.org/guidelines-resources/guidelines-for-perioperative-practice/guideline-essentials
- The Universal Protocol for preventing wrong site, wrong procedure, and wrong person surgery: Guidance for health care professionals. The Joint Commission. https://jointcomission.org/standards/universal-proto col/. Updated 2022 . Accessed December 29, 2022.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
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- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
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- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Skeletal System
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- Postpartum Care
- Basic
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- Bipolar Disorders
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- Concepts of Population Health
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- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
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- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
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- Concepts of Pharmacology
- Integumentary Important Points
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- Growth & Development
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- Med Term Basic
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