Tag Archives: #patientsafety

Clinical Education, Credentialling and Professional Development, Perioperative Nursing

đŸ› ïž The Essential Attributes of a Great Instrument Nurse-Scrub Tech- ODP

Leave a comment

Introduction
In the high-stakes environment of the operating room (OR), both scrub techs and instrument (scrub) nurses are indispensable. These professionals not only manage surgical instruments but also play pivotal roles in patient safety, OR efficiency, and team cohesion.

1. Clinical & Technical Mastery

  • Aseptic technique & sterile field control: Managing the sterile field from prep to closure is crucial to prevent surgical-site infections.

  • Instrument knowledge & standardized preparation: Familiarity with instruments and consistent table setup enhances workflow and reduces errors

  • Accurate instrument and sponge counts: Precise counting is essential to prevent retained foreign bodies

2. Non-Technical Skills

  • Situational awareness & multitasking: Staying alert to the OR environment helps anticipate needs and manage unexpected disruptions

  • Teamwork & communication: Clear, timely communication reduces errors and builds team trust

  • Anticipation (“third hand”): Proactively anticipating the surgeon’s needs helps maintain procedural flow

3. Physical & Emotional Resilience

  • Manual dexterity & endurance: Handling delicate instruments plus long periods in surgery demand both precision and stamina

  • Stress management & composure: Maintaining calm under pressure is essential to prevent errors

4. Continuous Improvement & Professionalism

  • Adaptability & lifelong learning: Ongoing education, simulation training, and staying updated with OR advances are vital

  • Ethical conduct & integrity: Upholding standards—even when unsupervised—strengthens trust and safety culture

5. Technology & Innovation

  • Robotic and simulation tools: Emerging tech (robotic scrub nurses, training systems like Nosco Trainer) can augment—but not replace—human anticipation and precision

đŸ§© Summary Table

Attribute Impact on Patient Care & OR Efficiency
Technical Proficiency Reduces infection risk, expedites setup and transitions
Attention & Awareness Prevents retained items, maintains sterile conditions
Communication & Teamwork Improves coordination, minimizes miscommunication
Resilience & Dexterity Supports long, complex procedures
Continuous Learning Ensures competency with evolving procedures
Ethical Standards Builds credibility and trust through consistent practice

 

 

 

 

 

📚 References

  1. Glaser B, Schellenberg T, Neumann J, et al. Measuring and evaluating standardization of scrub nurse instrument table setups: a multi‑center study. Int J Comput Assist Radiol Surg. 2022 periopnursing.theclinics.com+2BioMed Central+2Wikipedia+2BioMed Central+2Wikipedia+2MDPI+2SpringerLink+1SpringerLink+1.

  2. Mohammadi M, Omid A, Tarrahi MJ, Ghadami A. The impact of intraoperative non‑technical skills training on scrub practitioners’ self‑efficacy: a randomized controlled trial. BMC Med Educ. May 7, 2025 BioMed Central.

  3. “Surgical instrument counting: Current practice and staff perspectives…” SciDirect. 2024 ScienceDirect.

  4. “What are the non‑technical skills used by scrub nurses?: An integrated review.” CORE, 2014 Academia+1core.ac.uk+1.

  5. Mitchell L, Flin R, Yule S, Maran N, Rowley D. Thinking ahead of the surgeon: identifying non‑technical skills for scrub nurse performance. J Adv Nurs. 2010 Academia.

  6. “What skills are essential for a Scrub Nurse?” Nursing‑Science.com Nursing Science+1Nursing Science+1.

  7. “Effects of Simulation‑based Scrub Nurse Education for Novice Nurses…” Nurs Simul. 2021 Wikipedia+15ScienceDirect+15Nursing Simulation+15.

  8. “Understanding stress factors for scrub nurses in the perioperative…” SciDirect. 2021 arxiv.org+7ScienceDirect+7Academia+7.

  9. “Robotic Scrub Nurse: Surgical Instrument Handling…” DeGruyter, 2023 SpringerLink+5De Gruyter Brill+5Nursing Science+5.

  10. Wikipedia: Instrument nurse, updated 1.2 years ago Wikipedia+1MDPI+1.

  11. Royal Cornwall Hospitals Trust: Scrub Practice Standards Clinical Guideline doclibrary-rcht.cornwall.nhs.uk+1BioMed Central+1.

 

Nursing Workforce, Operating Room Leadership

đŸ§± When Rostering Feels Like Jenga: The Unseen Burden of Building OR Teams

Leave a comment

đŸ’„ Introduction: Rostering Is No Small Feat

In a perfect world, every surgical team is consistent—familiar nurses, trusted techs, the surgeon’s “dream team.” But in the real world? Staffing the OR is a high-stakes game of Jenga.

Nurse managers must balance:

  • Leave, breaks, and unexpected absences

  • Maternity cover, new grads, and on-the-fly replacements

  • Skill levels, specialty experience, and surgeon preferences

One wrong piece—and the entire surgical list could collapse.

🧠 The Real Cost of Unseen Stress

While CEOs review performance metrics, the behind-the-scenes chaos of managing staff schedules is rarely noticed—until it impacts patients, delays cases, or increases staff burnout.

According to BMC Health Services Research (2019), communication breakdowns and inadequate team familiarity significantly contribute to flow disruptions in the OR, which can ultimately affect patient safety and surgical efficiency.

🔄 Enhancing Surgical Team Competency Through Cross-Specialty Rotations

In the dynamic environment of the operating room, consistent team composition is often challenged by factors such as staff breaks, holidays, maternity leave, sudden illnesses, and the necessity to train new personnel. These variables can disrupt the continuity that surgeons rely upon for optimal performance.

To mitigate these challenges, structured cross-specialty rotations have been identified as a valuable strategy. A comprehensive review published in the Journal of Surgery and Research underscores several benefits of such rotations:

  • Broadened Clinical Exposure: Trainees gain experience across various surgical disciplines, fostering a more versatile skill set.

  • Enhanced Teamwork: Exposure to different specialties promotes better understanding and collaboration among multidisciplinary teams.

  • Improved Patient Outcomes: A diverse training background equips surgical staff to handle a wider array of clinical scenarios effectively.

Moreover, the British Journal of Surgery emphasizes that cross-specialty training is instrumental in preparing surgeons for the complexities of modern patient care, which often requires a collaborative, multidisciplinary approach.

💡 Implementing Supportive Systems

To fully leverage the benefits of cross-specialty rotations, it’s crucial to establish systems that:

  • Facilitate Knowledge Sharing: Ensure that critical information is accessible to all team members, regardless of their primary specialty.

  • Support Continuous Learning: Provide ongoing educational resources to keep staff updated on best practices across specialties.

  • Promote Flexibility: Develop adaptable protocols that accommodate the dynamic nature of surgical team compositions.

By embracing these strategies, we can create a resilient surgical workforce capable of delivering high-quality care, even amidst staffing fluctuations.

🎯 Let’s Recognize the Real MVPs

To every perioperative manager playing roster Jenga

To every team that flexes, fills gaps, and keeps surgery moving

We see you. You’re not just building rosters—you’re holding the OR together.

đŸ§± The Nurse Manager’s Jenga: Balancing OR Staffing & Schedules

Section 1: The Daily Challenges

  • Staff Availability: Managing unexpected absences due to illness or emergencies.

  • Shift Preferences: Accommodating individual staff scheduling preferences.

  • Skill Mix: Ensuring the right combination of skills for each shift.

  • Compliance: Adhering to labor laws and organizational policies.

 

Section 2: The Impact on OR Efficiency

  • Delayed Surgeries: Scheduling issues leading to postponed procedures.

  • Increased Overtime: Staff working extra hours to cover gaps.

  • Burnout Risk: Elevated stress levels among staff due to scheduling conflicts.

  • Patient Satisfaction: Potential decline in patient experience due to staffing issues.

 

Section 3: Strategies for Stability

  • Advanced Scheduling Tools: Utilizing software to optimize shift planning.

  • Cross-Training Staff: Preparing staff to handle multiple roles as needed.

  • Open Communication: Maintaining transparent dialogue about scheduling needs.

  • Regular Reviews: Assessing and adjusting schedules proactively.Proactive Healthcare Staffing

“Supporting our nurse managers in their balancing act ensures a stable and efficient operating room environment.”

Operating Room, Policies, Technology, Workflow

Current Trends Impacting Operating Room Professionals

Leave a comment

   

 

Innovation in healthcare has made a significant impact to enhance patient care and healthcare outcomes.

The operating room focuses on improving surgical outcomes, by implementing strategies and technology that optimise patient care.

 

As an experienced operating room nurse, I have observed the positive impact of technology on patient care.

However, successful implementation of intra-operative technology necessitates a strategic plan and continuous monitoring.

 

According to the Australian Government, 2023-2035, The Nursing Supply and Demand Study,’ there will be a shortage of 70,707 nurses by 2035. In acute care the estimated short fall is 26,665 nurses. Supply is not expected to keep pace with demand.’

 

It is essential to consider the wellbeing of healthcare professionals who, according to research, are experiencing burnout, lack experience, face high turnover rates, represent an ageing workforce, feel overworked and undervalued.

 

Data shows recognition and gratitude enhance healthcare professionals’ wellbeing, teamwork, and sense of value, which is crucial for a sustainable healthcare delivery system.

 

Healthcare professionals wellbeing must be prioritised when introducing new technology, requiring a balanced approach to ensure safety, support and compliance. Stable adoption needs time for adjustments, support, education, and ongoing training.

 

Innovative technology that significantly affects patient care can greatly influence clinical workflows and overall workload.

 

Any adjustments to clinical workflow/workload impacts on patient safety and a number of factors should be thought through prior to implementation.

 

Key factors include:

 

  • Current workflow
  • Technology’s impact on clinicians’ responsibilities
  • Time for setup and preparation
  • Feedback and troubleshooting
  • Clinical skill mix, staffing numbers
  • Impact on instrument handling and patient safety
  • Responsibility for equipment management
  • Policies and governance on equipment use
  • Environmental conditions
  • Equipment monitoring and maintenance

 

 

It is crucial to acknowledge that operating room personnel, especially those in the roles of instrument and circulator, already adhere to mandated legal policy directives, for each surgical procedure they are involved with, requiring contemporaneous documentation, even when using hybrid systems.

 

Prioritising tasks and responsibilities is key to a fluent workflow. Patient safety should always be placed at the forefront of any task.

 

 

The adoption of new technology, along with the modification of policies and procedures, has altered the responsibilities and dynamics faced by healthcare professionals.

 

Peri-operative teams, who work across various surgical specialties, are highly skilled, adaptable, and knowledgeable professionals.

 

Their competencies should always be regarded with the utmost respect.

 

Peri-operative professionals recognise the need for change, however, in order to effectively integrate technology, and sustain a critical workforce, we need to identify, prioritise and support the clinical impact of technology.

 

Sustaining and supporting this skilled workforce is vital to our healthcare system.

 

 

https://hwd.health.gov.au/resources/primary/nursing-supply-and-demand-study-2023-2035.pdf

 

https://onlinelibrary.wiley.com/doi/10.1155/2024/2983251

 

https://www.sciencedirect.com/science/article/pii/S2666142X25000505

 

https://onlinelibrary.wiley.com/doi/10.1155/2024/2983251

 

https://pmc.ncbi.nlm.nih.gov/articles/PMC7164898/

 

 

Operating Room, Patient Safety

Communication in the OR

Leave a comment

The operating room is a culturally diverse background with various levels of multidisciplinary professionals working collaboratively to deliver optimized care.

 

 

A study by the British Journal of Anaesthesia, identifies;

 

 

 

  • Failures in peri-operative communication contributed to patient injury in 43% of 910 anaesthesia malpractice claims

 

 

  • The most common root cause of communication failure was insufficient or inaccurate information, occurring in 30% of procedures

 

 

As part of a team that assessed RCA’s and near misses, communication was highlighted as a contributing factor in a majority of cases. Nurses stated they did not feel heard and confident, especially as a novice.

 

 

Surgeons may also feel unsupported by staff they are unfamiliar with or who are unfamiliar with the flow of surgery.

 

 

We need to empower all operating room professionals to work collaboratively, but we also need to empower and provide knowledge and support to our clinicians, in order to support, and deliver enhanced patient care.

 

 

The annual cost of medical errors likely exceeds $17 billion, with 35% being surgery related

 

 

 

A recent publication, Towards the Future of Surgery, 2024 has highlighted the need for surgeons to further develop their soft skills.

 

 

This is something we should all consider. Here’s a little insight.

 

 

 

“It is clear how patient outcomes are becoming less and less dependent on technical skills (however, this is always essential) and increasingly dependent on non-technical skills. Surgeons have the potential to improve patient outcomes, reduce medical errors, and improve patient satisfaction through their leadership on the multidisciplinary team.”

 

 

“Leadership in surgery entails many non-technical skills, including professionalism, technical competence, motivation, innovation, teamwork, communication skills, decision making, business acumen, ethics, emotional competence, resilience and effective teaching.”

 

 

“Surgeons have the potential to improve patient outcomes, reduce medical errors, and improve patient satisfaction through their leadership on the multidisciplinary team.”

 

 

 

I believe we all have the ability to improve patient outcomes.

 

 

Our use of checklists, such as the Surgical Safety Checklist has reduced errors by 30%.

 

 

Research shows we can improve patient outcomes by developing a team culture by easily identifying surgical team members, via scrub or cap identification.

 

 

Team huddle has also improved team collaboration and work flow.

 

 

Effective communication aims to streamline practices and utilizing resources to share information is key when stakes and patient lives are at risk.

 

 

 

Lets all aim to improve communication, empower clinicians and share our clinical expertise.

 

 

 

 

 

 

ttps://www.bjanaesthesia.org.uk/article/S0007-0912(21)00349-4/fulltext

 

 

Towards the Future of Surgery, 2024

 

https://link.springer.com/book/10.1007/978-3-031-47623-5

Operating Room, Patient Safety

Situational Awareness in the OR

Leave a comment

The OR is an environment where the room for error in minimal, time is critical and perfection is expected 100% of the time.

 

 

Situational Awareness that can have a significant impact on the flow of surgery, time & costs.

 

 

Situational awareness encompasses the ability to observe, listen, absorb and act swiftly. 

 

 

A change in the environment can be sudden and simultaneous. Eg, a surgeon may have an uncontrolled bleeding vessel, whilst the anaesthetist is having problems securing a dislodged airway.

 

 

Distractions are the costly, which is why 100% attention should be focused on the patient and care delivery.

 

 

Each OR nurse/tech/ODP, should be aware of the environment in order to work as a team, prioritise and support the care required, in order to stabilise a situation.

 

 

Demonstrating situational awareness is critical to patient safety and team cohesiveness.

 

 

Recognising a change in the environment, and troubleshooting or prioritising a task prior to verbal direction can save time. An instrument nurse/tech/ODP may only need to move their eyes, in a certain direction, in order to communicate a task, to the circulator.

 

A circulator may use verbal and non-verbal communication to the instrument nurse/tech/ODP if there is an observation that is of concern, such as low irrigation fluids, especially if the surgeon has a bleeding vessel.

 

 

 

 

Timing is key and costly.

 

 

 

 

If the need to obtain a bag of fluids is required by the circulator, it is important they obtain direction by the instrument nurse/tech/ODP, as they may prefer the circulator to stay in the OR, due to the case going ‘open’, thus, requiring additional instrumentation & equipment.

 

Situational awareness requires assertiveness, listening to cues and observing minute changes, by all team members.

 

 

 

It can take years to develop & evolve these astute, efficient & life saving skills. 

 

 

 

 

Many senior OR staff have developed these astute skills over the years. Which is why experience and expertise should never be under valued or under estimated.

 

 

 

What does one minute of operating room time cost your organisation?

 

 

Electro Surgical Unit, Patient Safety

Patient Safety using an Electro-Surgical Unit

Leave a comment

Patients rely on healthcare facilities & health professionals to look after them during their surgical journey. The aim is to leave a healthcare facility in a more optimal state than when they were admitted.

In the OR an electro surgical unit is used in 80% of surgical cases, this involves an electrical current that can be localised- Bipolar (cautery), or is an electrical circuit- Monopolar. Incidences of electro surgical injuries according to research are under reported.

 

Monopolar is an electrical current that flows through the patient and requires a patient return electrode which connects to the electro surgical unit.

Thermal injury is a result of a burn from the use of electro surgery. This is why jewellery, piercings and any metal implants should be flagged with the peri-operative team, prior to surgery.

Laparoscopic cases have been show to increase the incidence of a surgical burn injury.

 

Research suggests that 3.6 per 1,000 laparoscopic procedures may result in a burn injury.

 

Electro surgical units are also a fire source, they are commonly referred to as a fire stick.

 

“It is currently estimated that around 500 to 600 surgical fires occur annually in the United States”, this impacts on patient safety but also impacts on healthcare facilities, costing them ‘millions of dollars annually”.

 

In order to reduce surgical burns the surgical team are responsible for assessing equipment & instruments prior to all surgical cases.

 

It is important that all surgical instruments are checked prior to use, to prevent thermal injuries, particularly in laparoscopic/robotic cases, where the insulation of laparoscopic instruments can become worn and compromised.

Leads & connections should also be checked.

 

Patient positioning is also extremely important so that no body part is touching any metal, especially in lithotomy and prone cases.

 

There are other safety precautions healthcare workers need to be mindful of, including prep solutions- pooling, alcohol and the use of oxygen, especially in the airway.

 

Pacemakers and any metal implants should also be flagged with the peri-operative team, in order for them to prepare the right equipment in advance of the surgery.

 

Depending on the type of surgery, bipolar may be a safer option.

 

Lets educate & support our healthcare workers

 

Educating and supporting clinicians is vital to empowering and informing best and safe practice.

Training & education requires time by employees and employers.

 

The value in supporting electrosurgery education benefits the facility by empowering and encouraging safe practice in addition to increasing a clinicians level of competence and understanding, all of which impacts, on safe surgical care & outcomes.

 

 

References
https://pubmed.ncbi.nlm.nih.gov/30472721/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456630/
https://www.jscimedcentral.com/jounal-article-info/Journal-of%C2%A0Dermatology%C2%A0and-Clinical-Research/Peri-Operative-Management-of-the–Patient-with-Body-Piercings-8253
https://www.infectioncontroltoday.com/view/managing-new-class-electrosurgical-risk
https://jackson-medical.com/prevent-electrosurgical-fires/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5599256/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407433/
https://www.sciencedirect.com/science/article/abs/pii/S0002961016310285
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456630/
Patient Safety, Policies

Costs of staff ‘running’ for supplies outside of the OR, could cost up to $1,500.00.

Leave a comment

A hospitals operating room, store room, can be overwhelming, lots of surgical trays, equipment & supplies everywhere, most of the time in an order that make sense to a supply administrator but not to the surgical team..argh and with limited details to find what you actually need, quickly.

 

This impacts on costs, why, because there are many times when a surgeon may need additional supplies, unexpectedly, intra-operatively. When equipment can not be easily found this builds tension in the OR, in addition to prolonging surgical time, which can also impact on patient outcomes.

 

Research suggests that nurses spend 26% of intra-operative time outside of the OR, attending to additional needs of the surgeon, which would involve collecting additional equipment and supplies to support an optimized surgical outcome.

 

If the equipment required is necessary this can bring the entire operating room to a stand still, costing approximately $1,500.00 for the loss of 15minutes, waiting for the nurse to find the equipment.

 

Research also suggests that nurses ‘spend 21minutes per shift looking for lost equipment, taking them away from direct patient care’.

 

Hospitals need to provide the infrastructure for clinicians to optimize patient safety and to support them in their roles which would remove unnecessary stress, that wastes critical time. Improving clinical resources to streamline practices will improve efficiency and productivity, which will impact on staff and patients.

 

https://www.sciencedirect.com/science/article/pii/S1743919118305338

 

 

https://www.himss.org/resources/applying-rtls-technology-improve-nurse-efficiency-and-patient-care#:~:text=Time%20spent%20looking%20for%20equipment%20certainly%20takes%20them%20away%20from,shift%20searching%20for%20lost%20equipment.

Patient Safety, Policies, Technology

Implications of Equipment Failure During Surgery

Leave a comment

Research states that, ‘Implications of equipment failure during surgery’, occurred in 92% of surgical cases.

According to research,’equipment failures occurred in 76.9% of surgical cases. Equipment availability was impacted by 37.3% of surgical cases.

Unfortunately this is not surprising to those in the industry. I have witnessed first hand the lack of operating room checks, due to, time poor staff, who are already overloaded with paperwork and surgical setups.

When I first started working in the operating room as an instrument and circulating nurse, one of the first things I was taught, was to check the OR environment. This involved turning wall switches on and off, increasing/decreasing hardware settings.

Fast forward twenty plus years and there is more equipment to check, that is more technical and complex.

Staff are not given time to check equipment and the environment, which leads to intra-operative delays, stress and tension. Surgical time is impacted, patient safety is impacted, the waitlist is impacted and costs increase.

I hope that as we engage in more specialised practices that time is spent on checking the surgical environment and hard ware prior to the start of a surgical case load, or that specialised technical support is available to take the load off our already time poor health care professionals.

If you are a facility that provides your staff with additional time to setup and check equipment or has a technical support person. I would love to hear from you.

Contact Us

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685966/

 

https://qualitysafety.bmj.com/content/22/9/710

 

 

Patient Safety, Uncategorized

Intra-Operative Pressure Injuries (PI)

Leave a comment

A patient has surgery to address a disease, illness, or trauma. They are vulnerable and anxious and surgery maybe the final option.

Surgery can be costly and a patient does not need another complication, such as a Pressure Injury (PI).

According to the Agency for Healthcare Research & Quality, pressure ulcers cost $9.1-$11.6 billion per year in the US. Cost of individual patient care ranges from $20,900 to 151,700 per pressure ulcer.

https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html#:~:text=Cost%3A%20Pressure%20ulcers%20cost%20%249.1-%2411.6%20billion%20per%20year,ranges%20from%20%2420%2C900%20to%20151%2C700%20per%20pressure%20ulcer.

As healthcare professionals it is our role and responsibility to provide the best care we can, to our patients.

This is why pressure area care should be assessed and addressed.

There are a number factors that impact on intra-operative pressure care and what equipment should be used to support blood circulation and minimise pressure on vessels and tissue.

A patients own health and comorbidity can also impact on the predisposition for a postoperative PI.

Correct patient positioning, monitoring pressure sites and utilising equipment can aid in reducing PI. Moisture and heat sources such as a warming blankets can also play a role in the likelihood of skin breaking down.

It can be difficult to identify early stages of skin breakdown intra-operatively, which is why assessments and precautions should be undertaken preoperatively and postoperatively.

Research in identifying and educating health care workers is necessary to reduce the risks to patients. A 2019 study detected that 1 in 150 patients developed an intra-operative stage 1 PI. This study highlights the need for education and further research to assess a patients risk and implement strategies to reduce PI.

See more from AORN about how much a PI is costing your facility.

https://www.aorn.org/syntegrity/resources/tools-calculators/pressure-injury-calc#:~:text=Pressure%20ulcers%20costs%20hospitals%20up%20to%20%2426.8%20billion,first%2C%20calculate%20how%20much%20they%E2%80%99re%20costing%20your%20facility.

Patient Safety, Scrub

Communication in the OR & Valuing Senior OR Staff

Leave a comment

The operating room is an environment where the room for error is minimal and time is always critical.
Surgery is becoming more complex, technical & challenging, which is why, communication & experience should be valued, especially when it comes to operating room professionals.

Effective verbal, observation & listening skills are qualities all surgical team members must demonstrate. Rothrock (2011) states that, “ improved communication is imbedded in human factors, culture, and social systems, all of which are more complex than checklists, mnemonics, and acronyms”.

A senior and experienced OR nurse, ST or ODP is able to recognise a change in the environment, they are able to ‘read the room’ & assess where attention should be focused.

They are able to ask concise questions at pivotal moments.

Example, does the laparoscopic or robotic case need to be ‘opened’? If so what trays & equipment do I require? Is there a bleeding vessel, are more fluids required for irrigation, are additional clips, ties, endoloops required?

Senior staff are able to think ahead because of their experience and surgical exposure especially if they are skilled across multiple surgical specialties.

Time can be critical during these intense moments and cohesive teamwork is vital in reducing surgical time. Surgical errors and complications arise when there is tension.

Time and experience matter, and there is usually a higher cost for these skilled clinicians, is the money worth it? Yes indeed!

Experienced OR staff  bring a wealth of experience, they have trouble shooting skills & clinical knowledge, they are able to think quickly and prioritize the needs of the surgical team.

Surgical time can have a direct impact on a patient, leading to longer post-op recovery which can impact on reduced bed availability and increased hospital costs.

Thank you to all the senior operating room professionals who have a wealth of skills and experience. Never forget how valuable you are.

Patient Safety, Policies

Who is responsible for monitoring the Intra-Operative IDC?

Leave a comment
I wanted to get your feedback on this issue as I observe this intermittently across varying OR’s and I wondered who should take ownership or is it a collective level of responsibility?
The IDC (indwelling catheter) may have been placed by the surgical team, nurse or OR professional, once insitu, who is responsible for monitoring the urine output and if needed updating the fluid balance chart?
I have observed catheters not draining as the catheter was kinked after positioning the patient and this was only observed after I had completed a surgical count, connected equipment and opened all supplies, as a circulator there are other priorities which take place.
I have also observed the catheter being full, requiring a jug to empty it intra-operatively, and the other day the catheter had not drained anything after 1.5hrs into the case.
There are a number of reasons why the urine was not draining, this is for another blog, however my main concern is, who should be responsible for observing and monitoring urine output intra-operatively, or is it a collective level of responsibility?