Through a 2012 audit, Hanford, Calif.-based Central Valley Network, part of Roseville, Calif.-based Adventist Health, found compliance with safe surgical attire protocols were low, and then took action to improve them.
Their process was detailed in the Association of periOperative Registered Nurses' Periop Insider newsletter.
A six-month audit period uncovered the following common surgical attire errors:
- Incorrect head covering
- Jackets unavailable, in the wrong size or removed while on shift
- Jewelry not removed
- Masks worn under the chin outside of the practice area
- Scrubs worn outside the facility
After altering surgical attire inventory to address those deficiencies, Central Valley Network also took a strategic approach to instill best practices with the staff.
"We knew we needed to take a bold approach that really put safe attire practices directly in front of every team member in a very visual way, while also driving home the evidence behind the practices," Cheryl Curcin, BSN, Central Valley Networks' clinical education coordinator for perioperative services, told AORN.
They did so with a three-pronged approach:
1. Using a well-respected physician champion who models safe operating room practices and is a known leader who is concerned about safety. Central Valley Network chose an orthopedic surgeon who was chief of staff at the time. "In my OR, if someone sees something that is not right, I want them to speak up because everyone is on the same team and we all have an equal responsibility to feel comfortable speaking up; we also have an equal responsibility to listen when a team member voices a concern," Lancy Allyn, MD, the surgeon in question, told AORN.
2. Using visual cues to encourage correct attire. Central Valley Network's marketing team collaborated to create a life-size poster of Dr. Allyn wearing correct attire that bore the heading, "Are you ready to cross the red line?" The team also created another poster with Dr. Allyn in scrubs in the parking lot. Designed to look like a "Wanted" poster, it served as a reminder that the practice didn't fit protocols. Those posters were posted by every major exit at the facility.
3. Tailoring educational material and training for front-line staff and leadership so everyone's roles were clear. Central Valley Network also regularly updates the education and reminds new staff of policies.