COMPETENCIES

SCRUB NURSE CIRCULATING NURSE

1. Schedule of Operation (With B.O 1. Schedule of Operation (With B.O Clearance)

Clearance) Prepare the room and the ff:
Prepare the room a. Anesthesia Machine and Medication Box
a. Back Table (major 1/major 2/minor 1) and the yellow
 Surgical drums box at the ref.
 Supplies b. Spinal mayo table
b. Mayo Table c. Prep table and catheterization set
 Instruments d. Added machines:
 Supplies  Suction
 Oxygen
 Cautery
 Cardiac monitor
 Patient monitor
 Infusion pump
 Blood warmer
e. E-cart
f. Forms:
 Rx pad, OR/DR charge slip,
General Surgical Assessment
Checklist, Surgical Safety
Checklist, Post Operative Order
Sheet, and OR/DR Charge
Slip(supplies)
 Record of Operation
 Nurse’s Operating Room Record
 Anesthesia Record
 Pre-anesthetic Evaluation Record
 Specimen pathologic request form
 Dietary request form
g. Cap and Leggings

2. The ward nurse informed to wheeled in 2. The ward nurse informed to wheeled in the
the patient: patient:
a. Open and prepare all the ff sterile a. Open and prepare all the ff sterile items:
items:  Surgical prep and catheterization set
 Surgical drums  Spinal mayo table
 Supplies
 Instruments
 Soaked scissors and needle
holders

3. Once the patient is in the lobby 3. Once the patient is in the lobby
 a. Do surgical scrubbing a. Check for precautions
b.Gowning and Gloving b. Introduce yourself to the patient
c. Set up the mayo table and the back c. Check the patient using the ff. guidelines:
table  Pre-op checklist
d.Arrange the instruments,  Surgical safety checklist (SIGN
 Load the scalpel holder with the IN)
desired blade.  General surgical assessment
 Prepare the ATR/s and attached checklist (PRE-OPERATIVE)
to needle driver/holders’ d. Check the Vital Signs (Temperature,
 Make sponge stick (4x4 with Respiratory Rate, Pulse Rate, Blood
det. and Ovum forcep), Pressure and O2 Saturation, FHB)
 Make peanuts on allis forcep e. Put on the leggings and OR cap
 NATR (Strands and Schnidtz) f. Loosen the back of the patient’s gown
 Cautery pen on towel clips g. Check the IVF patency and all contraptions
 Poole drain on towel clips h. Receive endorsement from the assigned
ward nurse
 Check the consent of operation and the
one who signed.
 Special endorsement of the ff.:
 Due medications
 Nebulization
 CBG
 Attach to cardiac monitor
 Intra-op X-ray machine
 X-ray films
 Post-op ECG
 All needed lab works
i. Transfer patient safely to inside stretcher
using easy move going to Operating Room.

4. Patient at the OR (major 1/major 4. Patient at the OR (major 1/major 2/minor 2)

2/minor 2) a. *Take note the time
b. Transfer patient to OR table safely
c. Attached patient to patient monitor
d. Do the initial counting
 Sponges:
a. Do the initial counting  2/3
 Sponges:  Lap packs
 2/3  4x4
 Lap packs  Peanuts
 4x4  Square packs
 Peanuts  Loose needle
 Square packs  ATR/s
 Loose needle  Instruments
 ATR/s  Mosquito curve
 Instruments  Mosquito straight
 Mosquito curve  Allis
 Mosquito straight  Kelly
 Allis  Bab cock
 Kelly  Ochsners curve
 Ochsners straight
  Bab cock  Ovum
 Ochsners curve  Needle holders
 Ochsners straight  Thumb forceps
 Ovum  Tissue forceps
 Needle holders  Adson toothed/nontoothed
 Thumb forceps  Blade handle #3
 Tissue forceps  Blade handle #4
 Adson toothed/nontoothed  Blade handle #7
 Blade handle #3  Metzenbaum
 Blade handle #4  Mayo scissors
 Blade handle #7  Suture scissors
 Metzenbaum  Bandage scissors
 Mayo scissors  Umbilical scissors
 Suture scissors  Army navy
 Bandage scissors  Richardsons
 Umbilical scissors  Self retaining + Screws
 Army navy  Towel clips
 Richardsons  Others : Additional
 Self retaining + Screws Individual instruments
 Towel clips
 Others : Additional
Individual instruments e. Pray (before Anesthesia Induction)
f. Position the patient and prep for induction
of anesthesia
g. Assist the anesthesiologist upon
induction. *Take note the time.
h. Place cautery pad and prepare x-ray film.
i. Do the perineal prepping and
catheterization
j. Do the surgical prepping.
k. Do the TIME OUT while drapping.
l. Pour the NSS irrigation to the sterile bowl.

b. Assist surgeon in gowning and

gloving
c. Assist surgeon in draping
d. Place the mayo table and back table m. Take note the time started (cutting
over the patients legs time)
e. Put on the sterile OR light handle to the n. Set-up cautery.
unsterile OR light handle o. Turn ON the suction.
f. Pass the 1 sponge to the surgeon
st p. Place 2 kick buckets for soaked sponges and
for wipping off the betadine waste.
g. Pass the 1 knife. *Note the
st q. Prepare the sponge rock for soaked sponges
cutting time. and pick-up forcep
h. Prepare the cautery pen and the poole r. Position the back table
drain using the towel clip and clip on s. Update forms
top of the linen t. Be ready and anticipate always for the OR
i. Anticipate and pass the needed items of team needs.
the surgeon and assistant surgeon.
j. Prepare the ATR/s attach to needle u. Specimen out. Take note the time.
holders (small needle ------ short needle
holder); (big needle ------- long needle
holder)
k. Specimen out. Note the time and v. Baby out and placenta out. * Take note
secure specimen. the time and the gender of the baby.
l. Baby out and placenta out. Take note
the time and the gender of the baby.

w. Do the counting
m. Do the counting  1 count --- before peritoneum’s
st

 1 count --- before peritoneum’s

st closure or prior to closure of a cavity
closure or prior closure of a within a cavity (ex, uterus at CS). *
cavity within a cavity (ex. uterus Record & report to the surgical
at CS) team.
 2 count --- before the closure of
nd

muscle and anterior fascia

 Final count --- during subcutaneous
tissue closure.* Record & report to
 2 count ---before the closure of
nd

the surgical team of the Final

muscle and anterior fascia
Count. Sign the Nurses Operating
 Final count ---during
Room Record.
subcutaneous tissue closure.
*Sign the Nurses Operating
Room Record.
x. Prepare 2 cherry balls with betadine.

y. Take note the top dressings/packing

and offer transpore.
n. Prepare 2 cherry balls with
z. Take note the time ended.
betadine using mosquito/kelly
aa. Clean patient. Drain the urine output.
forcep.
o. Take note the top dressing/packing. .
bb. Safely transfer patient to Room/RR via
inside stretcher with easy move.
p. Take note the time ended cc. Check and read post-op orders for any
q. Clean patient and change new clarification if you can’t understand the
patient gown with diaper hand writing of the surgeon.
r. Safely transfer to inside stretcher dd. Secure specimen. And make sure to log in
with easy move. at the specimen logbook
s. Discard properly all sharps and
needles. TO RECOVERY ROOM:
t. Soak the instruments, suction  Prepare the following:
bottle, buckets, sponge rock.  Patient monitor
u. While soaking:  ECG machine
 Return unused stocks and  E-cart
instruments.  Glucometer
 Clean the room (tables, bed,  Droplight
anesthesia machines, replace  Infusion pump
plastics).  Woolen Blanket
 v. Inform the Orderly for floor  Aldrete Score form
cleaning and UV sterilization  Vital signs monitoring sheet
w. Wash the instruments, dry and pack and  I and O (hourly) if needed
label all sets/individual instruments  Medicine’s Box
x. Wash the Doctors slippers  Carry out Doctors Order at the Recovery
y. Collect and hamper the Scrub Suit of Room and
the Doctors and log it on the hamper  Log patient’s name at the RR sheet
logbook. provided.
 Drain output, measure and record.
 Inform ROD for post op evaluation and for
transfer out at least 30 minutes before.

TO ROOM/WARD:
 Finalized all the papers before transferring
out the patient
 Inform ward/room Nurse prior to transfer
and emphasize the needed things to prepare
at the bedside. (ex. Oxygen, suction
machine, infusion pump and etc…)
 Transfer patient safely to room/ward with
easy move.
 Endorse patient at the bedside properly.

5. Forward the specimen with formalin to

laboratory for histopath and let the folks
and the laboratory sign the specimen
logbook.

6. Check and refill sevoraine

7. Erase all the writings on the white board.

8. Collect and check the following:

 Used ampules, vials, IVF
 Used syringes
 Anesthesia breathing circuit
 GA mask
 Airway
 Suction Catheter
 ET Tube
 KY
 Leukoplast
 Gloves
 Epidural set
 Spinal needle

*Please return the unused/discard properly all

used items
9. Review and get the replacement of the
medicines used in the pharmacy after
arrangement from the billing section and
 return to its proper place.

5. Counter check/ review the OR/DR 10. Check , charge and record the ff:
Supplies Charges  OR/DR charges
 OR/DR Supplies Charges (forward to
CSR and get the replacement and
return to its proper place and file the
copy.)
 Equilife Charges (forward to billing
and attach yellow copy to pt. chart.)

11. Log case to the OR logbook at the

Recovery Room.

END