Procedure-Specific Planning

Clinical Objective

Confirm that all case-specific materials, resources, and logistical decisions are in place before the patient enters the OR — so that nothing required intraoperatively is sourced under pressure or improvised in conditions that compromise sterile technique.

Why This Matters

Improvisation during surgery is a contamination risk. Rushing to locate a missing implant size, sourcing a last-minute wound dressing, or discovering lavage materials are not stocked forces decisions under time pressure and increases the likelihood of breaks in sterile technique. Procedure-specific planning eliminates these scenarios before they occur. Each element of this checklist exists because its absence has, in practice, forced a compromise during a case.

Critical Control Points

• Planning completed the day prior — not on the morning of surgery

• Surgeon and scrub technician both confirm readiness before the case begins

• Any missing item identified here triggers a supply resolution — not an intraoperative workaround

• Lavage materials confirmed as part of routine planning — not reserved for high-risk cases only

Planning Checklist

Complete for every case the day prior. Flag any unresolved items before proceeding.

Case Parameters

Record the following before the case begins. These inform intraoperative decisions including prophylaxis redosing.

Step-by-Step Protocol

1. 1

   Review the procedure plan the day prior. Confirm implant set selection based on patient size, anatomy, and surgical approach.

2. 2

   Identify a backup implant plan. Document the alternative construct or size range.

3. 3

   Estimate expected operative duration. Flag cases projected beyond 90 minutes for elevated risk tier review and redosing planning.

4. 4

   Confirm imaging availability. Preload preoperative radiographs; confirm fluoroscopy if indicated.

5. 5

   Confirm lavage materials are stocked for this case. Do not assume availability — verify.

6. 6

   Select wound dressing appropriate to procedure type, location, and patient risk tier.

7. 7

   Confirm postoperative protection strategy. Ensure client communication is planned before discharge.

8. 8

   Surgeon and scrub technician jointly confirm readiness at the pre-case briefing.

Key Pitfalls

• No backup implant plan — a single missing size becomes an intraoperative crisis that forces a sterility compromise.

• Lavage materials treated as optional or sourced on the day of surgery rather than planned in advance.

• Wound dressing selected intraoperatively rather than planned based on the procedure type and risk tier.

• Postoperative protection not communicated to the client until discharge — too late for effective preparation.