SELF/Perioperative Nursing/Orthopedic Equipment/Psychomotor Skills Practice Instructions
Orthopedic Surgical Equipment Set Up and Assistance – Perioperative Nursing (ECSACONM)
[edit | edit source]Overview
[edit | edit source]This page provides a psychomotor skills practice guide for the setup and management of orthopedic surgical equipment, developed for perioperative nursing training under ECSACONM (East, Central and Southern Africa College of Nursing). It is intended as a self-directed developer worksheet, outlining the sequential steps, associated learning objectives ("good skills"), common errors, and practical guidance for preparing, organizing, testing, and managing orthopedic surgical equipment while supporting the surgical team.
This practice develops the skills needed to prepare, organize, test, and manage orthopedic surgical equipment while maintaining aseptic technique, supporting the surgical team, and promoting an efficient operative workflow. Perform every task exactly as you would in the operating room, handling instruments, powered equipment, implants, and external fixation components safely throughout the exercise.
A simulated operating room environment is recommended. A colleague may act as the simulated patient by lying on an operating table or similar surface with one limb positioned and draped as it would be for an orthopedic procedure. This provides a realistic setting for practicing equipment setup, sterile organization, limb positioning, draping, instrument passing, powered equipment management, and external fixation assembly.
This practice requires at least one assistant. The assistant should perform the assistant (circulator) actions described in the practice guide, including opening sterile supplies, assisting with non-sterile equipment setup, providing additional instruments or implants, participating in equipment testing, and responding to simulated requests throughout the procedure. The assistant may also introduce occasional simulated equipment problems or missing items to allow practice of troubleshooting, communication, and safe decision-making.
NB: Although no real patient is involved, perform every action as though patient safety depends on it. Verify all equipment before use, maintain an organized sterile field, communicate clearly with your assistant and the simulated surgeon, recognize and manage any simulated equipment malfunction or break in sterility promptly, and maintain implant accountability throughout the exercise.
Purpose
[edit | edit source]To guide nursing students and practitioners through a systematic, step-by-step process for setting up and managing orthopedic surgical equipment, ensuring equipment readiness and function, aseptic technique, safe limb positioning and draping, effective support of drilling and external fixation, and implant accountability throughout the procedure.
Psychomotor Skills Practice Instructions
[edit | edit source]| # | Step | Assistant Instructions | Instructions | Good Skills (Learning Objectives) | Common Errors | Guidance |
|---|---|---|---|---|---|---|
| 1 | Gather supplies | State aloud: "I confirm that all required orthopedic instruments, powered equipment, implants, external fixator components, suction and irrigation equipment, positioning devices, sterile supplies, and backup equipment are available, compatible with the planned procedure, sterile where required, functional, and organized before setup begins." | ||||
| 2 | Perform hand hygiene and don sterile gown and gloves | State aloud: "I perform surgical hand antisepsis followed by sterile gowning and gloving using aseptic technique. If contamination occurs at any point, I immediately correct it before entering the sterile field." | ||||
| 3 | Set up sterile instrument table | Assists with opening and passing sterile supplies to the scrub nurse. | Arrange instruments by function and anticipated use, place heavy instruments toward the back of the field, organize implants and fixation components by size, maintain clear visibility of all items, and ensure frequently used instruments are easily accessible. | You will be assessed on whether you can create a logical, organized sterile field that supports efficient workflow. | Cluttered field, implants mixed with instruments, poor accessibility, instruments placed randomly. | Organize the field to minimize searching and unnecessary movement during surgery. |
| 4 | Set up and test orthopedic drill | Prepares and tests the orthopedic drill system outside the sterile field. | Assemble the drill system, insert and secure the battery, select the appropriate drill bit, verify attachment security, test function before sterile use, confirm rotation direction if applicable, and verify backup equipment is available. | You will be assessed on whether you can prepare a fully functional drill system and test it before use. | Wrong drill bit, unsecured attachments, dead battery, drill malfunction discovered during the procedure. | Test equipment before it enters the sterile workflow. Always verify backup availability. |
| 5 | Prepare pins, rods, clamps, and external fixator components | Opens and passes external fixator components; remains available to assist as directed. | Organize pins, rods, clamps, and connectors by size and type, inspect components for defects, verify compatibility, stage components in anticipated order of use, and maintain sterility throughout preparation. | You will be assessed on whether you can prepare fixation components efficiently and accurately. | Missing components, incompatible parts, incorrect sizing, disorganized setup. | Keep similar components grouped together and clearly visible. |
| 6 | Load and verify suction and irrigation setup | Prepares and tests suction and irrigation equipment; remains available to assist as directed. | Connect suction tubing and irrigation components, verify flow, secure tubing to prevent disconnection, position equipment for easy access, and confirm immediate readiness before the procedure begins. | You will be assessed on whether you can prepare functional suction and irrigation systems. | Suction not tested, disconnected tubing, inadequate flow, unsecured lines. | Verify equipment function before the surgeon needs it. |
| 7 | Assist with draping and limb positioning | - | Assist with positioning the limb according to the surgical plan, maintain sterility during draping, stabilize the limb when required, protect exposed sterile areas, and ensure adequate access for fixation and imaging. | You will be assessed on whether you can support safe positioning and exposure while maintaining sterility. | Limb instability, drape contamination, inadequate exposure, poor positioning for imaging. | Positioning should support both surgical access and imaging access. |
| 8 | Assist during drilling and pin insertion | - | Anticipate required drill bits, pins, depth gauges, and accessories, pass items in functional orientation, maintain organization of the field, provide irrigation when requested, and support uninterrupted workflow. | You will be assessed on whether you can support drilling and pin insertion efficiently and safely. | Delayed instrument delivery, poor anticipation, disorganized field, disruption of workflow. | Stay one step ahead of the procedure without guessing. |
| 9 | Assist with external fixator frame assembly | - | Present rods, clamps, and connectors in the anticipated sequence, maintain organization of unused components, support efficient assembly, and verify that required components remain available throughout assembly. | You will be assessed on whether you can support frame assembly efficiently and accurately. | Wrong component provided, delayed assistance, confusion regarding assembly sequence. | Keep all remaining components organized and visible throughout assembly. |
| 10 | Maintain sterile field and organize used/unused instruments | - | Continuously maintain an organized sterile field throughout the simulated procedure. Separate used and unused instruments and implants, protect powered equipment and delicate instruments, keep the operative field organized, and immediately address any simulated contamination. | The sterile field remains organized throughout the procedure, instruments are clearly separated according to use, contamination is prevented or corrected immediately, and workflow remains efficient. | Mixing used and unused instruments, cluttered sterile field, poor instrument accountability, contamination, or delayed recognition of sterility breaches. | Regularly scan the entire sterile field—not just the instrument in your hand—to maintain organization and recognize developing problems before they interrupt the procedure. |
| 11 | Perform post-procedure management of orthopedic instruments and implants | Assists with transport and/or equipment handling. | State aloud: "After the procedure, I document all implants used, confirm implant accountability, protect orthopedic instruments and powered equipment, keep reusable instruments appropriately prepared for transport according to local policy, report any damaged or malfunctioning equipment, and communicate implant information, equipment issues, and immobilization devices during patient handoff." | |||
References
[edit | edit source]
| Authors | Ian-laurel |
|---|---|
| License | CC-BY-SA-4.0 |
| Organizations | SELF, ECSACONM |
| Cite as | Ian-laurel-1 (2026). "SELF/Perioperative Nursing/Orthopedic Equipment/Psychomotor Skills Practice Instructions". Appropedia. Retrieved July 30, 2026. |