Standard Operating Procedures

Theatre
Procedure

a) The in-patient nurse in-charge needs to prepare a theater list the day prior the scheduled
procedure for all elective surgery cases. This is to enable adequate preparation by the
theatre staff.
b) Written informed consent from all the scheduled patients for surgery. If Patient either
cannot consent or is under the legal age, and the next of kin or legal guardian signs the
consent they must do so on their behalf. The consent includes administration of
anaesthetics, surgical blood transfusion.
c) The in-patient in-charge, anesthetist and operating surgeon must take pre-patient's
preparations for the operation done in good time. This includes investigations
• fasting orders
• pre-medication
• site preparation (shaving, marking etc.).
• Pre-operative review by the anesthetist and the operating surgeon also be done before the
patient is brought to the theatre.
d). Responsibilities of the Anesthetist in the Operating Theatre;
• Checking the anesthetic machine, oxygen source, monitors, and laryngoscope and suction
machine.
• Label all anesthetic medication properly.
• Stand-by supply of oxygen and equipment: Ambu-bag, emergency drugs
• Setting up intravenous lines and administering intravenous fluids, blood, and medication.
• Setting monitors
• Pre-medication
• Induction, maintenance, monitoring, and reversal of anesthesia.
• Patient monitoring, documentation during immediate postoperative
• break time for at least an hour
• Detailed anesthesia notes and records, along with posting of the operation instructions
e) The operating surgeon and assistant should see that proper instrument, swab, packs and
gauze counts during the operation. The surgery was done under general anesthesia with
close monitoring of the vital.
f) The performing surgeon shall write detailed notes on the operation including post-
operation instructions. He/she is also responsible for recording any procedure performed
in the Main theatre book.
g) The operating surgeon should conduct post-operation review and put in place adequate
mechanisms for dealing with any emergency e.g. bleeding in the post-operation period.
h) The operating surgeon should ensure that all specimens are well labeled and follow up
with the lab post operation.

i) The in-patient in charge and theatre technician shall be responsible for the following in
theatre;
• Maintenance of theatre cleanliness and waste disposal
• Observation of proper theatre attire by all theatre users
• Observation of proper scrubbing-in technique and maintenance of sterile areas for
operations
• CSSD
• Maintenance of equipment and organizing for repairs and replacement
• Theatre supplies
• Theatre should be cleaned immediately after every procedure and ready for next.
• The Anesthetists should monitor the patient after surgery for at least 1 hour.
• There should be proper documentation on the management of patient at this
stage.