All materials for a procedure are not gathered in advance. The temptation to improvise with inappropriate materials often results in an injury.

Gather all essential instruments and materials in advance. Ensure auxiliary materials are at least available.

The surgical tray is disorganized. Sharps can be hidden.

Keep the tray organized, with sharps easily visualized.

Instruments are placed on the tray inside their packaging. Wrappers are not sterile and can clutter the tray. Wrapped instruments are not available for immediate use and can slow the operator.

All items on the tray should be unwrapped and ready for use before beginning a procedure. Where possible, do not leave wrappers on the tray; if wrappers must be left on the tray, designate an area of the tray for them, preferably away from any sharps.

Force is used to activate or open a device such as a cap, needle, or blade. Injury from a sudden “give” often occurs.

If a device (e.g., syringe, needle, or disposable blade) becomes stuck, do not use force. Discard the entire device and its contents. Draw up new material with fresh devices if needed.

Stock bottles are not handled properly: (a) by double dipping, (b) when they are left on a contaminated Mayo stand, (c) when they are left open for long periods of time, or (d) when open near a sink.