Surgical Instrumentation procedure.
The anesthesiologist will give a hando
1. Gather Materials
2. Purpose of Surgical Operation
Surgery is performed for a number of reasons,
including treatment of a disease or injury, such as
removal of the gallbladder to treat in ammation and
gallstones, termed a cholecystectomy. Surgical
procedures that treat or cure disease are classi ed as
curative surgeries. Other purposes for surgery include
the following:
Diagnostic: Con rm presence of a disease
Exploratory: To determine the extent of the disease
condition
Curative: To treat the disease condition
a. Ablative: Removal of an organ
b. Constructive: Repair of congenitally defective
organ
c. Reconstructive: Repair of damaged organ
Palliative: Relieve distressing signs and symptoms but
not curing the disease
3. Stages of Operation
The term perioperative nursing refers to all the
activities and responsibilities assumed by a nurse
before, during, and after a surgical procedure. A
systematic tool, known as the nursing process, guides
the nurse in these procedures to ensure the quality of
care that a surgical patient will receive.
1. Preoperative Phase
This extends from the time the client is admitted to the
surgical unit, to the time he/she is prepared physically,
psychosocially, spiritually and legally for the surgical
procedure, until he/she is transported into the
operating room.
2. Intraoperative Phase
Extends from the time the client is admitted to the
operating room, to the time of administration of
anesthesia, surgical procedure is done, until he/she is
transported to the recovery room (RR) / post-
anesthesia care unit (PACU)
3. Postoperative Phase
The postoperative phase is from the time of admission
in the recovery room to the time of the follow-up
evaluation.
Extends from the time the client is admitted to the
recovery room, to the time he is transported back into
the surgical unit, discharged from the hospital, until the
follow-up care.
This is the last phase of perioperative nursing, and it is
just as critical as other phases. The patient needs to be
closely monitored for complications from the
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report to the nurse in the recovery room. The nurse’s
notes from the intraoperative phase are veri ed prior to
admission to the recovery room to make ensure that
the recovery room nurse is receiving the patient
anticipated.
4. Functions of Scrubs and Circulating Nurse
Scrub:
a. Works directly with surgeon within the sterile eld,
passing instruments, sponges and other items
needed during the procedure.
b. Members of the surgical team who prepares and
preserves a sterile eld in which the operation can
take place.
c. Responsible for the sponge counts, the blades and
needles and instruments check throughout the
operation.
d. Has a job requiring anticipation, quick reaction and
conscientious observation as well as knowledge of
anatomy and of operative procedures.
• Assists the surgical team
• Maintains sterility
• Handles instruments, prepares sutures,
receives specimen, counts
• Drapes patient
• Wears sterile gown, gloves
Circulating:
a. Checks all equipment for proper functioning such
as cautery machine, suction machine, OR light and
OR table
b. Make sure theater is clean
c. Arrange furniture according to use
d. Place a clean sheet, arm board (arm strap) and a
pillow on the OR table
e. Provide a clean kick bucket and pail
f. Collect necessary stock and equipment
g. Turn on aircon unit
h. Help scrub nurse with setting up the theater
Assist with counts and records
• Assists the Scrub nurse, opens & obtains
instrument, keeps record, adjust lights,
receives specimen, coordinates
• Positions the patient for surgery
5. Enumerate 13 Principles of Sterile Technique
13 Principles
1. Only sterile items are used within the sterile field.
2. Gowns are considered sterile only from the waist to
shoulder level in front and the sleeves.
 3. Tables are sterile only at table level.
4. Persons who are sterile touches only sterile items or
areas.
5. Unsterile person avoid reaching over a sterile field;
persons avoid leaning over an unsterile area.
6. Edges at anything that encloses sterile contents are
considered unsterile.
7. Sterile field is set up just before a surgical procedure
8. Sterile areas are continuously kept in view.
9. Sterile persons keep well within the sterile area.
10. Sterile persons keep contact with sterile area to
minimum.
11. Unsterile persons avoid sterile areas.
12. Destruction at integrity at microbial barrier result in
contamination.
13. Microorganism must be kept to an irreducible
minimum.
14. There should be no compromises with sterility.
Sterilization is the process of removing ALL
microorganisms including the bacterial spores.
However, not all things or area can be sterilized. The
following principles are employed to employ sterile
technique in: Skin
Air contains dust, droplets and shedding that may
cause contamination. Environmental control measures
include:
Movement around the sterile eld is kept to a
minimum.
Drapes are not ipped and fanned to avoid the spread
of dusts.
Talking inside the operating room is kept to a minimum
because moisture droplets are expelled with force into
the mask when a person is talking.
6. Classi cations of Instruments
- Cutting and Dissecting (Sharps)
- Clamping and Occluding (Clamps)
- Grasping and Holding (Graspers)
- Exposing and Retracting (Retractors)
- Suturing and Stapling
- Viewing
- Suction and Aspirating
- Dilating and Probing
- Measuring
- Accessory Instruments
Handwashing
Prescribed Number of Stroke
First Cycle
Left Nails: 20 strokes across nails
Left Fingers: 10 strokes to each side
Left Hand: 10 strokes to each side
Left Arm: 6 strokes to each side
Left Elbow: 3 strokes
Rinse brush
Right Nails: 20 strokes across nails
Right Fingers: 10 strokes to each side
Right Hand: 10 strokes to each side
Right Arm: 6 strokes to each side
Right Elbow: 3 strokes
Rinse hands, arms and brush
Second Cycle
Left Nails: 10 strokes across nails
Left Fingers: 5 strokes to each side
Left Hand: 5 strokes to each side
Left Arm: 3 strokes to each side
Rinse brush
Right Nails: 10 strokes across nails
Right Fingers: 5 strokes to each side
Right Hand: 5 strokes to each side
Right Arm: 3 strokes to each side
Rinse hands, arms and brush
Third Cycle
Left Nails: 5 strokes across nails
Left Fingers: 3 strokes to each side
Left Hand: 3 strokes to each side
Rinse brush
Right Nails: 5 strokes across nails
Right Fingers: 3 strokes to each side
Right Hand: 3 strokes to each side
Discard brush
Rinse hands and arms
Turn o the faucet then proceed to
OR

7. Identi cation of Blades

8. Put Blade in Holder

9. Identi cation of Instruments

10. Dispose Sharps and Wash Equipment

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