Operating room nurses are generally divided into traveling nurses and instrumentation nurses. The traveling nurse is a very important position in the operation. In addition to special circumstances, shall not leave the operating room without authorization, pay attention to indoor cleanliness at any time, appropriate adjustment of lights and room temperature, to the doctor to wipe the sweat; timely addition of surgical items needed, and record for inspection. Instrumentation nurse is responsible for conscientiously implement the rules and regulations and technical procedures, supervise and check the aseptic operation of the surgical staff, pay attention to patient safety, and prevent errors and accidents.
I, traveling nurse: is a kind of surgical nurses, the other is the instrumentation nurse. Roving nurse is a very important post in surgery. In addition to special circumstances, shall not leave the operating room without authorization, pay attention to indoor cleanliness at all times, appropriate adjustment of lights and room temperature, to the doctor to wipe the sweat; timely addition of items needed for surgery, and record for inspection, surgery, speech action to light, prohibit gossip and noise.
Pre-operative:
1, prepare for the various items needed before surgery, check the power suction device in the operating room, the parts of the operating table, ready for surgery patient position, pillow and sandbags, do a good job of cleaning the operating room, to maintain the room temperature between 20-25 degrees Celsius.
2, preoperative understanding of the patient's ideological situation, do a good job of comfort and explanation to reduce the patient's nervousness and fear.
3, warm reception of surgical patients, in accordance with the surgical notification form carefully check the bed number, name, point of receipt with the patient into the operating room of the medical records, medicines, etc., to check the patient's preoperative preparations are adequate, jewelry, denture, whether to remove valuables, verification of the patient's blood cross-test results, blood transfusion preparations, open the venous channel.
4, the patient into the operating room after checking the patient's name, bed, hospitalization number, name of surgery, surgical site, blood type, to avoid accidental errors.
5, check whether the skin preparation of the surgical area meets the requirements, check the results of various drug tests, and receive blood orders.
6, arranging various types of personnel in place, preoperative and instrumentation nurse nurse **** with the counting and registration of the number of instruments on the operating table, dressings, etc., intraoperative closure of the body cavity and incision before suture with the instrumentation nurse **** with the counting and checking the number of instruments, dressings, etc., in order to prevent the left behind.
In surgery:
1, set up the patient's surgical position, fully exposed to the surgical field of vision, but must make the patient comfortable, to prevent limb pressure. If medication or blood transfusion is required during surgery, the checking system must be strictly enforced.
2, adhere to the workstation, pay attention to the progress of the operation, adjust the lights at any time, accurately and timely supply of intraoperative supplies, closely observe the changes in the condition of the patient, to ensure that the transfusion of fluids and blood is smooth, and fully estimate the possible accidents, make good preparation for first aid, and take the initiative to cooperate with the resuscitation.
3, preoperative and before and after the closure of the body cavity should be with the hand-washing nurse count the number of gauze, gauze pads, suture needles, etc., and is responsible for the record.
4, supervise all kinds of personnel on the implementation of aseptic management regulations and aseptic operation, such as violation of immediate correction.
Post-surgery:
1, after the operation to bandage the wound, due to the condition of the need for major surgery, should be in collaboration with the doctor, the anesthesiologist to escort the patient.
2, after the end of surgery, do a good job of cleaning and organizing the operating room, the use of objects returned to the original place.
The roving nurse's responsibility:
The roving nurse's responsibility is to do a good job of preparing for the operation; fully responsible for the safety of the patient in and out of the operating room; and the surgical team, anesthesia staff to work closely with the surgical team, in order to efficiently and safely complete the surgical task (from the medical education network). Requirements of the traveling nurse to do:
①Creating the best surgical environment and conditions for the patient, make a good nursing plan, nursing care of patients;
②Ensure that the patient is comfortable, safe, so that the patient to accept the surgical treatment in a calm state of mind, to prevent accidents;
③Adhere to the concept of asepsis, to do aseptic technology, "guardian", beware of violations of the aseptic technology, "guardian", to prevent violations of the aseptic technology.
3) adhere to the concept of asepsis, be the "guardian" of aseptic technique, beware of violation of aseptic operation behavior, and give timely correction;
4) master the condition, the name of the operation, the operation style, so as to have a clear idea of the plan, plan, and step by step initiative to cooperate with the surgical team and the anesthesia;
5) be familiar with the patient's preparation for all kinds of pre-surgery, the operation position, and use of instruments and other items.
Two, instrument nurse: also known as hand-washing nurse is a kind of surgical nurses, the other is traveling nurse. As an instrumentation nurse, not only should have rich professional knowledge and skillful operation skills, but also have a high sense of responsibility, keen observation ability and good communication ability and affinity, and be able to timely and accurately deal with unexpected emergency situations, always keep in mind the spirit of prudence, to do in mind. She conscientiously implements all rules and regulations and technical operation procedures, supervises and checks the aseptic operation of surgical personnel, pays attention to patient safety, and strictly prevents errors and accidents. Under the leadership of the head nurse, she serves as an instrumentation nurse and is responsible for pre-surgical preparation, cooperation during surgery and post-surgical organization.
Pre-operative preparation
1, the day before the operation to see the surgical notification form, to understand the operation and pre-operative steps, anesthesia mode, to do a good job.
2. Visiting the patient with the visiting nurse, checking whether the patient's preoperative examination is completed, and informing the patient of the time of fasting, the preparation of the skin in the operation area, and the cleanliness of the patient's own work, and answering the patient's questions carefully and conscientiously in order to alleviate the patient's and the family's nervousness and fear.
3, if necessary, to participate in the case discussion, in order to intraoperative surgical cooperation, to ensure the smooth progress of the operation.
4, the morning of the day of surgery to prepare for the operation of the various items required (such as special or large surgery, should be one day in advance and the surgeon to communicate with the preparation of the day of the operation of the special items required to ensure the smooth progress of the operation), including: sterile dressings, sterile instrument trays, sterile surgical gowns, sterile open table package, as well as the need for disposable aseptic items. Strictly aseptic operation, keep in mind the spirit of prudence, and prepare spare items.
5, playing aseptic table: strict aseptic operation, two people check the expiration date of the goods and drugs used, the packaging is intact and not wet, the liquid is not turbid, no impurities and in accordance with the operating specifications and the order of playing on the aseptic table. After playing the aseptic table timely and accurately put the sterilization instructions on the back of the surgical care sheet.
6. Clean the operating room with the visiting nurse, keep the operating room clean and quiet, adjust the temperature and humidity, and keep the room at a suitable temperature and humidity.
7. After all the preparations for the operating room are done, assist the visiting nurse to pick up the patient into the operating room, place the patient in a comfortable position, and establish intravenous access.
8, such as general anesthesia surgery and the visiting nurse to assist the anesthesiologist for preanesthetic induction and tracheal intubation.
9, to assist the visiting nurse and the surgeon to place the patient in the position required for surgery, longer surgery, the position should be fixed comfortably, firmly and accurately, to prevent movement. After the position has been placed, it should be fixed with fixation straps and properly padded for protection.
10, do a good job of preoperative preparations, dress, nail clipping, in accordance with the six-step cleansing method and the requirements of hand brushing 20 - 30 minutes in advance to brush hands.
Operative cooperation
1, strict aseptic operation principle, according to the provisions of the sterile table, and the classification of surgical instruments discharged. Ask the surgeon if he/she needs special supplies and inform the traveling nurse to prepare them in time.
2, cooperate with the doctor to disinfect the surgical area, spread the sterile sheet, supervise the doctor to disinfect the scope and aseptic operation, and immediately point out and give correction if there is any inappropriateness.
3, before the opening of the surgical table, before the closure of the surgical wound and before the end of the operation, together with the traveling nurse to count the inventory instruments, gauze, gauze pads, needles, threads, etc., in order to prevent left behind in the wound.
4, the anesthetic used in the operation and the temporary addition of items must be checked with the visiting nurse for two people to prevent the occurrence of errors and accidents.
5, strict aseptic operation, keep the surgical area and instruments clean, neat and dry, and often remind the surgeon to be careful with the use of instruments to prevent the patient from being scalded by electrocoagulation or accidentally injured by the instruments during the operation.
6, the instrument nurse should have a high sense of responsibility, closely observe the surgical steps and the need to do a good job, and be able to accurately and quickly pass the surgical need for instruments and items, pass the sharp instruments to pay attention to the safety of preventing accidental injuries, take the initiative to deal with all kinds of emergencies flexibly and promptly inform the nurse and anesthesiologist of the progress of the operation and the special situation.
7, if the operation is relatively large should accurately record the patient's in and out of the volume, and two people to check, at any time to inform the anesthesiologist and surgeon.
8. Storage of skin and cartilage removed during surgery: When handing over the skin or cartilage to the surgeon, care must be taken to prevent it from falling off or being lost. If there is any skin stored and pathology to be done, the visiting nurse should be informed promptly and accurately, and a two-person check should be carried out to prevent forgetfulness and loss.
9, after the operation to assist the surgeon to bandage the wound in the operation area. General anesthesia patients ready suction, to assist the anesthesiologist to pull out the tracheal tube.
Post-operative treatment
1: After the surgical patient safely leaves the operating room, promptly and accurately dispose of the items that have been used in the operating room, and sterilize the operating room with ultraviolet air. If the procedure is infected, the instruments and the operating room should be treated accordingly depending on the nature of the infection.
2: Responsible for the postoperative instruments and instrument room personnel inventory and handover, sharp and fine instruments and items should be placed separately and a separate shift, so as to avoid stabbing collision damage, and give appropriate treatment.
Equipment nurses work duties edit
1, preoperative to the sick room to visit patients, understand the condition. Participate in the pre-operative seminar if necessary and familiarize yourself with the surgical steps in order to work closely with the operator[1] ?
2. You should wash your hands and put on the surgical gown half an hour in advance. The sterile instrument table should be laid out, and the surgical instruments should be categorized and arranged on the elevating table and instrument table in the order of use, and the instruments, gauze, saline pads, and suture needles should be checked in detail with the roving nurse.
3. Assists in laying sterile surgical drapes.
4. When the skin is incised, the knife that has cut the skin and the gauze pad that has wiped the subcutaneous blood should be immediately withdrawn from further use and replaced with a clean blade and a wet gauze pad. Pass instruments accurately according to the procedure, using sign language whenever possible. When instruments are finished, retrieve them quickly and wipe them clean and return them to their original location. The suction head needs to be suction washed with saline after each use to avoid blood coagulation and blockage of the lumen.
5, surgery requires a variety of stitches, should be worn beforehand 1 ~ 2 mouth needle, sutures with sterile towel protection, pass the needle and thread, should first pull the thread out 6 ~ 8cm, at any time to clean up the bundle of thread stumps, to prevent bringing into the wound.
6, to protect the instrument table and surgical field clean, strict implementation of aseptic operation, before incision of jejunal organs, the lower part of the incision with a sterile towel to protect, has been contaminated with instruments and supplies should be placed into the curved disk isolation.
7, the specimen retained during the operation, saline gauze wrapped properly, towel clamp fixed. Can not be left behind, need to be sent to the examination, the physician to fill out the application form for inspection, intraoperative sample culture, should be handed over to the visiting nurse in a timely manner for inspection.
8, suture the body cavity and deep subcutaneous tissue before, should check with the roving nurse in detail instruments, dressings, stitches, etc., to prevent foreign body left behind.
9, after surgery, according to the principle of elimination of a wash and elimination of cooking instruments dry (baking and wiping oil, according to the surgical instrument card packing, sterilization spare. (Sharp, precision and valuable medical equipment should be cleaned separately, processing, into a special cabinet).
10, to help organize the surgical room.