St.

Paul University Philippines

Tugueagarao City, 3500

Mark Robin B. Umuso

Professional Accountability in Perioperative Nursing

In the battle to improve patient safety, surgical site infection is a major focus of the various
quality assurance associations as well as the Centers for Medicare and Medicaid Services (CMS).
This year, for specific procedures, surgical site infections will be included in CMS’s denial of
payment for hospital-acquired complications. In light of the growing global economic crisis, this
also presents an added challenge to hospitals trying to maintain fiscal well being. Developing
“zero tolerance” for healthcare-acquired infections must take center stage if we are to be
successful.

This is an undeniable opportunity for nursing to shine. Sterilization, aseptic technique, skin
preparation, appropriate antibiotic timing, maintenance of normothermia, environmental controls
and handwashing are but a few of the measures falling under the umbrella of perioperative
nursing practice. Not only are nurses accountable for their individual practice, they are
responsible for coordinating team intervention. This is an awesome charge.

Performance excellence is dependent upon the nurse’s self confidence and critical thinking. The
American Nurses Association (ANA) Code of Ethics for Professional Ethics refers to this in
Provision Four, Duty to Self. Clearly we are mandated to maintain our knowledge and skill with
education and networking with professional colleagues. This commitment to lifelong learning is
essential in maintaining the high standards we need to serve our patients and coordinate the
team’s efforts to achieve positive patient outcomes.

What better place to network and take advantage of educational opportunities than the 56th
AORN Congress to be held in Chicago, March 14-19? Chicago is an exciting venue, with the
additional lure of the city’s famous St. Patrick Day’s celebrations. Educational events offer many
topics of importance on infection control. Our new intensive educational workshops include the
Sterilization Certificate Program on March 14 and Infection Prevention on March 15. There are
educational sessions daily addressing topics of interest. Sterilization, multidrug-resistant infected
wounds, SCIP implementation, cardiac surgical site infections, and sterile processing department
operations are a sampling of what is planned. Networking is enhanced by the various receptions,
special evening events and our Specialty Assembly meetings.

Susan K. Banschbach, RN, MSN, CNOR, is AORN president and director of surgery services at
St. Francis Hospital in Tulsa,
Reaction:

Professional accountability in perioperative nursing is a broad descriptor encompassing

everything from the manner of our dress, to our values, ethics and moral beliefs. The cornerstone
of our practice, however, is the sacred trust our patients place in that professional accountability.
The patient sees the perioperative nurse as their advocate, looking out for their safety as they
journey through a very vulnerable time. Central to that trust is the patient’s expectation to be free
from infection. Professional accountability applies to everyone involved in health care.

Accountability is a legal obligation in health care it is also an ethical and moral

responsibility. A professional nurse has the responsibility to practice within his/her scope of care,
calling upon his/her knowledge and skills to make decisions in the best interest of the patient.
The level of responsibility and accountabilitydepends on professional levels. The Charge Nurse
has more responsibility then the staff nurse, the RN has more responsibility, and therefore their
levels of professional judgment and practice are different. Their levels of professional
accountability are not different.Professional nursing is based on altruism, integrity,
accountability and social justice. Judgments and practice that are based with those ethical values
will always be in the best interest of the patient, no matter what the professional level.

And most of all, nurse practice acts and nursing practice standards provide the foundation
for perioperative nurses' accountability and responsibility. Core activities for perioperative
nursing care include assessment, diagnosis, outcome identification, planning, implementation,
and evaluation. When these activities are incorporated into daily practice, perioperative nurses
are empowered to provide safe and competent care.

St.Paul University Philippines

 Tugueagarao City, 3500

Mark Robin B. Umuso

Learning Journal

The surgical suite, also called the operating room is a mysterious and fascinating arena.
This is where a patient usually encounters their surgical experience. This is where the surgical
care givers wear masks and work behind closed doors. I’m beginning to feel more like a
beneficiary than a volunteer helper, because I’ve been allowed to experience and learn so much.
I watched the entire surgical process in the operating room on my first day of exposure on Jose
Reyes Memorial Medical Center to learn more and to adopt on my new environment. The
surgeons and other members of the surgical crew are always generous with information, patiently
explaining medical procedures and stuff if you care to ask them. The nurses were great; as the
doctors and med-students were performing all of these tasks (quite well I might add) the nurse
was explaining and reassuring the patient about what was going on. The patient was very brave.

I learned a great deal about the nursing roles in the operating room from this experience.
There were two roles in this operating environment, scrub nurse and circulating nurse. The scrub
nurse was responsible for working within the sterile field. The scrub nurse also organizes,
anticipates and provides the tools necessary for the surgeon to complete the procedure. The two
other nurses in the room were circulating nurses. These two were responsible for retrieving
supplies outside of the sterile field. These nurses also anticipate the needs of the scrub nurse and
monitor/record counts. This is an important task because you wouldn’t want to forget a sponge in
someone.

It was indeed a great and meaningful experienced.