intraoperative nursing management

7/30/2019 IntraOperative Nursing Management

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IntraOperative Nursing Management

Ideal Actual Rationale

Identify patient byasking her to

state her name

and by checking it

in her id band and

chart.

Patient wasidentified by

asking her to state

her name and by

checking it in her

id band and chart.

To make surethat we will do

the right

procedure to the

right patient.

Confirm that the

patient has signed

the operating

consent.

Was able to

confirm that

patient has signed

the consent.

To have proof

that patient has

signed the

operating

consent so that

in case

something goes

wrong, the

hospital has alegal basis and

proof from

accusations.

Create quiet and

calm atmosphere

for patient. to

decrease patient

apprehensiveness

Theres music

during the

procedure but is in

minimal volume.

Students inside

the theatre are

also limited. A

calm atmosphere

was created for

the patient.

To lessen

patients anxiety

and to reserve

her energy for

the surgery.


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Check

preoperative

assessment.

Preoperative

assessment was

checked.

To make sure

that the patients

condition is okay

for the surgery.

To have

patients

baseline data.

Checks the time

of administrative

order

premedication

and any adverse

reaction is

reported to

anesthetist.

The reception

nurse has checked

the time of the

administrative

order of the

premedication and

noted any adverse

reaction and was

reported to the

anaesthetist.

To avoid

unnecessary

delays due to

reactions and

from side effects

or allergies of

the patient from

the medications.

Use the check list

to complete the

preparation for

anesthesia and

surgery.

Used the checklist

to complete the

preparation for

anesthesia and

surgery.

To track the

procedures

performed and

to make sure all

needed

preparations

was done.

Transfer patient to

the anesthetic

room.

Patient was

transferred in the

theatre room.

For the

induction of

anesthesia.

Position the client

according to

where the site of

incision will be.

Patient was placed

in supine position.

Placing the

client in a proper

position will

provide a better


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exposure of the

operative area

or site. This will

also reduce the

risk of injury to

the client.

Avoid undue

exposure.

The client was

dressed in a gown

upon arrival and

inside the theatre.

During the skin

preparation for the

induction of the

anesthesia, her

privacy was still

kept by not

exposing other

parts of the bodyexcept her back.

During the

surgery, the client

was draped

properly and was

given privacy.

To give the

patient privacy

and to protect

her dignity.

Ensuring safety

by strapping

patient.

Patient was

strapped in the OR

table.

To prevent falls

and injury.

Managing the

nursing care of

the patient and

The circulating

nurse managed

the nursing care of

To provide

quality care for

patient during


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coordinating the

needs of surgical

team members for

each procedure

using critical

thinking skills.

the patient and

coordinated the

needs of surgical

team members for

the procedure.

the procedure

and help the

scrub nurse with

what they need.

Assess the

patients condition

before, during,

and after the

procedure.

The circulating

nurse assessed

the patients

condition before ,

during and after

the surgery.

To make sure

that all the pre

operative meds

given was on full

effect and to

make sure that

patient was

totally sedated

and is not

experiencing

pain.

Manage

equipment to be

used.

The circulating

nurse assisted in

getting the needed

equipment and

listed it promptly.

To have a

complete set of

instruments

appropriate for

the surgery.

Having a list of

the number of

instruments is

essential for the

closure of the

incision. To

make sure that

there are no

instruments left

in the patients


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body.

Continuously

evaluates

patients

outcomes during

intra operative

phase.

The

anesthesiologist is

the one evaluating

the patients

outcome during

surgery.

To ensure that

the patient is in

a good condition

and to assess if

there are any

complications

during the

surgery.

Monitor aseptic

practices.

The circulating

nurse did not

come in contact

with anything

sterile during the

surgery. They did

not move too close

to the backup

table which was

considered sterile.

The nurse gave

packed instrument

and observed the

sterile technique.

To avoid breaks

in sterile

technique while

coordinating

movement and

related

personnel.

Perform surgical

hand scrub.

The scrub nurse

performed surgical

hand washing

before arranging

the instruments in

the sterile field.

To make sure

that there is 0

possible

microorganism

during the

surgery.

After The NOD has This is needed


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ScrubbingPrepare

the sterile

instruments

.Performs proper

draping. Assess

surgeons in

wearing gowns

and gloves.

Prepare

appropriate

needles and

sutures. Counts

all swaps,

sponges, and

sterile

instruments.

aseptically

prepared the

sterile instruments,

performed proper

draping, assisted

in the gowning and

gloving of the

surgeon, prepared

the necessary

needles and

sutures, counts all

swaps, sponges

and the rest of the

sterile instruments.

to be prepared

before the

procedure to

make sure that if

there is any

lacking

instruments, it

can still be

prepared and to

make sure that

there is an initial

counting of

instruments for

basis before the

closure of the

incision.

Arranges sterile

instruments inexpected orders

for use

The NOD scrub

nurse arrangedthe sterile

instruments in

order of use.

To avoid

crisscrossing ofthe hands and

accidental fall of

instrument.

Hands

instruments to the

surgeons and

helps to keep an

eye on the

patients

condition.

At the 1s half of

the procedure, the

NOD scrub nurse

was the one

assisting the

doctor in the

handing of

instruments to the

surgeon. But on

the 2nd half, the

student scrub

The NOD scrub

nurse is the one

that will show

the student on

how to hand

properly the

materials and to

educate the

student on what

is the name of

the unknown


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nurse was given

the opportunity to

hand instruments

and necessary

supplies to the

surgeon and has

kept an eye on the

condition of the

patient.

instruments.

The students

should know

how to hand

instruments to

the surgeon for

training and

preparation for

the future.

Listens carefully

to what the

surgeon is saying.

The student scrub

nurse was

carefully listening

to the demands of

the surgeon and

complied.

Counts

instruments

before wound

closure.

The NOD scrub

nurse was the one

who counted the

instruments every

after wound

closure.

To make the job

fast and

accurate and to

show the

students on how

to perform it

correctly.

intraoperative nursing management

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