OT Nsg.pptx

Ot nursing and roles

1. OPERATION THEATRES NURSING Ms Shiwani Sah

2. Surgical Team :

3. Patient Surgeon Anesthesiologist or anesthetist Operation room nurses OT supervisor OT sister incharge Scrub nurse Circulatory nurse Recovery room nurses Anesthetic nurses 5) Medical students 6) attendants, cleaner, dhobi 7) OT technicians

4. OBJECTIVES OF OT MANAGEMENT: To provide safe therapeutic environment for patient and staff. To maintain asepsis and to maintain this technique during all surgical procedure. To provide best team support to the anesthesiologist, surgeoms and oher junior coworkers To ensure and maintain all equipment drugs updated ad replace timely. To develop the habit of economy regarding equipments , medicines and time.

5. To understand operative procedures and their significance to the patient and his well being or recovery. To provide adequate gown,mask , slippers for all staffs,doctors,medical and nursing students. To practice good personal health habits. To understand the value of recording and reporting. To understand some of emergency operations which may arise in OT and to know own responsibility in this situation.

6. MANAGEMENT OF OT: To maintain cleanliness of OT all the time. Anybody entering OT should be clean and should wear washed clean gown , cap and mask. Room temp should be maintain evenly. Aseptic technique should be maintained strictly during all procedures. Recording and reporting of each operation Cleaning ,drying , and replacement of all the instruments. Sterilization of instrument and make ready for operation next day. Keeping the OT safe and prevent from any possible accidents.

7. Special management of The patient The nurse and surgeons Instruments Dressing Rubber gloves Catheter , drains and drainage tubes Ligatures Syringes The operation table Apparatus Anesthesia

8. QUALITIES OF OT NURSE Rapidly working power often under tension. Follow the direction quickly and accurately Can cope in any situation calmly, quiety and efficiently. Alert in observation and have knowledge on imagination integrity to read the surgeons mind. Interested in the provision of goal meeting. Organizes the work effectively Follow the rules and regulation rigidly Patience in all the time Must be able to provide confidence and reassurance. Must be able to work on-calls turn by turn.

9. SCRUB NURSE: The scrub nurse scrubs the hand, war surgical attire (dress), arrange the necessary instrument for the particular procedure & provide the surgical instrument to surgeon during a phase or steps of surgery. The scrub nurse must know the type of operation to be performed

10. Scrub nurse responsibilities Before Operation : The scrub nurse scrubs up carefully, covers her/his operating theatre clothing with a sterile gown & hand with sterile gloves. She should scrub at least 10 minutes before the surgeon scrubs. The scrub nurse is responsible for selecting, setting, checking & arranging instruments required on the instrument table so that they are rapidly accessible. Place knife blades on handles. Check suture & needles. Know the kinds of sutures generally used by each surgeon to avoid unnecessary delay in procedure. Have sutures ready set out the sutures in advance & ready one or two sutures a head of the surgeon to avoid delay.

11. She/he is responsible for counting with circulating nurse for all instruments, needles & sponges before starting any operations & before any cavity is closed & must inform the surgeon that item are correct even though he may not asked. Cover the sterile articles on the sterile table with a sterile towel until the pt. is anaesthetized & the surgeon is ready to drape the operating field.

12. During Operation: Initially assist with draping & check whether draping is adequate. Arrange & secure necessary items on the operation table. Supply the instruments & other articles to the surgeon & assisting by observing the operative procedure. A good scrub nurse will learn to anticipate a surgeon's needs often having instruments ready being asked for it. Keep field neat tidy & dry.

13. It is his/her duty to prepare the ligature & sutures having them ready immediately when he may not asked. Check the articles before use & immediately after use especially materials which are liable to get in disorder or inside the abdomen at any time, e.g., suction tips, suture needles, forceps etc. Observe the colour of the blood oozing from the pt. to note any lack of oxygen & if any, it should be reported to the surgeon & anesthetist because any amount of observation will do only good to the pt. even though it is the responsibility of the anesthetist.

14. Do last count together with circulating nurse & notify the surgeon that count is correct (or not) even he may not ask about it. Prepare suture for wound closure. Prepare dressing for covering the wound. Cover the wound & secure it properly.

15. After operation: Care of instrument & disposal of sharps as per hospital regelation . Care of rubber goods. Remove blades from scalpel handle for cleaning. Care of specimen (tissues biopsy) to be sent to the laboratory. Decontaminate the used articles.

16. Proper disposal of different types of waste products from the operation. Disposal of sharps Disposal of infectious materials Disposal of blood & body fluids Disposal of remaining suture & needles etc as per hospital regulation. Handed over the pt. to post operative nurse. Guide & supervise the cleaner about cleaning &sterilization of the instrument.

17. CIRCULATORY NURSE The circulatory nurse is an assistant to scrub nurse, surgeon, anesthetic or whole surgical team & is not requiring wearing sterile attire.

18. Responsibilities of circulating nurse. Before operation: Preparation of operation room unit clean & tidy, check whether all equipment's is ready for operation, adequate light & basic supplies must be in the room. Co-coordinating the entire team. Assist the scrub nurse with gowning, gloving, handling over sterile package & solutions etc. Count sponge needles & instruments card, verifying consent & necessary items needed for surgery. Keep pt. in proper position.

19. Assist with the preparation of the pt.'s operation area (clean with soft water or paint with antiseptic) or necessarily. Check the skins for cuts, abrasion infections or skin lesions. Adjust the buckets to receive the discarded sponges. Attach the suction apparatus & see that it is in working condition & assist the anesthetist when required. She should have the ability to anticipate the needs of that situation. She/he is responsible for positioning things according to site of the operation. She/he is responsible for cautery plates & focus of the operating light to the site of operation.

20. During operation: Keep checking all the equipment's that are in good working conditions. Keep room clean & tidy. Regulate the temp of the room as necessary. Maintain accurate records of sponges, needles, instruments with the scrubnurse , count to them before operation & before closing the cavity being operated on & closing of skin incision.

21. Replace saline or water in basins as necessary, near the surgeon, instruments nurse & assistant doctor. Retrieve instruments, etc. which accidentally fall from the table. Complete necessary forms used in surgery eg , operation form, and sponge counting records form, tissue specimen special reports form & forms for incidents / accidents if it occurs. She should be alert & respond to any happening in the operation room. The circulatory nurse monitors the patient & documents specific activities throughout the operation to ensure the pt's safety & well-being, monitors aseptic technique.

22. Prepares adhesive plaster, scissors, binder or bandage for securing the dressing following the wound closure. She/he should stays in the OT watching the scrub nurse & ready to bring any thing she required. After finishing the last count she/ he should prepare trolleys & the instruments for the next operation (case).

23. After Operation: Assist in securing dressing; fix dressing with tape. See that the pt. is safely transferred to the recovery room after operation. Make sure that the operating tables are clean with virex solution after each operation. Care of drains, catheter, IV line etc. Care of specimen eg , level the specimen & send it to lab. Assist with general cleaning & preparation of the operation room for the next operation. Proper disposal of surgical wastes eg , sharp objects needles, blades.

24. THANK YOU