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and pressure, and/or administration of medication.

but should be performed under strict aseptic technique.

Positive patient identification is required prior to performing the

procedure/labeling. Refer to Corporate Policy (00.PAT.80)

Patient Identification: Inpatient/Outpatient.

1. Povidone-iodine prep solution

2. 4 x 4s

3. Bandaids

4. Alcohol wipes

5. Local anesthetic

6. Medication to be injected if indicated

7. Linen-saver pads

8. Sterile hemostat and/or dressing set

9. Ace bandage, 4-inch or 6-inch, depending on joint to be

aspirated, if ordered

10. Sterile syringes:

2—3 ½ cc

1—5 cc

1—20 cc

11. Sterile needles:

2—23-gauge, 1 ½ inch

2—21-gauge, 1 ½ inch

2—19-gauge, 1 ½ inch

12. Appropriate lab slips

13. Patient labels

14. Optional, but recommended:

a. 1 pair sterile drapes

b. 2 sterile drapes

2. Perform a “time-out” per Hospital Policy (00.PAT.79) to reverify

correct patient, procedure, and site. Document the

“time-out” on section 2A of the Pre-Procedure

Checklist/Moderate Sedation Record..

3. Position the patient according to the joint to be aspirated.

4. Set up sterile field with assembled equipment.

5. Draw up dosage of medication as ordered.

6. Assist the physician as necessary.

7. Identify the specimen containers with the patient’s ID label.

8. Enter appropriate information on SCM to obtain a

laboratory requisition for the ordered tests.

9. Apply direct pressure to the site for five (5) minutes. Then

apply 2 x 2 dressing, bandaid, or Ace bandage as ordered.

10. Positioning patient:

a. If the procedure is performed in bed, reposition the

patient with side rails up and call light within reach.

b. If the treatment room is utilized, assist the patient

off the table to the wheelchair or stretcher and

return to room. Reposition the patient with side

rails up and call light within reach.

c. In either situation, instruct the patient to notify the

nurse if increased pain, redness, or swelling

occurs.

11. Clean equipment per hospital policy.

12. Deliver appropriately marked specimens (date/time and the

collectors initials on the label, or the witnessing nurse) with

requisitions to the laboratory.

13. Teach patient to report any signs and symptoms (i.e.,

bleeding, increased pressure, increased pain or swelling).

performed, by whom, color and amount of fluid obtained,

that specimens were obtained and sent to the laboratory for

tests ordered, how the patient tolerated procedure, the

condition of aspiration site, and any other pertinent

information. Include patient teaching (cover signs and

symptoms such as bleeding, increased pressure, increased

pain or swelling).

2. SCM I&O Flowsheet: If the patient is on Intake and Output,

document the amounts of fluid obtained as output.

3. Medication Administration Record (MAR): For drug

therapy, specify the product, dosage, time, and type of

medication given.

Fourth Edition. Lippincott, Williams and Wilkins. Philadelphia:

PA..

SMHCS Corporate Policy. (00.PAT.79). Correct Patient,

Procedure, and Site Verification. (2006). SMH: Author.

SMHCS Corporate Policy. (00.PAT.80). Patient Identification:

Inpatient/Outpatient. (2006). SMH: Author.

Sharon Carniato, RN, HBSCN, ONC, Clinical Practice

Specialist, Orthopedics