Perioperative Nursing 101 Skills Lab Checklist

Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Skills Lab #1
Skills Lab #1 Skills Stations and Scavenger Hunt Checklist (student handout)

Ice Breaker
Quick introductions + tell us your most memorable moment in an OR to date (either
as a healthcare professional or as a patient).

Opening sterile items to the field

Check for expiration date
Awkward items tips and tricks (opening catheters, floppy items,
awkwardly peel packed items, etc)
Pointers on handing things off to your Surgical Tech
Open at least 5 sutures to the field.
Open 2 pairs of gloves to the field.
Open 2 large items to the field.
Open items standing an appropriate distance from the field, not
contaminating the field, compensating appropriately for dropped items
(always bring 2).

Giving Medications to the sterile field

Always wipe top of medication bottle with alcohol swab
Always draw up medications with syringe and fill needle, then decant
into cup on sterile field without contaminating (practice)
How to add medication to saline bag using clean technique
Decanting medication using pour spout (from bag)
Special considerations: Isosulfan blue, frozen implants, frozen
hemostatic agents

Opening sterile trays to the field

ALWAYS check ALL filters before setting it down on a sterile field.
Check wrappers for small holes (hands on demo and return demo with
wrappers)

SPD Tour
Tips on interacting with SPD staff
Review of IUSS protocol (best to never utilize unless no other option)
Scavenger hunt
Identify prepped surgical carts and various service line packs.
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Surgical Scrub:
Water (5 minute scrub)
Waterless

Gowning
Gowning Assisted (put on gown assisted, assist colleague with gowning;
also practice non sterile person role of turning and tying back of gown)
Gloving Assisted (put on sterile gloves with assistance, and assist
colleague with putting on gloves)

Gloving
Open Sterile gloves to field
Closed Gloving without contaminating (must have gown on) (3
repetitions each)

Trays and packs

Major Tray open, check, and count soft goods and write tally on board
Able to detect missing soft good during count
Open a basin/pack.
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Skills Lab #2
Icebreaker
What advocacy opportunities have you observed during your precepted shifts?
What practices have you observed during your precepted shifts that are different
from what you’re learning in this course and in your AORN modules?

Review
Opening sterile items to the field
Check for expiration date
Awkward items tips and tricks (opening catheters, floppy items,
awkwardly peel packed items, etc)
Pointers on handing things off to your Surgical Tech
Open at least 5 sutures to the field.
Open 2 pairs of gloves to the field.
Open 2 large items to the field.

Scenarios
Review entering room and preparing for first case of the day (return
demonstration, damp dusting, proper room inspection)
Review patient interview (return demo in pairs)
Review Circulating Nurse roles as the final checkpoint before patient
proceeds to OR
Review electro cautery safety considerations, grounding pad placement

Review assisting anesthesia with intubation (in groups of 3)

Cricothyroid pressure
Review assisting anesthesia with complicated intubation (what is nurse’s
role, review advocacy responsibilities and chain of command protocol)
Review Malignant Hyperthermia protocol and location of MH supplies in
your hospital (we will go into this in depth later in the course; for now just do a
brief overview).

Patient positioning
Verbalize importance of having everything in the room before patient arrives.
Padding options
Head, neck, back, hips, knees, arms, heels

Length of procedure
Type of anesthesia
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Ergonomic positioning basics

How to attach arm boards to table
How to move and adjust arm boards on table (up and down, side to
side)
How to align table for C-Arm accommodation, type of case, etc
How to break table
How to manually lock/unlock table if remote is not functioning
How to position table (practice airplaning safely, sitting up,
Trendelenburg, Reverse Trendelenburg, slide forward and backwards)
Verbalize weight restrictions based on table position (how can you tell?)

Restraint options
Types of restraints (useable, reusable)
Safe application of restraints (padding, 2 fingers worth of space
between patient and strap)
Arm, Leg, Body
Pink Pads (how to safely reposition)

Patient Transfer
Glide sheets/hovermats safety and basic usage (transfer from gurney to
table and back)
Backboard transfer (transfer from gurney to table and back)
Wound consideration when transferring post procedure
Consideration for mobility issues with injured/contracted patients

Supine position, arms out

Appropriate positioning, padding (as patient and as RN)
Repeat x 2 as RN, then switch to patient role at least once
Timed positioning as a group (who is most thorough and efficient
under time pressure?)
Supine position, arms tucked
Appropriate positioning, padding (as patient and as RN)
Double draw sheet technique for arm tuck
“Thumbs up” position to ensure ergonomically placed arms
Repeat x 2 as RN, then switch to patient role at least once

Timed positioning as a group (who is most thorough and efficient

under time pressure?)
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Tourniquet application
Upper arm
Upper leg
Safety precautions
Padding, initial placement, prepping concerns, waterproofing
Contraindications for tourniquet use
Charting tips / Advocacy tips for Circulating RN for when surgical team
does not take recommended breaks to reperfuse limb
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Skills Lab #3

Review
Opening sterile items to the field
Check for expiration date
Awkward items tips and tricks (opening catheters, floppy items,
awkwardly peel packed items, etc)
Open at least 5 sutures to the field.

Patient Transfer
Glide sheets/hovermats safety and basic usage (transfer from gurney
to table and back)
Backboard transfer (transfer from gurney to table and back)
Wound consideration when transferring post procedure
Consideration for mobility issues with injured/contracted
patients

Patient Positioning
Prone, arms tucked
Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
Anesthesia considerations.
Practice positioning x 2, then serve as patient at least once
Prone, arms out
Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
Anesthesia considerations
Practice positioning x 2, then serve as patient at least once

Lateral, right (from supine)

Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
Axillary support
Anesthesia considerations
Practice positioning x 2, then serve as patient at least once

Lateral, left (from supine)

Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Axillary support
Anesthesia considerations
Practice positioning x 2, then serve as patient at least once (note
difference in feeling with and without axillary support)

Scenarios
Timed scenarios, two groups at a time position from gurney in
Prone, arms tucked
Prone, arms out
Lateral, left
Lateral, right
Evaluated on speed, safety, efficiency, and appropriateness of padding
and restraint application. If group is advanced, add in positioning considerations
such as open wounds, contractures, mobility limitations, etc.,

Surgical Site Preparation

Hair removal considerations (least amount possible)
How to determine necessary hair removal (groin, axillary region, head,
abdomen)
Safest way to remove hair
WHERE to remove hair (outside of OR)
What if you MUST remove hair in OR (how to minimize contamination)?

Fire in the OR
Role of Circulating RN in fire prevention
Tips/best practices for fire prevention
Sterile water ready in room at all times
60 ML syringe of sterile water/saline for airway fire response if
indicated
No pooled prep solution
Cautery pencil holster always utilized
All cords for equipment in good repair
Special considerations for head/neck/airway procedures
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)

Skills Lab #4

Icebreaker
How does each member of your surgical team impact the mood and flow of the case
and room? What impact do you as a Circulating RN have on the case in progress?

Review
Surgical Site Preparation
Hair removal considerations (least amount possible)
How to determine necessary hair removal (groin, axillary region, head,
abdomen)
Safest way to remove hair
WHERE to remove hair (outside of OR)
What if you MUST remove hair in OR (how to minimize
contamination)?

Review of Universal Protocol/ Procedure Timeout / Closing Count

Patient Positioning
Semi-fowler’s / beach chair
Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
Anesthesia considerations
Practice positioning x 2, then serve as patient at least once

Lithotomy
Ergonomic considerations for head, face, eyes, arms, hands, chest, hips,
pelvic region, knees, toes, restraints
Proper alignment of knees and shoulders
Anesthesia considerations
Practice positioning x 2, then serve as patient at least once

Surgical Site Preparation

Arm and hand, circumferentially
Trauma considerations when holding limb
Mobility and body habitus considerations for bariatric/contracted
patients
Ergonomic considerations for RN
 Perioperative Nursing 101 Skills Lab Checklist
Dates for Spring 2023: Saturday, Feb 11, Mar 4, Apr 1, Apr 29, 2023 (0745-1200)
How to ask for and manage positioning/prepping assistance
Appropriate timing for prepping during ortho cases
Open wound considerations

Leg and foot, circumferentially

Trauma considerations when holding limb
Mobility and body habitus considerations for bariatric/contracted
patients
Ergonomic considerations for RN
How to ask for and manage positioning/prepping assistance
Appropriate timing for prepping during ortho cases
Open wound considerations
Abdomen
Hair removal (review)
Bariatric considerations
Umbilicus considerations / tips for most thorough cleaning
Open wound considerations
Appropriate preparation area for open versus laparoscopic cases
Considerations for preparation above xyphoid process
Safeguards for eyes
Safeguards for ears

Considerations for pelvic preparation

NEVER prep abdomen and pelvis simultaneously
Male pelvic prep considerations
Female pelvic prep considerations
Post operative pelvic prep considerations (rinse, wipe off prep solution
to avoid skin irritation)

Considerations for challenging equipment

Hana table review (ask anesthesia tech to open equipment room)
Boot placement, padding, alignment, movement, positioning,
transfer considerations
ESWL Table considerations
LASER safety considerations for staff and patients

Review: Nurse as advocate, charting considerations for case exceptions, review

questions, prepare for final exam.