The Perioperative Nursing The Perioperative Nursing RoleRole

January 12th, 2009January 12th, 2009

Humour is goodHumour is good

Perioperative NursingPerioperative Nursing

RNs & RPN’sRNs & RPN’s

Certificate program offered at Certificate program offered at

various collegesvarious colleges

CNA certificationCNA certification

6 month orientation 6 month orientation

Operating Room Nurses Operating Room Nurses AssociationAssociation of Canada of Canada

(ORNAC)(ORNAC) Recommended standards, Recommended standards,

guidelines and position guidelines and position statements for perioperative statements for perioperative registered nursing practiceregistered nursing practice

Perioperative NursePerioperative Nurse

Gatekeeper to infectionGatekeeper to infection

Patient advocatePatient advocate

Team player in a multidisciplinary teamTeam player in a multidisciplinary team

Promotes a safe environmentPromotes a safe environment

Critical thinkerCritical thinker

Scrub NurseScrub Nurse

Checks the surgeon’s preference card for special Checks the surgeon’s preference card for special needs/requests.needs/requests.

Performs surgical hand scrub, dons sterile gown Performs surgical hand scrub, dons sterile gown and gloves and gloves

Arranges sterile instruments, other sterile supplies Arranges sterile instruments, other sterile supplies and completes sterile draping of equipment and completes sterile draping of equipment

Performs pre-surgical counts with circulating RN Performs pre-surgical counts with circulating RN prior to initial incision.prior to initial incision.

Anticipates the procedural steps in accordance Anticipates the procedural steps in accordance with the surgeon’s preferences and needs for with the surgeon’s preferences and needs for supplies and equipment during the case.supplies and equipment during the case.

Scrub NurseScrub Nurse

Controls instruments, sutures, needles during Controls instruments, sutures, needles during the case and performs the count procedure the case and performs the count procedure with the Circulating Registered Nurse and with the Circulating Registered Nurse and accounts for all items on the sterile field.accounts for all items on the sterile field.

Follows safety measures, e.g., handling and Follows safety measures, e.g., handling and disposing of sharps to prevent injury. disposing of sharps to prevent injury. Handles delicate items carefully and Handles delicate items carefully and cautiously so as to prevent damage.cautiously so as to prevent damage.

Promptly reports any break in technique and Promptly reports any break in technique and follows appropriate measures to correct follows appropriate measures to correct action.action.

Assists with application of sterile dressing.Assists with application of sterile dressing.

Circulating NurseCirculating Nurse

To give direct patient care including To give direct patient care including emotional support, physical care as well emotional support, physical care as well as provision of safety and confidentiality.as provision of safety and confidentiality.

To direct and co-ordinate activities of the To direct and co-ordinate activities of the Operating Room Suite.Operating Room Suite.

To provide patient advocacy.To provide patient advocacy. Assist in the preparation of the OR Suite Assist in the preparation of the OR Suite

for the day by assembling required for the day by assembling required anaesthetic equipment, IV’s, anaesthesia anaesthetic equipment, IV’s, anaesthesia drugs, positioning aids / padding, etc.drugs, positioning aids / padding, etc.

Circulating NurseCirculating Nurse

Demonstrates knowledge regarding methods of Demonstrates knowledge regarding methods of external and invasive monitoring and is aware of external and invasive monitoring and is aware of location of emergency equipment.location of emergency equipment.

Receives, assesses, identifies patient, verifies consent Receives, assesses, identifies patient, verifies consent and checks chart for completeness. Reviews and and checks chart for completeness. Reviews and signs pre-operative preparation record. signs pre-operative preparation record.

Assists the anaesthetist and surgeons with positioning Assists the anaesthetist and surgeons with positioning and placement of protective padding pre, intra and and placement of protective padding pre, intra and post operatively.post operatively.

Calls a timeout Calls a timeout Observes progress of surgery, anticipates needs of Observes progress of surgery, anticipates needs of

surgical team and keeps record of counted supplies.surgical team and keeps record of counted supplies.

Circulating NurseCirculating Nurse

Uses surgical conscience to Uses surgical conscience to maintain and monitor the integrity maintain and monitor the integrity of the sterile field.of the sterile field.

Documents accurately the nursing, Documents accurately the nursing, surgical and other health care team surgical and other health care team activities during the perioperative activities during the perioperative phase.phase.

Accompanies anaesthetist and Accompanies anaesthetist and patient to PACU and gives pertinent patient to PACU and gives pertinent report or enhances anaesthetist’s report or enhances anaesthetist’s report.report.

Surgical ConscienceSurgical Conscience

IntuitionIntuition

FactsFacts

Desire for the very best Desire for the very best

outcomes for our patientsoutcomes for our patients

advocacyadvocacy