Ot nursing and roles

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.

24. THANK
YOU