Description: Clinical issue: Would standardizing the back table setup lead to an improvement in instrument set integrity and improve verbal communication to enhance patient and staff safety? Team members included:Perioperative nursesSurgical scrub techniciansSterile Processing personnel (SPD)ManagementPreparation and planning:began with focusing on the intra-operative back table setups. Their differences depended on instrument sets needed, scrub personnel preference, and personnel training in the operating room. We then reviewed current practice of instrumentation inspection, as well as, intraoperative cleaning of instrumentation. This practice was compared to the SPD workload. review of literature regarding organized workflow strategies and its effect on work quality was the primary focus.
Assessment: Developed a standardized back table setup to be used for a majority of surgical proceduresAn intraoperative standardization was implemented that focused on inspecting and cleaning of instrumentationA strategy for effective handoff communication between scrub personnel and team members reflecting safe practice was simplifiedImplementation:Conducted workflow analysis to assess and redesign existing back table setupDesigned simplified standard back table setup with operating room and SPD staffDeveloped visual handout with clear language and images of standardized workflow for staff reference, along with video graphics showing desired setup standards in employee break roomMeasured/monitored compliance with daily audits in the OR and SPDEducated operating room staff on the importance of the standardized setup to create a buy in to the practice changeOutcome:Standardized back table setup and situational awareness promoted a safer environmentDecreased number of interruptions associated with instrument set inconsistenciesScrub personnel were more efficient and focused in their workflow Transition of care communication was enhanced and more effectiveImplications for Perioperative Nursing:The simplicity of a standardized back table setup provides an environment for the care team to be focused on patient and individual safetyThe entire process spotlighted engaging employees and increased ownership of safe quality patient care