Operating Room

PART I
Ns. Heri Kristianto. SKep., MKep
Department of Medical Surgical
Nursing

Definition
One of the hospital unit to operate service
Surgery: unique human experience
Perioperative nursing 3 phases of surgical
intervention
Combining of physiologic, psychosocial,
task oriented and patient

Clasification of Surgical Procedures

Purpose
Diagnostic, Ablative, Constructive,
Reconstructive, Palliative, Transplant
Risk
Minor & Major
Urgency
Elective, urgent, emergency

Procedure
Receptionist
PRE
Premedication

Operation Room

Recovery Room

INTRA

POST

Three zone concept

Outer zone or non restricted area
Intermediate zone or semirestricted area
Inner zone or restricted area

Outer Zone (Protective Zone)

Receptionist
Holding/ admision area
Post Anesthetic Care Units (PACU)
Dressing room
Office
Lounges
Laboratory

Intermediate Zone (Clean Zone)

Clean & sterile supplies

Sterilization processing
Distribution area for instrument &
nondisposable equipment
Corridors leading to procedure rooms
Substerile utility areas

Inner Zone
The procedure room where surgery is
performed and adjacent substerile areas
where the scrubs sinks & autoclaves are
located

Surgical Team

The surgeon
The first assistant to the surgeon
The anesthesiologist
The nurse anesthetist
The scrub asisstant
The circulating nurse

Procedure surgical:

Preoperative
Instrument
Intra operative
Postoperative
Documentation

Preoperative
Team Surgical

Patient

Procedure taught:
1. Deep breathing & coughing
2. Turning
3. Leg & arm exercise

Shaving of
Schedule
Informed Consent surgical area
Enema
Vital sign
Fast

General discussion:
Goals
Description of
operation

Instrument
Sterilization equipment & room
1. Steam sterilization: autoclave
2. Chemical sterilization: ethylene oxide
3. Physical sterilization: ionizing radiation
(Cobalt 60)

Intraoperative

Transporting, moving and lifting the patient

Positioning the patient for surgery
Performing the surgical skin prep
Conducting & maintaining accurate records
of counts
Maintaining accurate documentation of
nursing activities

Positioning the patient for surgery

Skin Prep

Post operative

1.
2.
3.
4.
5.

Periods begins with the transfer of the patient to

the designated postanesthesia area and ends with
the resolution of the surgical experience
The activities should be completed:
Intraoperative documentation
Specimens
Special equipment PACU
Moved to recovery bed
Verbal/ written reports

Documentation
The patients record should reflect the
perioperative plan of care, including
assessment, planning, implementation,
evaluation, and expected outcomes