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  • Circulating Nurse Script

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    maga.abigail.bsn
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    1) This document outlines the steps of the WHO surgical safety checklist that is conducted before, during, and after a surgical procedure. 2) It includes introducing the surgical team members and their roles, addressing any patient-specific concerns, performing an initial instrument and sponge count before the first skin layer is closed, saying a prayer, and beginning the baseline count before incision. 3) It also includes performing a final count of instruments and sponges before the third layer of skin is closed and concluding the procedure.

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    1) This document outlines the steps of the WHO surgical safety checklist that is conducted before, during, and after a surgical procedure. 2) It includes introducing the surgical team members and their roles, addressing any patient-specific concerns, performing an initial instrument and sponge count before the first skin layer is closed, saying a prayer, and beginning the baseline count before incision. 3) It also includes performing a final count of instruments and sponges before the third layer of skin is closed and concluding the procedure.

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    © All Rights Reserved
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    188 views1 page

    Circulating Nurse Script

    Uploaded by

    maga.abigail.bsn
    1) This document outlines the steps of the WHO surgical safety checklist that is conducted before, during, and after a surgical procedure. 2) It includes introducing the surgical team members and their roles, addressing any patient-specific concerns, performing an initial instrument and sponge count before the first skin layer is closed, saying a prayer, and beginning the baseline count before incision. 3) It also includes performing a final count of instruments and sponges before the third layer of skin is closed and concluding the procedure.

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    of 1

    OR SCRIPT (CIRCULATING NURSE)

    This will be done once the patient has been prepared/draped and all OR Initial Counting
    team members are ready.
    INITIAL COUNTING
    WHO Surgical Safety Checklist (Before closure of the 1st layer of the skin)
    Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    Good morning/afternoon/evening (OR team/everyone):
    the team, we will now start with the INITIAL COUNTING for instruments,
    sponges and needles, starting with …
    W.H.O. Surgical safety checklist:

    Our patient is (name), (age). ⸏ 4 by 8 OS (8) – COMPLETE ⸏ Bandage scissors (1)


    In for (type of procedure/operation) under (type of anesthesia) ⸏ Blade holder (2) ⸏ Thumb forceps (1)
    With NO known allergies. ⸏ Blade (2) ⸏ Tissue forceps (1)
    NO difficulty of airway or aspiration risk. ⸏ Needle holder (2) ⸏ Debakey forceps (1)
    NPO for (time)
    HbSAg (negative/positive)
    ⸏ Ovum (1) ⸏ Suture (1)

    BO clearance (secured/not secured) ⸏ Cherry (1) ⸏ Army Navy (2)


    Pre-op medications given (drug name/dose/route/time given) ⸏ Kelly Curve (4) ⸏ Richardson (1)
    • Cefuroxime 750 mg @ 1 pm ⸏ Kelly straight (4) ⸏ Suction tip (1)
    • Metoclopramide 1 ampule IVTT @ 2 pm ⸏ Allis (4) ⸏ Cautery tip (1)
    • Ranitidine 1ampule IVTT @ 2:30 pm.
    ⸏ Bobcock (2) ⸏ Free tie (1)
    ⸏ Mayo scissors (1) ⸏ Towel clips (5)
    Names of Surgical Team ⸏ Metzenbaum (1)

    May I ask the Surgical team members to kindly introduce Circulating nurse:
    themselves and their roles? Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    the team, INITIAL COUNTING of instruments, sponges and needles done
    a. Dr. Name (Surgeon) and complete.
    b. Dr. Name (Asst. Surgeon/Assist)
    c. Dr. Name (Anesthesiologist)
    d. Name (Scrub Nurse)
    Final Counting
    e. Name (Student Scrub Nurse)
    f. Name (Circulating Nurse) FINAL COUNTING
    g. Name (Student Circulating Nurse) (Before the closure of the 3rd layer of the skin)
    Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    Patient-Specific Concerns the team, we will now start with the FINAL COUNTING for instruments,
    sponges and needles, starting with …
    May I ask the Surgeon for any patient-specific concerns? May I
    ask the Anesthesiologist for any patient-specific concerns?
    ⸏ 4 by 8 OS (8) – COMPLETE ⸏ Bandage scissors (1)
    ⸏ Blade holder (2) ⸏ Thumb forceps (1)

    Prayer
    ⸏ Blade (2) ⸏ Tissue forceps (1)
    ⸏ Needle holder (2) ⸏ Debakey forceps (1)
    Let us now pray: (+) ⸏
    ⸏ Ovum (1) Suture (1)
    God, the greatest Master of healing arts. Bless us and guide us and make ⸏ Cherry (1) ⸏ Army Navy (2)
    us your instruments in alleviating the pains of your ailing servants. Make
    ⸏ Kelly Curve (4) ⸏ Richardson (1)
    our eyes alert, our hands skillful and sensitive and fill our mental
    faculties with keenness to make righteous judgment so that others may ⸏ Kelly straight (4) ⸏ Suction tip (1)
    live. Amen. (+) ⸏ Allis (4) ⸏ Cautery tip (1)

    ⸏ Bobcock (2)
    ⸏ Free tie (1)
    You may begin.
    ⸏ Mayo scissors (1)
    ⸏ Towel clips (5)
    (START OF PROCEDURE begins at the TIME OF INCISION)
    ⸏ Metzenbaum (1)

    Baseline Counting Circulating nurse:


    Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    BASELINE COUNTING the team, FINAL COUNTING of instruments, sponges and needles done
    and complete.
    Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    the team, we will now start with the BASELINE COUNTING for instruments,
    sponges and needles, starting with …
    ⸏ 4 by 8 OS (8)
    ⸏ Bandage scissors (1)
    ⸏ Blade holder (2) SEQUENCE
    ⸏ Thumb forceps (1) CATEGORY SCHISTO EVMC
    ⸏ Blade (2)
    ⸏ Tissue forceps (1) WHO Surgical Safety Checklist 1 2
    ⸏ Needle holder (2) Names of Surgical Team 2 3
    ⸏ Debakey forceps (1)
    ⸏ Ovum (1) Patient-Specific Concerns 3 4
    ⸏ Suture (1) Prayer 4 5
    ⸏ Cherry (1)
    ⸏ Army Navy (2) Baseline Counting 5 1
    ⸏ Kelly Curve (4)
    ⸏ Richardson (1) Initial Counting 6 6
    ⸏ Kelly straight (4) Final Counting 7 7
    ⸏ Suction tip (1)
    ⸏ Allis (4)
    ⸏ Cautery tip (1)
    NOTE:
    ⸏ Babcock (2)
    ⸏ Free tie (1) • Induction of Anesthesia ___________________________________
    ⸏ Mayo scissors (1)
    ⸏ Towel clips (5) • Type of Anesthesia _________________________________________
    ⸏ Metzenbaum (1)
    • Time of Incision _____________________________________________
    • End of Operation ___________________________________________
    Excuse me, Dr. (Surgeon), Dr. (Asst), Dr. (Anesthesiologist) and the rest of
    the team, BASELINE COUNTING of instruments, sponges and needles done
    and complete.

    LGHM

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