operation theatre techniques ppt
During the perioperative period several members of a multidisciplinary team may be present, together with occasional visitors, who may possess varying degrees of knowledge, training and experience. Ensuring a sterile surgical environment is an essential part of surgical safety.
Since the Health and Safety at Work Act 1974 the phrase has become synonymous with workplace legislation and the Management of Health and Safety at Work Regulations 1999 introduced more specific requirements to manage health and safety. There are additional health and safety issues specific to theatres. Every employee who works with ionising radiation should make full and proper use of the protective equipment provided. Every sharp object in a theatre should be regarded as a potential source of injury. Theatre hats are worn routinely, and prevent loose hair and skin from falling on wounds or equipment (Parker, 1999).
Needles, blades or instruments should never be passed directly hand to hand, but should be passed via a ‘neutral zone’, for example a receiver (Perry and Barnett, 1998). Special consideration must be given to patients under general anaesthetic, as they are unable to take care of their own safety needs or voice any concerns.
In the theatre environment, the principles of decontamination and asepsis underpin many health and safety policies and protocols, with the aim of avoiding the introduction and spread of infection.
Many of these checks may not be feasible in emergency surgery, however checks should be completed where possible if they do not cause the patient any harm. Please feel free to contact me if you have any questions or comments. There must be a wide margin of safety marked by an invisible wall at the trolley edges, which marks the barrier over which non-sterile items should not cross.
With the introduction of new European Union rules regarding the testing of re-usable materials it has been suggested that it will be increasingly common to use single-use gowns and drapes that are designed to resist wetting, tearing and bacterial penetration and dispersal (Line, 2003). When lasers are in use theatre staff should wear eye protection, doors should be locked and windows covered to protect those outside the theatre (Kitching and Edge, 2003). The count requires full concentration, should be audible, and should be carried out by two people, one of whom must be qualified. The number of people present in theatre should be limited to those necessary for the procedure and those present must wear lead aprons. The patient should not be in contact with grounded metal objects as the provision of an alternative pathway for the electrical current could result in a burn. The patient’s surgical outcome is enhanced by the promotion of an aseptic environment (Association for Perioperative Practice 2011). This is to ensure no foreign body remains in a patient after closure of a wound (National Association of Theatre Nurses, 1998). The scrub practitioner is responsible for counting all items used in an operation before incision, at first layer closure, and at skin closure. Any person who enters a theatre should wear theatre pyjamas. Last updated: May 23, 2019 Its continued use is controversial as evidence is not conclusive that wearing a mask reduces postoperative infection.
If the skin is exposed to laser radiation it can cause a burning sensation. A meticulous theatre-cleaning regime is fundamental to preventing infection.
The key areas of surgical infection control include: Prophylactic antibiotics are given to counter a high risk of wound infection or in regions where infection causes severe consequences (such as a prosthesis). If the patient has a pacemaker, this is the system of choice to avoid a monopolar current passing through the heart. This article has been double-blind peer-reviewed. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Instruments should be inspected by the scrub nurse and rejected if any visible sign of contamination remains after the sterilisation process. Diathermy may be used in either monopolar or bipolar mode. Sue Saunders, BSc, RN, is staff nurse, the Royal Bournemouth Hospital. This enables patients who have previously been assessed to arrive directly from home on the morning of their operation.
It provides initial checks for both operating staff and the ward nursing staff: Figure 1 – Example Nursing Checklist for Pre-Operative Management, Nursing check – completed by a member of the nursing staff involved in the patient’s pre- and post-operative care.
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