INTRAOPERATIVE NURSING
TOPICS INCLUDED INTRAOPERATIVE NURSING CARE
- Surgery Phases THE OPERATING ROOM
- The Operating Room Traffic control design & the ZONE Concepts
- Common Equipment
- Surgical Team
- Principle of Surgical Asepsis
SURGERY PHASES
PREOPERATIVE PHASE
- Admission to OR Suite and the Surgical
Operation
o Transportation to Operation Room
Suite
o Admission to Holding Area
▪ Place a warm blanket on the
patient & verifies patient using
two identifiers (name, date of UNRESTRICTED AREA (Outer Zone)
birth, nametag/bracelet, or - Within the operating suite/complex BUT still
chart). outside the Operating Room
▪ Verifies the surgical procedure, - Reception area, locker rooms, lounges, and
operative site and the name of offices
the surgeon verbally with the - No street clothes and shoes
patient. - Clean scrub suit and rubber sole slippers or
▪ Review patient’s chart for shoes
completeness.
▪ Take patient’s vital sign. SEMI-RESTRICTED AREA (Middle Zone)
▪ Verifies allergies, medications, - Main hallway that interconnects the various
skin tone, and physical areas / rooms
limitations. - Storage areas, work areas & scrubbing areas
▪ Note the patient’s mental - Scrub suit, slippers + cap
state.
▪ Puts a cap on the patient to RESTRICTED AREA (Inner Zone)
protect his or her hair. - Actual operating rooms/ theaters
▪ Notify the OR team - Proper surgical attire= scrub suit + slippers +
cap + mask
INTRAOPERATIVE PHASE
- Preparation of the Operating Room, Supplies OPERATING ROOM ETIQUETTE
and Equipment - Talking should be minimal
- Preanesthesia Preparation - All movements should be smooth and minimal
- Transfer of Patient to Operating Room Table
- Induction of Anesthesia OPERATING ROOM SANITATION
- Positioning the Patient - All horizontal surfaces should be damp dusted
- Skin preparation with disinfectant
- Draping - The floors and corridors should be swept and
- The Surgical Operation mopped
- Patient transfer from Operating Room to - Contamination should be confined/ contained
RR/PACU around the sterile field
- At the end of the operation, proper disposal of
all used/ soiled materials should be done
- Sharps, dirty sponges, etc. should be
segregated and disposed properly
- Dirty linens should be dropped in a hamper.
- Pail & kick buckets should be emptied and Cautery Machine
disposed the trash in a trash container.
- Suction bottles should be emptied and washed.
- Damp dusting, floor sweeping and mopping
should be done.
- All OR, corridors, scrub areas, etc. should be
terminally cleaned using chemical
disinfectants and mechanical frictions.
COMMON SURGICAL EQUIPMENT, SUPPLIES, AND
MATERIALS Syringe Pumps
Operating Table
Surgical Lights
Kick Bucket
Anesthesia Machine
THE SURGICAL TEAM
Highly trained personnel that work together as a
coordinated team for welfare and & safety of the
patient
Members of the Surgical Team
Sterile:
1. Surgeon
2. Assistant to the surgeon
3. Scrub Nurse
Non-Sterile:
1. Anesthesiologist
2. Circulating Nurse
3. Other members of the health Team
SURGEON
- Makes the major decisions concerning the
course of surgery
- The surgeon assumes full responsibility for all
medical acts of judgment and for the
management of the surgical patient
- Attends to the nature of response of the - Unsterile persons avoid reaching over sterile
patient & modifies the procedure as necessary field; sterile persons avoid leaning over
- Handles the organs and tissues, prevents unsterile area
excessive bleeding, maintains asepsis, & - Tables are sterile only at Table level
prevents injury
ANESTHESIOLOGIST
- Responsible for alleviating pain and promotes
relaxation with use of medications
- Maintains airway and oxygenation, infuses
fluids and medications as needed
- Alerts the surgeon about any complications
- Gowns are considered sterile only from the
waist to shoulder level, in front, and in sleeves
- The edge of anything that encloses sterile
contents are considered unsterile
CIRCULATING NURSE - Sterile persons keep well within the sterile area
- Responsible for the general management of - Sterile areas are continuously kept in view
the operating room - Sterile persons keep contact with the sterile
- Monitor and coordinate all activities within the areas to a minimum
room and to manage the care required for - Destruction of the integrity of microbial
each patient barriers results in contamination
- Always assures sterility, prepares all necessary - Microorganisms must be kept to an irreducible
materials/equipment needed in the operation minimum
- Assists in positioning the patient properly
- Counts all instruments, sponges, needles and
sharps with the instrument nurse
- Prepares the operative site thoroughly
- Takes care of the patient immediately after the
surgical operation
SCRUB NURSE
- Assists the surgeon during the operation
- Maintains accurate counts instruments,
sponges, needles and sharps in the sterile field.
- Responsible for establishing and maintaining
the integrity, safety, and efficiency of the
sterile field throughout the surgical procedure
PRINCIPLE OF SURGICAL ASEPSIS
- All articles used in the operation have been
sterilized previously
- If you are in Doubt about the sterility of
anything, consider as unsterile
- Sterile persons are gowned and gloved
- Sterile persons touch only sterile items or
areas; unsterile persons touch only unsterile
items or areas
