The following make acceptableed pra...

The following make acceptableed practices have been developed by dint of the AORN Recommended Practices Committee and have been approved from the AORN Board of Directors. They were instanted as proposed recommended practices for remark by members and others. They are effective Jan 1 2001

These commended practices are intended as achievable recommendations representing what is believed to be an optimal horizontal of practice. Policies and deeds will reflect variations in practice settings and/or clinical situations that determine the order to which the recommended practices can be implemented.

AORN recognizes the numerous exemplars of settings in which perioperative cherishs practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative or other invasive operations may be performed.

Purpose: These commended practices provide guidelines for positioning the patient in the perioperative setting. They are not intended to guard aspects of perioperative patient care addressed in other commited practices. The patient's position should provide optimum prospect for the procedure and access to IV lines and monitoring devices. Attention must be given to patient comfort and safety, as well as circulatory, respiratory, musculoskeletal, and neurologic make The procedure, surgeon preference, and patient condition determine equipment used for positioning. Working as a member of the team, the perioperative succor can minimize the risk of perioperative complications related to positioning.

commended PRACTICE I

Preoperative assessment for positioning exigencys should be made before transferring the patient to the operation bed.

1. The preoperative interview should include questions to determine patient tolerance to the planned position. Assessment includes the pair patient and intraoperative factors. Patient factors include, unless are not limited to,

* age,

* height and weight,

* skin condition,

* nutritional status,

* preexisting conditions (eg vascular, respiratory, circulatory, neurologic, immunocompromise), and

* physical/mobility limits (eg prostheses, implants, range of motion).

Intraoperative factors include, nevertheless are not limited to,

* anesthesia,

* extent of surgery, and

* position required.

Preplanning is necessary to make secure that the appropriate positioning devices and an adequate number of personnel are available to position the patient onward the procedure bed. Positioning requires knowledge and understanding of the physiologic events and implications of the position in relation to the patient's assessed status and limitations.(1) Patient injury (eg scorchs nerve damage, pressure ulcers, alopecia) can meet the eye as normal defense mechanisms are altered befitting to anesthetic agents and medications, as well as forced lengthened immobility during the procedure.(2)

2 The perioperative succor should actively participate in safely positioning the patient. Safe and appropriate positioning requires teamwork. Communicating specific patient destitutions to surgical team members contributes to safe positioning. Safely positioning the patient is a priority of perioperative cherishs Outcomes of safe and appropriate positioning may include

* optimal front of the surgical site;

* airway management, ventilation, and monitoring access for the anesthesia care provider;

* physiologic safety for the patient; and

* maintenance of patient dignity on controlling unnecessary exposure.(3)

make acceptableed PRACTICE II

Positioning devices should be readily available, clean, and in meet working order before placing the patient upon the procedure bed.

1 Equipment should be maintained and used according to manufacturers' written instructions. Equipment function should be verified before use. strictly functioning equipment and devices contribute to patient safety and assist in providing adequate exposing of the surgical site.(4)

2 Positioning devices should be provided for each surgical position and its variations. These devices include padding and influence relief devices. Firm and stable devices help distribute crushing evenly and decrease the potential for injury. Anatomic and physical limitations will dictate the archetypes of positioning devices that can be used for any individual patient.(5)

3 Personnel should be familiar with the special function and use of positioning equipment and devices. The appropriate device(s) should be exquisiteed to achieve the desired general intent Excessive stretching of neuromuscular and vascular fabrics should be avoided. Selection criteria for positioning equipment and devices include, if it were not that are not limited to,

* availability in a variety of appropriate sizes and shapes;

* durable material and design;

* ability to maintain normal capillary interface pressure;

* resistance to moisture and microorganisms;