Passing Specimens to a Circulator from a Sterile Field

The safe transfer of surgical specimens is a fundamental competency required across all surgical procedures to ensure that each patient receives appropriate care and accurate diagnoses. If specimens are not transferred safely, the risk of diagnostic errors increases, which puts patient safety and positive outcomes at risk. This educational video shows the steps required to transfer two types of surgical specimens safely: tissue and urine.

Specimens must be handled, transferred, and labeled properly within the perioperative environment to protect patient safety. Specimens obtained during operative procedures must be transferred from the sterile field to the circulating nurse only after verification with and permission from the surgeon. Errors occurring at any stage of this chain, whether through breach of sterility, inadequate surgeon verification, lack of permission from the surgeon, or inaccurate labeling, may result in misdiagnosis, specimen loss, or patient harm.

High-quality video instruction is an effective supplement to the textbooks and lectures that cover this material. Learners can replay segments of a video as many times as needed, stopping and starting it where appropriate to better understand the steps required to perform a specimen handoff properly.

This video demonstration is organized around four sequential steps:

1. Surgeon Verification and Permission to Handoff a Specimen

Specimens must not be passed off the sterile field without permission from the surgeon.

2. Non-Contact Bagging Technique

The specimen is placed into a specimen bag held by the circulating nurse, whose hands are cuffed beneath the bag to maintain sterility. The surgical technologist does not make contact with the outer surface of the bag. This technique is employed to preserve the integrity of the sterile field and the sterility of the surgical technologist’s gloved hand.

3. Label Verification

Following specimen transfer, the circulator and surgical technologist must verify that the information on the label is correct before the circulator may affix it to the specimen container. Four data points must be confirmed: the patient’s name, date of birth, medical record number (MRN), and the specimen type.

4. Handling of a Second Specimen

When multiple specimens are to be passed, surgeon reverification and permission for handoff must be repeated for subsequent specimens. The second specimen in this video is a urine sample. Care is taken to ensure the cap of the specimen cup has been sealed tightly prior to placement into the specimen bag to avoid spillage. Label verification by the circulator and surgical technologist is repeated using the same four-point protocol.

The importance of structured specimen management protocols in the perioperative setting is well recognized within the surgical and pathological literature.^1–3 This video aims to provide a resource to bridge the educational gap between written guidance and practical implementation. The video provides a high-quality, reproducible, educational tool that demonstrates a non-contact technique for specimen management and reinforces safe patient care through label verification.

We report no conflicts of interest, financial relationships, funding, sponsorship, equipment support, or other relationships that could be perceived to influence the content of this article.