Virtual tour in the Operating

Room set-up
Waiting Lounge
OR main Entrance
Receiving Area
Dressing /Changing Room
Scrubbing area
Hallway
Transport
OR ZONES

Unrestricted zone
• Can enter in street clothes
• Receiving desk
• locker rooms
• Changing rooms
Semi restricted zone
• Surgical attire required
• Hallways, storage areas
Restricted zone
• Controlled and germ-free
Scrub attire required
• OR and rooms where
sterile instruments are prepared
• Sterile Room, Inside Operating
theaters.
Operative permit/ Surgical
Consent
INFORMED CONSENT

Operative permit/ Surgical Consent

• An agreement by a client to accept a
course of treatment or a procedure after
complete information, including the risk
of treatment and facts relating to it has
been provided by the physician.
• The client signs the form and the nurse acts
as a witness.
INFORMED CONSENT

3 ELEMENTS:
1. It must be given voluntarily
2. It must be given by an individual
with the capacity and competence
to understand.
- 18 years and above, conscious &
oriented.
INFORMED CONSENT

3 ELEMENTS:
Are not considered functionally
competent:
- Confused, disoriented, sedated,
minors, unconscious, mentally ill
3. The client must be given enough
info to be the ultimate decision
maker.
CIRCUMSTANCES REQUIRING A
CONSENT:

1. Any surgical procedure where a

scalpel, scissors, sutures, hemostats
maybe used.
2. Entrance into a body cavity.
3. General anesthesia, local
infiltration, regional block.
CIRCUMSTANCES REQUIRING
A CONSENT:

• In a life-saving emergency, the

surgeon may operate without
consent.

• Every effort must be made to

contact the family.
12 Principles
of
OR technique
12 Principles of OR technique

Surgical Conscience
ü is one’s inner voice for the conscientious
practice of asepsis and sterile technique at all
times.
ü Is the foundation for the practice of strict
aseptic and sterile techniques.
ü It is self-regulation in practice according to a
deep personal commitment to the highest
values.
12 Principles of OR technique

1. All articles in the OR are previously

sterilized.
12 Principles of OR technique

2. Persons who are sterile touch only

sterile articles; persons who are unsterile
touch only unsterile articles.
12 Principles of OR technique

3. If in doubt of the
sterility of
something
consider it unsterile.
12 Principles of OR technique

4. Non-sterile persons
avoid reaching over
the sterile field;
sterile persons
avoid leaning
over unsterile field.
12 Principles of OR technique

5. Tables are sterile only at table level.

12 Principles of OR technique

6. Gowns are considered sterile only from the

waist to shoulder in front level, and on the
sleeves.
Areas of gown considered unsterile are:
• 1. Gown’s neckline
• 2. Shoulders
• 3. Under the arms
• 4. Back
• Not to allow the hands or any items to fall
below the level of sterile field.
• No sitting nor leaning against unsterile surface
because of great contamination.
Gowns are considered sterile only on the:
1. Front of gown from chest to the level of the
sterile field.
2. Sleeves of gown from 2 inches above the
elbow to the cuff.
Note: Cuff should be considered unsterile due
to it tends to collect moisture & it is not an
effective barrier. Therefore, cuff should always
be covered by sterile gloves.
12 Principles of OR technique

7. Edges of anything
that encloses sterile
articles is considered
unsterile.
12 Principles of OR technique

8. Sterile persons keep

well within the sterile area.
12 Principles of OR technique

9. Non-sterile persons keep away from sterile

area.
• Unscrubbed personnel should face the sterile
field on approach
• Should not walk between sterile fields or
scrubbed persons
• Should maintain a distance of at least 12-18
inches from the sterile filed and scrubbed
persons at all
12 Principles of OR technique
10. Sterile persons keep in contact with sterile
areas in a minimum.
• Face to face or back-to-back.
• Turn back to a non-sterile person or when
passing.
• Face a sterile area when passing the area.
• Ask a non-sterile person to step aside rather than
trying to crowd past him.
• Step back away from the sterile field to sneeze or
cough.
12 Principles of OR technique

• Turn head away from sterile field to have

perspiration mopped from brow.
• Stand back at a safe distance from the operating
table when draping the patient.
• Members of the sterile team remain in the
operating room if waiting for the case.
• Do not wander around the room or go out in
the corridors.
12 Principles of OR technique

11. Moisture may cause contamination.

12 Principles of OR technique

12. When bacteria cannot be eliminated from a

field, they must be kept to irreversible
minimum.