STATE REGISTERED NURSE, OPERATION THEATRE at KPJ Healthcare · KPJ…

ORGANIZATION AND MANAGEMENT I THE OPERATION THEATRE

1. Adherence to nursing care vision, mission, goals, and objectives, aligns with the scope of nursing services, and performs shift duties as assigned by the Unit Manager to ensure high-quality care rendered.

2. Notifies the unit manager of any changes in the situation that could impact the standards of care.

3. Collaborate with the Unit Manager in ensuring the smooth operation of the Operation Theatre (OT) and Central Sterile Supply Department (CSSD) daily.

4. Provide the operation theatre room ready for use by checking the completion of damp dusting, verifying the gas supply in the anesthetic machine cylinder, and preparing trolleys and standby items for use.

5. Collaborate with ward staff to ensure patients arrive at the OT on time, thereby optimizing the utilization of the OT.

6. Adherence to Patient Safety Goals; Save Surgery Save Live involves accurately identifying patients, preparing them for procedures, checking patients with staff, noting abnormalities, and referring patients to the surgeon and anesthetist if necessary.

7. Escort patients into the operating rooms safely and record all cases in the Operation Theatre Record Book.

8. Check and label specimens properly after each case, confirming with the surgeon, if necessary, before sending them to the laboratory or pathology services.

9. Provides personalized, holistic patient care using the nursing process approach, maintaining accurate documentation in patient folders, and promptly reporting any abnormal findings to relevant doctors or consultants.

10. Assess patients, providing emotional support and accompanying doctors while doing rounds, as well as assisting in procedures as needed.

11. Executing the doctor's orders, coordinating with team members related to the patient’s treatment, and fostering effective communication with all disciplines, patients, and relatives to ensure patient satisfaction.

12. Actively participates in the health education of patients and their families, unit meetings, dialogue sessions, and hospital activities.

13. Provide clear, compassionate, and culturally sensitive communication with patients, ensuring their understanding of their condition, treatment options, and care plan comprehensively.

14. Collaborate with the unit manager in administration, setting care standards, and fulfilling duties in the absence of the unit manager, while also carrying out assigned tasks and providing feedback.

15. Charge accurately, incorporating charges for equipment and consumable items into the patient's charges and verifying their completeness.

16. Inspect and document the supply of sterile packs to ensure the integrity of the packaging and maintain an adequate supply of unit stock from Central Sterile Supply Services.

A COORDINATOR NURSE:

1. Collaborate with the unit manager to ensure the smooth operation of Operation Theatre and the Central Sterile Supply Services, arranging vendor availability of necessary surgical supplies.

2. Conduct by receiving booking cases from ward staff and consultants over the phone and liaise with anaesthetists for emergency cases.

3. Organize the scheduled list and coordinate with the anesthetist before escorting patients to the operating theater.

4. Maintain records of monitoring parameters, including cancellations, postponements, and deviations from best practices, and review the operating theatre list before distributing it to other services.

A SCRUB NURSE:

1. Produce the operation room by cleaning, preparing trolleys, and ensuring all necessary items and equipment are available and functioning, discussing surgery with the surgeon's approach and any special preferences.

2. Check the patient identity, operative site, and consent form are correct, review patient information, and communicate potential risks, hazards, and complications to team members including providing privacy, comfort, and supportive care to the patient.

3. Execute scrubs for the patients before surgery, adhering to aseptic techniques, gowning, and gloving, conducting swabs, instruments, and suture counts with a circulating nurse, and assisting with patient draping.

4. Provide the surgical site before the knife is handed to the surgeon by attaching suction tubing and an electrosurgical cord, participating in a "time-out" with the team, anticipating the surgeon, and discreetly requesting additional supplies.

5. Provide the surgeon with the necessary instruments, maintain cleanliness, wipe blood and debris, and save tissue specimens for laboratory examination.

6. Maintain a sterile technique by keeping their hands at waist level, confined to the sterile area after preparation, reducing traffic, never turning back to the field or colleagues, and not reaching behind the operating team for instruments.

7. Performs counts on swabs and instruments before closing any cavities and skin, and communicates with the surgeon after each count.

8. In the event of incorrect count:

• Conducts thorough counts and searches both on and off the sterile field, promptly addressing discrepancies, and ensuring an x-ray is taken if the count is incorrect, reporting incidents to the Unit Manager and completing necessary documentation.

• Provide essential information about specimen collection to the circulating or recovery nurse, maintaining a respectful tone and considering the needs of patients and colleagues.

• Conduct the proper disposal of sharps and used items following hospital policy, maintaining cleanliness and accounting for all used instruments, and coordinating with Central Sterile Supply Services staff.

• Maintain meticulous records of crucial information on the swab count form, ensuring room cleanliness and equipment readiness for the next surgery.

AN ANAESTHESIA NURSE

1. Oversees and prepares anesthetic equipment for surgery, ensuring sterility and cleanliness of the equipment including laryngoscopes, suction machines, masks, General anesthesia machines, and ventilators and working environment.

2. Check and verify daily the General anesthesia machines and ventilator, using monitoring equipment and accessories in the GA trolley and pediatric difficult intubation set.

3. Review patient information, including age, weight, surgical procedure, anesthesia type, allergies, and risks, and prepare and track necessary drugs, including dangerous and psychotropic substances.

4. Accompanied the patient during anesthesia induction, assisted the anesthetist in monitoring the patient throughout surgery, and maintained accurate anesthesia documentation.

5. Monitor patient safety during positioning by protecting their limbs, skin, eyes, airway, cannula, and catheter; share vital information with the recovery unit; and maintain a clean and organized environment for subsequent sessions.

A CIRCULATING NURSE:

1. Set up the operating room for scheduled surgeries, regularly check and record temperature and humidity, and notify superiors of any abnormalities.

2. Provide essential equipment, lotions, packs, sutures, and specimen containers available, and inspect potential hazards related to the operating table and mechanical adjuncts (e.g., electro-surgical units).

3. Adhere safety protocols, including “Time out” procedures, aseptic techniques, and infection control.

4. Conducts surgical counts with the scrub nurse, documenting accountable items, and coordinates and anticipates item needs during surgery.

5. Records the start and end times of operations, completes peri-operative care forms, and tags used items.

6. Execute connecting the diathermy cables and suctions, adjusting operating lights, and ensuring proper labeling of collected specimens.

7. Disposing of used linen and waste properly maintains the cleanliness and readiness of the room and equipment and remains in the operating room unless another person is present.

A RECOVERY NURSE:

1. Execute post-anesthetic care, including receiving patients from the operating room, ensuring airway maintenance, assessing consciousness levels, and administering prescribed oxygen.

2. Oversee and document vital signs such as blood pressure, pulse, and respiration on the recovery chart and ensure compliance with blood transfusions and intravenous drips.

3. Execute post-operative instructions, inform ward staff about patient discharge readiness, and communicate relevant information to registered nurses.

4. Maintain meticulous recording of patient arrivals, departure times, and nursing care, and ensure a cleanliness and readiness room.

5. Manage the record-keeping, issue, and indenting of dangerous drugs.

IN THE CENTRAL STERILIZING SUPPLY SERVICE

DECONTAMINATION ROOM STAFF:

Maintained cleanliness in the working area, received and inspected used sets from wards, clinics, and operation theatres, prepared disinfectant solutions, cleaned and disinfected instruments manually or using mechanical machines, operated and maintained equipment like ultrasonic machines, washers, and dryers, and record monitoring parameters.

PACKING AND STERILIZING STAFF:

Maintained cleanliness in work areas and equipment, checked instrument condition and functionality during assembly, rejected improperly cleaned sets, packed and labeled sets before sterilization, and recorded monitoring parameters.

STORAGE AND DISTRIBUTION STAFF:

Maintained the sterile store's cleanliness, monitored temperature and humidity regularly, verified sterile set integrity, used the "First-In, First-Out" system when issuing instruments, assisted with weekly instrument inventory in the sterile store, and provided other nursing services quarterly.

AUTOCLAVE OPERATORS:

Execute cleaning of the autoclave chamber, maintain records, and conduct efficiency tests (Chemical, Biological, and Leak) before running the machine.

HUMAN RESOURCE AND DEVELOPMENT

1. Accountable for personal and professional growth and keeps up to date with professional change by maintaining mandatory learning hours.

2. Executes continuous professional development through annual competency evaluations and privileges every 3 years, and is proficient in performing calculations and medication calculations.

3. Participates and contributes to the teaching program of the unit or ward and orientation of new members of staff to the ward routine.

4. Engage in the supervision of staff, which includes:

• Assistant Nurses, Midwives, Care Assistants, and student nurses assigned to the unit for their clinical experience to achieve the clinical attachment objectives.

5. Collaborates with the unit manager to evaluate staff performance, provide constructive feedback, and optimize staff, supply, and service utilization for efficient resource allocation and coordination with consultants for effective bed management.

6. Participate and contribute to the development and maintenance of the nursing process, ensuring effective patient care and documentation.

7. Participates in research initiatives and advocates for quality improvement through evidence-based practice.

POLICIES AND PROCEDURES

1. Participates in the review and revision of nursing policies, procedures, and work instructions, providing valuable insights, promoting best practices for optimal patient care, and continuously improving the process.

2. Inspect the DDA drugs with the previous shift's nurse in charge and adhere to hospital policies and procedures in medication care, custody, and administration.

3. Checks daily and audits resuscitation trolley periodically as scheduled.

4. Promotes infection prevention and control by ensuring staff follow protocols, implementing surveillance activities, and demonstrating commitment through personal involvement.

5. Maintain confidentiality of patient’s personal and medical history

FACILITIES AND EQUIPMENT

1. Operates and maintains specialized equipment in a unit, guiding new staff on the use of it and maintaining accurate records.

2. Collaborate with the unit manager to maintain equipment, medical supplies, consumable items, and drugs, ensuring proper functioning, service according to the planned preventive maintenance (PPM) schedule, and adequate stock and linen supply.

3. Notify biomedical personnel of faulty equipment and assist in maintaining instruments and equipment through proper cleaning, handling, disinfection, and usage.

4. Participate in a quarterly stock count with the finance staff.

SAFETY AND QUALITY IMPROVEMENT ACTIVITIES

1. Participate in and support activities aimed at the continuous improvement of nursing services, including quality assurance, infection control, and fire and safety programs.

2. Conduct thorough investigations, root cause analyses, appropriate response actions, and timely completion of incident reports within the stipulated timeframe.

3. Collaborate with unit manager to collect and evaluate clinical and administrative data, participate in hospital-wide surveys like MSQH, JCI, IMS and etc. for continuous quality improvement efforts.

4. Participate and contribute to the Baby Friendly Hospital Initiative certification, with a focus on promoting exclusive breastfeeding.

5. Adhere to the Occupational Safety and Health Act and Regulations 1994, which mandate reasonable work care, employer cooperation, protective equipment use, patient safety goals, World Alliance recommendations, patient and family rights policies, standard people practice, and 5S activities.