After the overwhelming success of their 100,000 Lives Campaign, the Institute for Healthcare Improvement has launched the expanded 5 million lives campaign. The campaign is attempting to protect patients from five million incidents of medical harm over a 24-month period, ending December 9, 2008. The number of initiatives has been expanded to twelve, including:

Prevent Pressure Ulcers Reduce Methicillin-Resistant Staphylococcus aureus (MRSA) Infection Prevent Harm from High-Alert Medications Reduce Surgical Complications Deliver Reliable, Evidence-Based Care for Congestive Heart Failure Get Boards on Board

Deploy Rapid Response Teams Prevent Adverse Drug Events (Medication Reconciliation) Improve Care for Acute Myocardial Infarction Prevent Surgical Site Infections Prevent Central Line-Associated Bloodstream Infections Prevent Ventilator-Associated Pneumonia

The following are excerpts from AORN’s recommended practices for positioning the patient in the perioperative practice setting.

Recommendation IV
During the preoperative assessment, the perioperative registered nurse should identify unique patient considerations that require additional precautions for procedure-specific positioning.


Recommendation VI
Potential hazards associated with patient transport and transfer activities should be identified, and safe practices should be established.


Recommendation VIII
The perioperative registered nurse should actively participate in safely positioning the patient under the direction of and in collaboration with the surgeon and anesthesia provider.


Recommendation IX
After positioning the patient, the perioperative registered nurse should assess the patient’s body alignment, tissue perfusion, and skin integrity.


Recommendation X
The perioperative registered nurse should collaborate with the postoperative patient caregiver to identify patient injury due to intraoperative positioning.