Job Details

Description

GENERAL SUMMARY OF DUTIES:

To provide total patient care by utilizing the nursing process and implementing the standards of peri-procedure nursing.

To assume the leadership role for the operating/procedure room team and the management of the operating/procedure room during the intra-procedure period.

Responsibilities

POLICY:

A qualified licensed Registered Nurse will be assigned as Circulating RN on each procedure.

Procedure

• Receives report and room assignment.
• Performs hand scrub according to procedure.
• Prior to first scheduled procedure of the day, damp dusting horizontal surfaces:
  • Includes tables, equipment, overhead spotlights, and other ceiling and wall mounted equipment.
  • Uses damp cloth moistened with cleaner/disinfectant or alcohol.
• Prepares the Room:
  • Checks: lights, suction, electrosurgical unit, clocks, and other mechanical equipment in room.
  • Arranges furniture in room to facilitate the procedure; obtains additional furniture as needed.
• Prepares for Procedure:
  • Assists Scrub person in opening sterile supplies and instrumentation.
  • Removes all additional supplies from case cart; places on shelf of circulating table.
  • (Allows case cart to be used for patient-contaminated equipment while keeping clean/sterile supplies readily available.)
  • Assists scrub person into gown.
  • Performs initial count with Scrub person according to procedure and documents on peri-procedure record.
  • Prepares patient equipment, i.e., bovie pad, prep tray, positioning materials, etc.
• Provides patient care:
  • Assesses the patient in the pre-procedure holding area.
  • Introduces self to patient.
  • Verifies patient identification, procedure, procedure site, allergies.
  • Checks chart for completion.
  • Determines additional protective equipment needed according to criteria for "Standard precautions."
  • Verifies that the physician, assistant, and anesthesia personnel are available and ready to proceed.
  • Transports patient to the designated operating/procedure room.
  • Positions patient on operating/procedure table, checks for body alignment and comfort; offers warm blanket.
  • Calls for the attending physician and/or assistant if they wish to speak with the patient prior to anesthesia.
  • Stands by the patient during induction; assists anesthesia personnel as necessary.
  • Assists the physician in the positioning of the patient as necessary.
  • Supports and pads areas of pressure.
  • Uses safety straps and/or tape for stabilization.
  • Turns on and positions surgical spot light.
  • Places electrosurgical ground pad on patient according to procedure.
  • Performs sterile skin prep according to procedure.
  • Assists with draping as necessary.
  • Assists scrub person in positioning mayo stand, ring stand, and back table.
  • Connects electrosurgical unit cord and suction.
  • Turns on electrosurgical unit; informs attending physician of settings.
  • Positions sponge buckets.
  • Dons gloves and/or uses instrument to position soiled sponges on sponge bucket rim and bags according to procedure.
  • Provides necessary sterile supplies as needed.
  • Monitors operative/procedure field for breaks in technique.
  • Confines and contains contaminated articles/areas. While wearing gloves:
    • Place used items on case cart.
    • Clean up blood spillage/tracks, etc. with clean cloth and cleaner/disinfectant.
  • Communicates need to holding area for next patient readiness.
  • Initiates closing counts.
  • Identifies specimen with the attending physician, labels containers, and completes lab request form.
  • Completes procedure nursing records and charge forms. Records intraoperative medications, dose, and time of administration. Records implants.
  • Provides dressing material to Scrub person; assists in applying dressing as necessary.
  • Moves waste and linen hampers to the field.
  • Removes ground pad; checks and documents skin condition.
  • Dons gloves; assists anesthesia personnel as necessary during extubation and emergencies.
  • Notifies the recovery area nurse that patient will be arriving soon; alerts them to any needed equipment.
  • Assists anesthesia care provider in transferring the patient to the recovery area.
  • All procedure records, patient x-rays, and specimens are to accompany patient to the recovery area.
  • Gives report to recovery area nurse:
    • Patient's name.
    • Patient allergies.
    • Procedures performed.
    • Provides contributing intra-procedure information, i.e., drains, catheters, etc.
    • Reports medications given intraoperatively.
    • States physical limitations.
    • States impairments resulting from the procedure.
    • Reports patient's pre-procedure level of consciousness.
    • Communicates necessary equipment needs.
    • Reports other pertinent information.
  • Places x-rays, specimens, and procedure records in designated locations.
  • Washes hands.
  • Checks with Administrative Director/designee for changes in case or room assignment.
  • Proceeds to the pre-procedure holding area to assess the next patient and review chart.
  • Communicates with team members to determine room status; assists with room cleaning and set-up as necessary.
  • Communicates with nurse running the schedule of the room status concerning on-time, delay, or early completion.
  • If it is necessary to leave the operating/procedure room during the procedure, inform the scrub person and anesthesia personnel.
  • Unnecessary traffic in and out of the room should be discouraged to minimize human bacterial shedding and curtail air turbulence.