Lecture Notes: Intraoperative Nursing Care

Introduction

• Focus on intraoperative nursing care
• Role of the nurse during surgery
• Operating room dynamics

Operating Room Teams

Sterile Team

• Members: Surgeon, Surgical Assistant (PA, RNFA), Scrub Person
• Responsibilities:
  • Scrub in, wear sterile gowns and gloves
  • Handle sterile instruments
  • Operate within the sterile field

Clean Team

• Members: Anesthesia Care Provider, RN Circulating Nurse, Biomed/Radiology Techs
• Responsibilities:
  • Abide by clean technique
  • Function outside and beyond the sterile field

Nurse's Roles and Responsibilities

Key Responsibilities

• Advocacy, safety, dignity, confidentiality, privacy
• Circulating nurse ensures these for the patient, especially under general anesthesia

Pre-surgery Preparation

• Prepare room with necessary supplies
• Use surgeon preference cards
• Check all equipment for functionality
• Ensure aseptic technique is maintained

During Surgery

• Monitor sterile technique
• Conduct sponge, sharps, and instrument count before and after surgery
• Complete chart review and pre-surgery reassessment
• Handle patient transfer to the OR and positioning
  • Consider correct skeletal alignment, prevent pressure

Patient Positioning

• Common positions: Supine, Prone, Lateral, Lithotomy
• Consideration for surgical access and airway management

Site Preparation

• Skin preparation to reduce microorganisms
• Use of antimicrobial agents
• Risks with flammable antiseptics

Assisting Anesthesia Care Provider

• Understanding anesthetics and emergency procedures
• Place monitoring devices (blood pressure, pulse ox, ECG)
• Act as a communication link with other departments
• Assist in patient transfer to PACU

Special Considerations for Geriatric Patients

• Altered response to anesthetic drugs
• Risk of skin injury, osteoporosis, and hypo/hyperthermia

Universal Protocol

• National Patient Safety Goals to prevent surgery mistakes
• Surgical timeout: Verify patient, surgery, site
• WHO surgical safety checklist

Conclusion

• Intraoperative nursing is a specialty area with additional training for those interested
• Next section will cover post-operative nursing care

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• Resources: Supplemental handouts and videos on Canvas
• Personal anecdote: Professor Marshall's husband’s experience as an OR nurse

Prepare for part five focusing on post-operative nursing care.