TITLE:            GUIDELINE FOR INTRAOPERATIVE IMPLANT RECORD (MR #847) 

INSTRUCTIONS:

This form is only used when the surgical patient receives an implant(s) in the operating room.

1.  Label the space provided on all three (3) copies with the patient’s sticker.  Verify that you have the correct patient labels.

2. MANUFACTURER: Document the name of the manufacturer for the implant.

3. SIZE/TYPE: Document the type of implant and the size that is implanted.

4. CATALOG NUMBER: Document the catalog number for the implant.

5. LOT NUMBER: Document the lot number for the implant. 

6. Implant stickers with the identifying information may be used if provided.  Place a sticker on all three (3) copies of the record.

7. RN SIGNATURE: The RN who dispenses and documents the implants signs and dates the record.

8. The attending surgeon for the case signs and dates the record.

NOTE:  There will be a designated area for the physician signature on the next printing.

9. At the end of the case the copies of the record are separated.  The white (top) copy is placed in the patient’s chart under the tab “op report”.  The yellow copy is turned in at the OR Control Desk. The pink copy is placed loose in the front of the chart for the surgeon if needed.

 RESOURCE PERSON(S):            Sharon Schneider, BSN, RN, CNOR