This document outlines the roles and responsibilities of various members of the surgical team in an operating theatre, including the patient, surgeon, anesthesiologist, operation room nurses, and others. It describes in detail the key roles of scrub nurses and circulating nurses. Scrub nurses are responsible for preparing instruments and supplies for surgery and passing them to the surgeon during procedures. Circulating nurses assist with preparing the operating room and patient, and ensure the safe functioning of equipment during operations. Both roles require strict adherence to aseptic technique and protocols to maintain a safe environment for surgical procedures.

1. OPERATION THEATRES
NURSING
Ms Shiwani Sah

2. Surgical Team :

3. 1) Patient
2) Surgeon
3) Anesthesiologist or anesthetist
4) 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.

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