Preoperative

Transfer After Clipping

Patient Operating Room Environment Prep Technician Anesthetist

Clinical Objective

Ensure that the clipped and prepared patient is transported to the operating room without recontamination of the surgical site. Clean transport surfaces, a designated clean pathway, and avoidance of floor contact preserve the antiseptic integrity achieved during skin preparation. This brief transit phase represents a high-risk moment when contamination can silently occur before surgery begins.

Why This Matters

Recontamination during transfer is common and underappreciated. Organisms acquired from a gurney surface, floor contact, or ungloved handling during transport can subsequently be dragged across the surgical field during final prep. Treating transfer as a formal aseptic step — not just patient movement — is essential.

Critical Control Points

Use only a clean, disinfected transport surface after clipping is complete
Prevent the patient or surgical limb from contacting the floor at any point
Use a direct, clean route from prep area to OR
Minimize number of staff handling the patient during transfer
Confirm OR is ready before initiating transfer to avoid holding the patient in a corridor

Transfer Readiness: Go / No-Go

Verify all conditions before moving the prepped patient. Any 'No-Go' condition must be resolved before transfer begins.

Go Conditions

OR table is clean and set up

Confirm with circulating staff before leaving prep area

Transport gurney has been disinfected

Verify since last patient use

Clean route to OR is clear

Avoid active procedure corridors

Designated handler assigned for limb protection

One person responsible throughout transfer

Protective covering available if transit > 60 seconds

Sterile towel or wrap

No-Go Conditions — Resolve Before Transfer

OR not ready or still being cleaned

Wait — do not hold patient in corridor

Transport surface not cleaned since last patient

Disinfect and allow contact time

No handler available to protect surgical limb

Assign before moving

Patient is agitated and at risk of self-contamination

Ensure adequate sedation or restraint

⚠ Corridor Hold Prohibited

Never hold a prepped patient in a shared corridor while waiting for the OR. Return to the prep area if OR is not ready.

Step-by-Step Protocol

1
Confirm OR readiness before beginning transfer — do not hold a prepped patient in a hallway
2
Place the patient on a clean, freshly disinfected gurney or transfer surface
3
Wrap or cover the prepped surgical site loosely with a sterile towel if transit is more than 60 seconds
4
Carry or lift distal limbs — do not allow them to dangle and contact surfaces or floors
5
Use a designated clean corridor or route; avoid shared high-traffic areas when possible
6
Minimize personnel involved in transfer; one handler guides limb protection throughout
7
On arrival to OR, confirm patient positioning before removing any protective covering

Key Pitfalls

Allowing the surgical limb to contact the gurney side, wheel, or floor during transfer
Transferring the patient before the OR is fully set up, requiring waiting in the corridor
Using the same gurney for both dirty and clean patients without disinfection
Excessive personnel clustered around the patient during transfer creating turbulence near the prepared site
Removing the protective covering prematurely before the patient is positioned on the table

What Actually Matters

Transfer is one of the most neglected steps in surgical prep — teams focus on what happens in the OR and forget that a 30-second gurney ride on an unwashed surface can undo meticulous antisepsis.