The Perioperative Nursing Role January 12th, 2009

Humour is good

Perioperative Nursing RNs & RPN’s RNs & RPN’s Certificate program offered at various colleges Certificate program offered at various colleges CNA certification CNA certification 6 month orientation 6 month orientation

Operating Room Nurses Association of Canada (ORNAC) Recommended standards, guidelines and position statements for perioperative registered nursing practice Recommended standards, guidelines and position statements for perioperative registered nursing practice

Perioperative Nurse Gatekeeper to infection Gatekeeper to infection Patient advocate Patient advocate Team player in a multidisciplinary team Team player in a multidisciplinary team Promotes a safe environment Promotes a safe environment Critical thinker Critical thinker

Scrub Nurse Checks the surgeon’s preference card for special needs/requests. Checks the surgeon’s preference card for special needs/requests. Performs surgical hand scrub, dons sterile gown and gloves Performs surgical hand scrub, dons sterile gown and gloves Arranges sterile instruments, other sterile supplies and completes sterile draping of equipment Arranges sterile instruments, other sterile supplies and completes sterile draping of equipment Performs pre-surgical counts with circulating RN prior to initial incision. Performs pre-surgical counts with circulating RN prior to initial incision. Anticipates the procedural steps in accordance with the surgeon’s preferences and needs for supplies and equipment during the case. Anticipates the procedural steps in accordance with the surgeon’s preferences and needs for supplies and equipment during the case.

Scrub Nurse Controls instruments, sutures, needles during the case and performs the count procedure with the Circulating Registered Nurse and accounts for all items on the sterile field. Controls instruments, sutures, needles during the case and performs the count procedure with the Circulating Registered Nurse and accounts for all items on the sterile field. Follows safety measures, e.g., handling and disposing of sharps to prevent injury. Handles delicate items carefully and cautiously so as to prevent damage. Follows safety measures, e.g., handling and disposing of sharps to prevent injury. Handles delicate items carefully and cautiously so as to prevent damage. Promptly reports any break in technique and follows appropriate measures to correct action. Promptly reports any break in technique and follows appropriate measures to correct action. Assists with application of sterile dressing. Assists with application of sterile dressing.

Circulating Nurse To give direct patient care including emotional support, physical care as well as provision of safety and confidentiality. To give direct patient care including emotional support, physical care as well as provision of safety and confidentiality. To direct and co-ordinate activities of the Operating Room Suite. To direct and co-ordinate activities of the Operating Room Suite. To provide patient advocacy. To provide patient advocacy. Assist in the preparation of the OR Suite for the day by assembling required anaesthetic equipment, IV’s, anaesthesia drugs, positioning aids / padding, etc. Assist in the preparation of the OR Suite for the day by assembling required anaesthetic equipment, IV’s, anaesthesia drugs, positioning aids / padding, etc.

Circulating Nurse Demonstrates knowledge regarding methods of external and invasive monitoring and is aware of location of emergency equipment. Demonstrates knowledge regarding methods of external and invasive monitoring and is aware of location of emergency equipment. Receives, assesses, identifies patient, verifies consent and checks chart for completeness. Reviews and signs pre- operative preparation record. Receives, assesses, identifies patient, verifies consent and checks chart for completeness. Reviews and signs pre- operative preparation record. Assists the anaesthetist and surgeons with positioning and placement of protective padding pre, intra and post operatively. Assists the anaesthetist and surgeons with positioning and placement of protective padding pre, intra and post operatively. Calls a timeout Calls a timeout Observes progress of surgery, anticipates needs of surgical team and keeps record of counted supplies. Observes progress of surgery, anticipates needs of surgical team and keeps record of counted supplies.

Circulating Nurse Uses surgical conscience to maintain and monitor the integrity of the sterile field. Uses surgical conscience to maintain and monitor the integrity of the sterile field. Documents accurately the nursing, surgical and other health care team activities during the perioperative phase. Documents accurately the nursing, surgical and other health care team activities during the perioperative phase. Accompanies anaesthetist and patient to PACU and gives pertinent report or enhances anaesthetist’s report. Accompanies anaesthetist and patient to PACU and gives pertinent report or enhances anaesthetist’s report.

Surgical Conscience Intuition Intuition Facts Facts Desire for the very best outcomes for our patients Desire for the very best outcomes for our patients advocacy advocacy