Rustling Up OR Safety
When you get creative, following the rules can be fun.
Looking for a way to improve your sharps and bloodborne pathogen safety? Get creative. We posted cartoon drawings of a doctor and a nurse, both with oversized hands and faces, above the scrub sinks. We mark the hands with red dots where doctors or nurses suffer sharps injuries, and mark the faces with red dots where they suffer splash exposures. The drawings of "Dr. Hepatitis" and "Nurse-Tech HIV" are comical, but you can look at them and see the hazards that had been reported.

We also took a second look at our "neutral zone" policy. During procedures, the neutral zone is essentially the holding area for a few surgical instruments, including sharps. The "passing zone," on the other hand, is where a single item only is laid down for another person to pick up. This prevents surgeons and nurses from having to reach in among multiple sharps for the item they need. But how could we make our personnel want to follow these rules? The answer: by making it fun. I deputized my nurse educators to act as "neutral zone sheriffs," with badges, to enforce the laws of our land. They were authorized to ticket our OR staff — but the tickets were rewards for compliance that they'd observed. The tickets could be exchanged for candy and placed in a bucket at the nursing station. Later, we'd hold a drawing for assorted gift cards. Our bulletin board became a "neutral zone roundup," collecting the data and posting our "Most Wanted" for compliance. These rewards weren't worth much, but you'd be surprised how much they made our staff — including surgeons — want to be involved in our safety efforts.

Vangie Dennis, RN, CNOR, CMLSO
Clinical Manager, Procedural Nursing
Gwinnett Medical Center Duluth
Duluth, Ga.
[email protected]

A Productive Close to Your Day
A few minutes before a shift ends, have groups who worked together (RNs and techs or RNs and MDs) pause for a 2-minute conversation. Have them discuss these talking points. Everyone should contribute.

• What went really well that day and what do they feel good about?
• If they had to replay the day, what do they wish they had done differently?

As simple as it sounds, the first question allows for timely positive feedback and recognition. We never pause to let our colleagues know that they did a good job or how much help they were.

The second question doesn't place blame, but lets staff evaluate what they could or should have done to make the day go more smoothly. It also gives individuals the opportunity to say they're sorry to a co-worker they may have offended or forgot to help during a crazy workday. Staff might realize they have nothing to suggest for improving on the day, but even that is worth hearing before they go home. Regardless, asking these questions at the end of each and every day will make the exercise a habit, so that when something does go wrong during a shift and feelings are hurt, an established forum for dealing with the problem already exists.

J. "Ski" Lower, RN, MSN, CCRN, CNRN
Independent Consultant
Severn, Md.
[email protected]

Ready, Set, >> >> >> >>
Let's Operate!
At the start of each day, our entire clinical team huddles informally outside the OR doors, much like a football team would. Everyone is welcome — circulating nurses, pre- and post-op staff, techs and surgeons. We even try to coax the front desk workers into the ring. Whoever feels inspired on a particular morning leads the team in a spirited cheer. It seems our favorites are "Go team!" or "Go Madison!" Some find it silly. Others truly enjoy the huddle. Either way, it's quick and it's fun. It's also an opportunity to start the day off right, with a focus on team unity. Plus, the first patients of the day have a clear view of the merriment. They have remarked that the huddle made them feel good about the care they were to receive because it's apparent our surgical team has fun and works well together.

Donna White, RN, BSN
Director of Nursing
Madison Street Surgery Center
Denver, Colo.
[email protected]