Transcript Scrub Nurse

scrub nurse
scrub nurse is a specially trained nurse who works with surgeons and the
medical team in the operating room. Scrub nurses are extremely valuable
members of the surgical team, providing support in the operating room and
patient care outside of it as well. This career can be very demanding, but
also quite rewarding, and careers in nursing are constantly expanding due to
the rising need for these crucial health care professionals. Some scrub nurses
even become highly sought after members of surgical teams, especially
experienced scrub nurses who are familiar with a wide range of procedures
• Scrub nurses are more formally known as peroperative
nurses. Peroperative nursing involves patient care before,
during, and after surgery. There are a number of different
peroperative nursing positions; the scrub nurse is actually
fulled “scrubbed in” for the surgery, meaning that he or she
has used special soaps and wears sterile garments so that the
nurse can work next to the operative field. A scrub nurse
hands instruments to the surgeon and helps to keep an eye on
the patient's condition. Scrub nurses are also familiar with
the operation of emergency room equipment
DUTIES OF SCRUB NURSE
• Duties of a Scrub Nurse. The duties of a scrub nurse may
not seem that difficult to individuals looking at surgery
from the outside. ... What Are the Duties of the Scrub
Nurse During Surgery?
Before an operation
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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
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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 .
ROLE OF SCRUB NURSE
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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 reaction and
conscientious observation as well as knowledge of anatomy
and of operative procedures .
circulating nurse
• A circulating nurse, another type of
operating room (OR) nurse, works
on the perimeter of the operating
room, monitoring patient care,
ensuring that the room stays sterile,
and keeping track of instruments and
sponges. Perioperative nurses also
help to prepare patients for surgery,
and they provide valuable care and
monitoring for patients when their
surgeries are over. Surgeons may do
the cutting, but a scrub nurse is
every bit as important.
circulating nurse is a type of surgical nurse who
circulates in the operating room to monitor the
procedure. He or she acts as a patient advocate,
ensuring that the conditions in the operating room
remain safe and sterile. Circulating nurses also
perform a wide variety of other tasks, which
range from helping to set up the operating room
for surgery to filling out paperwork which
pertains to the surgery. This nursing career
requires a very fine attention to detail, and a lot of
stamina, as circulating nurses must be present and
active throughout a surgery.
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 nurse with setting up the theater
• Assist with counts and records
During the Induction of Anesthesia
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Turn on OR light
Assist the anesthesiologist in positioning the patient
Assist the patient in assuming the position for anesthesia
Anticipate the anesthesiologist’s needs
If spinal anesthesia is contemplated
After the patient is anesthetized
• Reposition the patient per anesthesiologist’s instruction
• Attached anesthesia screen and place the patient’s arm on the arm
boards
• Apply restraints on the patient
• Expose the area for skin preparation
• Catheterize the patient as indicated by the anesthesiologist
• Perform skin preparation
During Operation
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Remain in theater throughout operation
Focus the OR light every now and then
Connect diatherapy, suction, etc.
Position kick buckets on the operating side
Replenishes and records sponge/ sutures
Ensure the theater door remain closed and
patient’ s dignity is upheld
• Watch out for any break in aseptic technique
End of Operation
1-Assist with final sponge and instruments count.
2-Signs the theater register.
3-Ensures specimen are properly labeled and signed.
After an Operation
1- Hands dressing to the scrub nurse.
2-Helps remove and dispose of drapes.
3- Helps to prepare the patient for the recovery room.
4-Assist the scrub nurse, taking the instrumentations to the
service (washroom).
5-Ensures that the theater is ready for the next case.
ROLE OF CIRCULATING NURSE
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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 condition before, during and
after the operation to ensure an optimal outcome
for the patient
Must be able to anticipate the scrub nurse’s needs
and be able to open sterile packs, operate
machinery and keep accurate records
coordination
• In an operating room, there are two areas: the sterile
operating field, and the nonsterile area. During the
surgery, the goal is to keep the operating field totally
sterile for patient safety. Circulating nurses monitor the
sterile field, informing operating room staff when
something might compromise the sterility. They also
connect the people in the sterile field with the nonsterile
area. For example, a circulating nurse can open an
autoclaved package so that someone in the operating field
can access the sterile tool inside.
• The other type of surgical nurse is a scrub nurse, a nurse
who scrubs in so that he or she can work in the surgical
field, assisting the surgeon. Scrub nurses also monitor
patient safety and the safety of the sterile field while acting
as assistants to the surgeon, and they generally work closely
with the circulating nurse throughout the procedure.
Keeping lines of communication within the surgical team
open is critical, so that emergent problems can be quickly
and professionally addressed.
• Because the circulating nurse works in the non sterile field, this
member of the surgical team does not need to be sterile. For patient
safety, however, the circulating nurse and other staffers in the non
sterile area usually wear face masks, keep their hair contained under
surgical caps, and take other measures to avoid compromising the
clean conditions in the operating room.
Scrub Surgical Technologist
The scrub surgical technologist handles the instruments supplies, and equipment
necessary during the surgical procedure. He/she has an understanding of the
procedure being performed and anticipates the needs of the surgeon. He/she
has the necessary knowledge and ability to ensure quality patient care during
the operative procedure and is constantly on vigil for maintenance of the
sterile field. Duties are as follows:
• Checks supplies and equipment needed for surgical procedure
• Scrubs, gowns, and gloves
• Sets up sterile table with instruments, supplies, equipment, and
medications/solutions needed for procedure
• Performs appropriate counts with circulator prior to the operation and before
incision is closed
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Gowns and gloves surgeon and assistants
Helps in draping sterile field
Passes instruments, etc., to surgeon during procedure
Maintains highest standard of sterile technique during
procedure
Prepares sterile dressings
Cleans and prepares instruments for terminal sterilization
Assists other members of team with terminal cleaning of room
Assists in prepping room for the next patient
Circulating Surgical Technologist
The surgical technologist assisting in circulating obtains additional
instruments, supplies, and equipment necessary while the surgical
procedure is in progress. He/she monitors conditions in the operating room
and constantly assesses the needs of the patient and surgical team. Duties
are as follows:
• Obtains appropriate sterile and unsterile items needed for procedure
• Opens sterile supplies
• Checks patient’s chart, identifies patient, verifies surgery to be performed
with consent forms, and brings patient to assigned operating room
• Transfers patient to operating room table
• Assesses comfort and safety measures and provides verbal and tactile
reassurance to the patient
• Assists anesthesia personnel
• Positions patient, using appropriate equipment
• Applies electrosurgical grounding pads, tourniquets,
monitors, etc., before procedure begins
• Prepares the patient’s skin prior to draping by surgical team
• Performs appropriate counts with scrub person prior to the
operation and before incision is closed
• Anticipates additional supplies needed during the procedure
• Keeps accurate records throughout the procedure
• Properly cares for specimens
• Secures dressings after incision closure
• Helps transport patient to recovery room
• Assists in cleaning of room and preparing for next patient
Preparing by :
Samah El-khakdi
Eman Sada
Doaa abu khadaije