Medical Ethics In The Operating Room Medical Ethics In The Operating Room a Reminder.
Operating Room
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Transcript of Operating Room
Operating Room
PART I
Ns. Heri Kristianto. SKep., MKepDepartment of Medical Surgical
Nursing
Definition
• One of the hospital unit to operate service• Surgery: unique human experience• Perioperative nursing 3 phases of surgical
intervention• Combining of physiologic, psychosocial,
task oriented and patient
Clasification of Surgical Procedures
• PurposeDiagnostic, Ablative, Constructive, Reconstructive, Palliative, Transplant
• RiskMinor & Major
• UrgencyElective, urgent, emergency
Procedure
Receptionist
Premedication
Operation Room
Recovery Room
PRE PRE
INTRAINTRA
POSTPOST
Three zone concept
• Outer zone or non restricted area• Intermediate zone or semirestricted area• Inner zone or restricted area
Outer Zone (Protective Zone)
• Receptionist• Holding/ admision area• Post Anesthetic Care Units (PACU)• Dressing room• Office • Lounges• Laboratory
Intermediate Zone (Clean Zone)
• Clean & sterile supplies• Sterilization processing• Distribution area for instrument &
nondisposable equipment• Corridors leading to procedure rooms• Substerile utility areas
Inner Zone
The procedure room where surgery is performed and adjacent substerile areas where the scrubs sinks & autoclaves are located
Surgical Team
• The surgeon• The first assistant to the surgeon• The anesthesiologist• The nurse anesthetist• The scrub asisstant• The circulating nurse
Procedure surgical:
• Preoperative• Instrument • Intra operative • Postoperative• Documentation
Team SurgicalTeam Surgical
Preoperative
Patient Patient
ScheduleInformed ConsentVital sign
Shaving of surgical areaEnemaFast
General discussion:• Goals • Description of operation
Procedure taught:1. Deep breathing & coughing2. Turning3. Leg & arm exercise
Instrument
Sterilization equipment & room1. Steam sterilization: autoclave2. Chemical sterilization: ethylene oxide3. Physical sterilization: ionizing radiation
(Cobalt 60)
Intraoperative
• Transporting, moving and lifting the patient• Positioning the patient for surgery• Performing the surgical skin prep• Conducting & maintaining accurate records
of counts• Maintaining accurate documentation of
nursing activities
Positioning the patient for surgery
Skin Prep
Post operative
• Periods begins with the transfer of the patient to the designated postanesthesia area and ends with the resolution of the surgical experience
• The activities should be completed:1. Intraoperative documentation2. Specimens3. Special equipment PACU4. Moved to recovery bed5. Verbal/ written reports
Documentation
• The patient’s record should reflect the perioperative plan of care, including assessment, planning, implementation, evaluation, and expected outcomes