Archive January 2020 XXI, No. 1

Ideas That Work: 12-Step Process

Countdown to Room Setup

Natalie Stewart-Mast, BSN, RN
HANDS OF TIME The OR clock is a 12-step process that ensures nurses have completed all necessary tasks in order to safely and effectively start the case.

In the rush to start the next case, it’s easy for staff to skip steps when turning over and setting up a room. To make sure our nurses and techs complete all the necessary steps before they get the next patient, I developed (and illustrated!) this OR clock that hangs in all 18 of our ORs and helps orient new staff here at Vanderbilt Children’s Hospital. It took me a year to nail down all aspects of a proper room setup — not just what should happen, but also the order in which it should happen, all the while minimizing the time the circulator will be away from the patient’s bedside during induction. The 12-station checklist covers everything you need to ready a room in a safe and orderly fashion. In case you can’t read my handwriting, here’s what each hand on the OR Clock signifies:

LIKE CLOCKWORK Natalie Stewart-Mast, BSN, RN, stands before her OR Clock poster at the AORN Global Surgical Conference & Expo.

12 Is your bed ready to receive your patient?
1 Have you spoken with anesthesia?
2 Do you need your boom set up for your case start, do you need lead?
3 Have you communicated with your surgeon?
4 Have you started all necessary programs for your case?
5 Did you pull necessary supplies from the core, including drugs?
6 Is your case cart completed and in the room with necessary pans included?
7 Do you have all the necessary equipment in the room, and is it oriented appropriately for your case?
8 Help your scrub or first assistant open for the case.
9 Have you discussed with your scrub if they are ready to bring the patient back?
10 Do you have your positioning aids close and available for your case start? Did you turn on your Bovie machine, and is your suction hooked up and ready to attach to the field?
11 If you’ve completed all these steps, then your room is properly set up and you’re ready to go!

Natalie Stewart-Mast, BSN, RN
Monroe Carell Jr. Children's Hospital at Vanderbilt
Nashville, Tenn.

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