DUTIES OF SCRUB NURSE

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Before an operation

• Ensures that the circulating nurse has checked the equipment
• Ensures that the theater has been cleaned before the trolley is set
• Prepares the instruments and equipment needed in the operation
• Uses sterile technique for scrubbing, gowning and gloving
• Receives sterile equipment via circulating nurse using sterile technique
• Performs initial sponges, instruments and needle count, checks with circulating nurse

When surgeon arrives after scrubbing

• Perform assisted gowning and gloving to the surgeon and assistant surgeon as soon as they enter the operation suite
• Assemble the drapes according to use. Start with towel, towel clips, draw sheet and then lap sheet. Then, assist in draping the patient aseptically according to routine procedure
• Place blade on the knife handle using needle holder, assemble suction tip and suction tube
• Bring mayo stand and back table near the draped patient after draping is completed
• Secure suction tube and cautery cord with towel clips or allis
• Prepares sutures and needles according to use

During an operation

• Maintain sterility throughout the procedure
• Awareness of the patient’s safety
• Adhere to the policy regarding sponge/ instruments count/ surgical needles
• Arrange the instrument on the mayo table and on the back table

Before the Incision Begins

• Provide 2 sponges on the operative site prior to incision
• Passes the 1st knife for the skin to the surgeon with blade facing downward and a hemostat to the assistant surgeon
• Hand the retractor to the assistant surgeon
• Watch the field/ procedure and anticipate the surgeon’s needs
• Pass the instrument in a decisive and positive manner
• Watch out for hand signals to ask for instruments and keep instrument as clean as possible by wiping instrument with moist sponge
• Always remove charred tissue from the cautery tip
• Notify circulating nurse if you need additional instruments as clear as possible
• Keep 2 sponges on the field
• Save and care for tissue specimen according to the hospital policy
• Remove excess instrument from the sterile field
• Adhere and maintain sterile technique and watch for any breaks

End of Operation

• Undertake count of sponges and instruments with circulating nurse
• Informs the surgeon of count result
• Clears away instrument and equipment
• After operation: helps to apply dressing
• Removes and siposes of drapes
• De-gown
• Prepares the patient for recovery room
• Completes documentation
• Hand patient over to recover room

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• ROLE OF SCRUB NURSE Works directly with surgeon within the sterile field, passing instruments, sponges and other items needed during the procedure Members of the surgical team who prepares and preserves a sterile field in which the operation can take place Responsible for the sponge counts, the blades and needles and instruments check throughout the operation Has a job requiring anticipation, quick
• DUTIES OF CIRCULATING NURSE Before an operation Checks all equipment for proper functioning such as cautery machine, suction machine, OR light and OR table Make sure theater is clean Arrange furniture according to use Place a clean sheet, arm board (arm strap) and a pillow on the OR table Provide a clean kick bucket and pail Collect necessary stock and equipment Turn on aircon unit Help scrub
• PRINCIPLES OF ASEPTIC TECHNIQUE Only sterile items are used within sterile field. Sterile objects become unsterile when touched by unsterile objects. Sterile items that are out of vision or below the waist level of the nurse are considered unsterile. Sterile objects can become unsterile by prolong exposure to airborne microorganisms. Fluids flow in the direction of gravity. Moisture that passes through a sterile object
• Bag Technique Definition Bag technique - a tool making use of public health bag through which the nurse, during his/her home visit, can perform nursing procedures with ease and deftness, saving time and effort with the end in view of rendering effective nursing care. Public health bag - is an essential and indispensable equipment of the public health nurse
• ROLE OF CIRCULATING NURSE Responsible for managing the nursing care of the patient within the OR and coordinating the needs of the surgical team with other care provider necessary for completion of surgery Observes the surgery and surgical team from broad perspective and assists the team to create and maintain a safe and comfortable environment for the patient Asses the patient’s