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