Why Do I Need Preference Cards?

A preference card is one of the common universal features in any OR setting. Whether it is a large hospital or a two-room ambulatory surgery center, preference cards will be a common theme. A preference card is a source of information that will vary among procedures, surgeons, and facilities. It benefits everyone working in the OR setting to have current and updated preference cards.
 
Preference cards not only assist individuals new to the OR, but also individuals working casual, per diem, travel, or float pool. A nurse may be reassigned for a shift to a different OR due to staffing changes. It may have been months since this nurse has worked with a specific surgeon. The preference card will assist them by providing specific information on the scheduled surgery and needed supplies.

Features

The most common features of a preference card are the name of the surgeon and procedure. Beyond this, preference cards have a variety of formats and different levels of information. Each facility will have its own format. Some preference cards are attached to the supply and patient charges list while others are kept separate. Some are built into the electronic medical record while others are paper. And some may list each instrument on a tray or the radio channel a surgeon wants during a case. No limit exists to what may be found on a preference card.

Purpose

The purpose of the preference card is to act as a guide for the surgical case. A preference card may be specific to a single case, such as “Dr. Jones: Laparoscopic Cholecystectomy,” or it may serve as a general guide for several cases, such as “Dr. Smith: Excision of Lesion.” It is with the second example where changes may occur in terms of the lesion location and types of supplies needed. However, the same basic surgery supplies, such as a sterile table cover, sterile gowns, and sterile gloves, will remain the core of the list. The changes may be the type of suture or sterile drapes, or the positioning of the patient for the procedure.

How They Help

Preference cards are a help when the information is up to date and correct. They can be a hindrance, however, when they contain incorrect information or when incorrect ones are used. When preference cards are a hindrance, there will be a loss of resources in terms of time and supplies. Extra time is needed to gather supplies during a case and extra supplies may have needlessly been opened due to an incorrect or outdated preference card. The following is a real-life example of a time a preference card was a hindrance:

• The surgeon scheduled a skin grafting procedure and supplies and items were selected according to the preference card.
• The scheduled patient was brought to the OR, given general anesthesia, and intubated.
• The selected graft area and placement site were prepped and draped.
• The surgeon asked for the graft shaver device to obtain the autograft and then the “mesher” device (ie, a device used to create a mesh-type pattern on skin grafts).
• The “mesher” device was not on the preference card and was not available in the building because it was a loaner device brought in by a company representative.
• In this case, the patient needed to return to the OR the following day to complete the procedure and have a second autograft site.
• Because the preference card was not up to date, there was a loss of time and supplies, and patient safety was negatively affected.

Tips

In the event a preference card needs an update, the charge nurse, nurse supervisor, or person in charge of preference cards should be notified with the correct information. Because some facilities may have preset or preformatted preference cards with limited capabilities for restructuring or adding additional information (eg, check boxes, line items), it can be helpful to keep a personal preference card listing of the additional items and supplies needed. Some nurses use index cards with binder rings for personal reference for specific cases, whereas other nurses use note apps on their mobile phones.