Gearing Up for Safety and Comfort

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These products and devices will go a long way toward keeping your surgical team happy and healthy.


SAFE AND COZY A good set of scrubs is among a host of surgical gear items that can keep OR team members comfortable and protect them from injuries.   |  Pamela Bevelhymer, RN, BSN, CNOR

The Surgeons at Advanced Surgical Center never paid much attention to their own well-being while operating. Darleneya Robinson, RN, nursing director of surgical and anesthesia services at the facility in Duncanville, Texas, used to cringe when she watched her orthopedic surgeons standing in the same spot for hours on end with fluid runoff pooling at their feet. Ms. Robinson knew she had to put as much value on keeping her OR staff safe and comfortable as she did on patient safety.

Ms. Robinson’s first team-pleasing step involved purchasing a cart-based fluid waste management system. The mobile unit is rolled into ORs, and its large internal canisters have the capacity to collect the runoff of several fluid-heavy ortho cases before it needs to be emptied. When filled, a surgical tech or a nurse rolls the unit to a docking station, which automatically empties the contents into the sewer system. The setup eliminates the need for staff to lug heavy fluid-waste-filled canisters to a utility sink and takes away the risk of exposure to splash-back while they pour the contents down the drain.

Ms. Robinson then purchased disposable suction and anti-fatigue mats. The mats, which cost about $400 for a package of 10, attach to the ports of the fluid-collection cart. The 56-by-40-inch, air-cushioned floor coverings provide a padded place for surgeons to stand. Ms. Robinson says they’re worth the cost.

“They eliminate the need to put towels on the floor to sop up fluid and they add to surgeon comfort,” she explains.

Getting a handle on unwieldy cords is also an important component of a safe surgical floor. Teresa Boynton, MS, OTR, CSPHP, a consultant with Mobility Consulting and Presentations in Denver, Colo., says she’s seen surgical team members suffer serious injuries from tripping over cords, including an employee who lost the use of an arm from a fall in an endoscopy suite. “It’s critical for cords to be bundled and positioned so they’re kept safely out of high-traffic walkways,” says Ms. Boynton.

Wireless technology can also help with cord clutter. So can housing surgical equipment on floor- or ceiling-mounted booms. If that’s not possible, there are a variety of bright-colored cord covers that adhere to the floor. Additionally, clasps and positioning guards keep cords that need to be run across floors as close together as possible.

Gloves and scrubs
WORK ZONE Cords, tubing and fluids combine to increase risks of trips, slips and falls in a busy operating room.   |  Pamela Bevelhymer, RN, BSN, CNOR

Polyisoprene surgical gloves are now more form-fitting, easier to put on whether hands are wet or dry, and available with an emollient coating that moisturizes and soothes the skin of surgeons and surgical team members who spend hours on end wearing the protection. Some gloves offer a more precise anatomical fit for better movement than traditional models, and have cuff designs that keep them from rolling down the forearm.

Scrub tops and bottoms are more versatile, comfortable and utilitarian than ever, with sets that have combinations of waistband drawstrings, nearly a dozen pockets, moisture-wicking technology and materials that prevent lint and hair from sticking to them. Some have wrinkle-free technology that keep scrubs looking professional, even at the end of a long shift.

Form-fitting facemasks prevent venting from the sides, and some models come with integrated anti-fog face shields to offer staff and surgeons added protection during messier cases. When working in frigid ORs, surgical team members can opt to wear jackets warmed by batteries, heating elements plugged into a wall or air-activated IV packets stuffed into inside pockets. The garments are designed to be worn over scrubs and under surgical gowns. Cooling vests and neck wraps are also available to keep staff and surgeons comfortable as they work long cases in warm ORs.

Handling with care

Ergonomically healthy workplace practices are on the rise thanks to improving technology used in devices that assist with patient handling and movement. Ms. Boynton says items such as metal roller boards are becoming relics. They not only could pinch and tear patients’ skin, but they’re so heavy that surgical technicians and nurses faced injuries moving them into position at the bedside. Soft foam roll boards have been around for a while and are a much better alternative.

Air-assisted lateral transfer devices are a great improvement in patient handling technology. Rather than requiring at least four people to pull a patient from stretcher to bed, the inflatable mattresses hover a patient on a small cushion of air to make transfers much easier. Even a heavy patient can be moved by one or two people with minimal effort.

The addition of highly adjustable surgical tables and a wide variety of versatile table attachments has also helped to reduce OR staff injuries, says Ms. Boynton, because a member of the OR team no longer has to hold a patient of significant weight in place in an awkward position for an extended period of time, while also remaining completely still so surgeons can work unimpeded.

Finally, the value of floor-based lifts is being recognized. Ms. Boynton says lower-tech limb holders, while effective, are so heavy that just getting them in and out of the OR presents an injury risk of their own. Lifts in the OR assist with limb prep, limb holding and patient transfers. Ceiling-mounted OR lifts are even better — floor-mounted lifts can present a tripping hazard and are structures that need to be worked around — and being installed in an increasing number of facilities.

Radiation safety

The Joint Commission is putting a heightened focus on annual inspections of radiation safety items: lead aprons, drapes, and skirts; safety glasses; and mobile barriers, according to Mike Bohan, radiation safety officer at Yale New Haven Hospitals in Connecticut. “To make sure all the equipment is safe, inspect them visually and tactilely once a year,” he says.

Flatten the aprons, drapes and skirts out on a table and inspect the seams to make sure they’re tight. Look to see that there are no tears on the outer surfaces and run your hands over the items to make sure the lead inside isn’t lumping. Make sure the Velcro straps are in good working order. Glasses, overhead glass shields and mobile barriers are easy to visually inspect for cracks.

A fairly new technology allows you to track the inspections of radiation safety protective gear by installing color-coded Velcro tags on individual items. Each item is logged into an electronic data base, and tracking software is used to make sure they’ve been inspected annually. Finally, also consider issuing dosimeters to each employee who works in the OR when intraoperative imaging is employed. The dosimeters let you monitor staff members’ exposure levels and, in turn, assess the effectiveness of your safety gear. If everything is working as it should, the radiation dose levels captured on the dosimeters will be close to nonexistent, says Mr. Bohan. OSM

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