The Role and Responsibility of the Operating Department Assistant in Operating Theatres

1. The Role and Responsibility of the Operating Department Assistant in Operating Theatres Fasie Smith Nursing Operations Manager

2. I will discuss … • What is Nursing? • The theatre environment. • What is operating department assistance? • Roles and responsibility of individual team members.

3. What is nursing? … • Many definitions and theories for nursing. • For the purpose of this discussion:- • “Virginia Hendersons need theory” • “The unique function of the nurse is assist the individual, sick or well, in the performance of those activities contributing to health and recovery (or to peaceful death) that he would perform unaided if he ad the necessary strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible” • How does this relate to the nurse in the theatre environment.

4. The 14 Components of the Theory … • Breathe normally. Eat and drink adequately • Eliminate body waste. • Move and maintain desirable postures. • Sleep and rest. • Select suitable clothes – dress and undress. • Maintain body temperature within normal range by adjusting clothing and modifying the environment. • Keep the body clean and well groomed and project from injury. • Avoid dangers in the environment and avoid injury. • Communicate with other in expressing emotions, needs, fears and options. • Worship accordingly to ones faith. • Play and participate in various forms of recreation

5. The Theatre Environment and what happen there?... • Reception area • Anaestheticroom • Operating room/theatre • Recovery room • Disinfection and sterilization • Equipment and consumable stores

6. Definition … • The joint commission defines surgical technologist in its Lexikon: Dictionary of healthcare terms, organizations and acronyms for the era of reform as follows: • “An allied health care worker who works closely with surgeons, anesthetists, registered nurses and other staff to provide patient care and assuming responsibilities before, during and after surgery”

7. The Association of Surgical Technologist State (USA): … • Services the patients interest by providing assistance to the surgeon. • Predict the intra-operative needs of the surgeon. • Has a good understanding of the basic sciences: Anatomy, microbiology, pathophysiology and medic-legal practice within the theatre environment. • Technical knowledge and skill to manage surgical equipment and instrumentation. • Manage the surgical environment.

8. The Three Phases of Surgical Management… • Pre-operative • Intraoperative • Postoperative

9. Pre-operative Area (Specifics) … • Assist with the preparation of the operating room. • Conducting a preoperative patient interview. • Transporting the patient to the theatre. • Verify correct patient. • Transferring the patient to the operating table. • Positioning the patient. • Verify the correct surgical site. • Prepping the patient. • Draping. • Connect various tubes and cords. • Providing additional items to the surgical field during the procedure. • Maintaining documentation. • Caring for specimens. • Securing dressings. • Transferring patients from the operating tables. • Transporting patient to recovery area. • Preparing theatre for the next patient.

10. Intra-operative … • Maintaining a sterile field, including the establishment of a neutral zone. • Passing instrumentation, equipment and consumables to the surgeon and first assistant. • Assessing and predicting (anticipating) the needs of the surgeon to optimally perform the surgery at hand. • Preparing irrigation fluids. • Counting checks. • Management of specimens. • Clearing of skin (blood and prep solutions). • Preparing and applying dressings.

11. Post-operative Period … • Maintaining a sterile field until the patient is transported from the theatre. • D-assembling the sterile field. • Removing used instruments, equipment and consumables from the theatre. • Caring for and maintaining instruments, equipment and supplies following use. • Prepare for next patient. • Complete appropriate documentation.

12. The Team … • Surgeon, • Anaesthetist, • Nurse – scrub, anaesthetic and recovery area, • Administration, • Disinfection and sterilization, • Pharmacist , • Technologist – i.e. Cardiac.