DACUM Research Chart for Operating Room Circulating Nurse DACUM by benbrown


									DACUM Research Chart for
Operating Room Circulating Nurse
DACUM Panel Members

Patricia G. Felice Meckes
Kaiser Permanente
Downey, CA
                                     Produced by
Pamela Giblin
Saddleback Memorial Medical Center
Laguna Hills, CA

Judith A. Kidd
Fountain Valley Regional Hospital
Fountain Valley, CA

Lydia Helen Mormann
San Antonio Community Hospital
Upland, CA
                                            Leadership and Economic Development Institute
Louise Nowel                                         8800 Grossmont College Drive
Hoag Memorial Hospital                                El Cajon, California 92020
Newport Beach, CA

Patricia Sponberg
Mission Hospital
Mission Viejo, CA

                                                         Dates: June 7 – 8, 2002

DACUM Facilitator
Mary O’Connor
South Orange County Community
  College District
Anaheim, CA
                                     Developed and published under contract #01-005-002 with the California
                                     Community Colleges Chancellor's Office. This work is a product of the
DACUM Supervisor                     Statewide Special Project Collaborative in Health Occupations operated by
Joanne Gray                          Grossmont-Cuyamaca Community College District and does not necessarily
Saddleback College                   reflect the policy of the Board of Governors of the California Community
Anaheim, CA                          Colleges. Permission is hereby granted to reproduce this work, in whole or
RHORC Project Director               part, for classroom or curriculum use.
DACUM Research Chart for Operating Room Circulating Nurse                                                                                                                             June 7 – 8, 2002
Job Description: The operating room circulating registered nurse is the member of the peri-operative
team who serves as a patient advocate by assessing. planning, implementing, and evaluating care of the
surgical patient during the intra-operative period to optimize peri-operative outcomes.
           Duties                                                                              Tasks
                            A-1 Review         A-2 Inspect         A-3 Inventory      A-4 Pretest          A-5 Obtain proper instrumentation   A-6 Ensure        A-7 Inspect the    A-8 Monitor sterile technique
    Prepare/Open            surgery schedule   room cleanliness    basic O.R. room    equipment for        supplies according to preference    inventory of      integrity of all   during set up of sterile field
A   Operating Room                                                 equipment          functionality        card                                stock             sterile supplies

                            A-9 Set up         A-10 Perform
                            invasive lines     initial count of
                                               equipment /
                            B-1 Verify         B-2 Prepare         B-3 Select /       B-4 Prepare          B-5 Prepare        B-6 Prepare      B-7 Prepare       B-8 Prepare        B-9 Prepare suction device (e.g.,
    Obtain Specialty        laminar flow is    operating room      prepare video      sequential           laser equipment    positional       microscopes       smoke evacuator    Cav Ultrasound Suction equipment,
B   Equipment By            turned on          table               carts              compression                             devices                                               Berkeley Suction)
    Preference Card                                                                   devices
                            B-10 Prepare       B-11 Prepare        B-12 Prepare       B-13 Prepare
                            warming devices    orthopedic          auto transfusion   power
                                               equipment                              equipment

                            C-1 Identify the   C-2 Review the      C-3 Validate       C-4 Review the       C-5 Interview      C-6 Reinforce    C-7 Verify the    C-8 Report abnormal findings to       C-9 Verify
    Complete the            patient            medical record      the pre-op         patient physical /   the patient        patient          surgical site     surgeon and anesthesiologist          presence of
C   Patient Pre-Op                                                 checklist          psychosocial                            education                                                                surgical team
    Assessment                                                                        assessment
                            D-1 Admit          D-2 Apply           D-3 Provide        D-4 Assist with      D-5 Position the   D-6 Prep the     D-7 Assist with   D-8 Assist with    D-9 Apply additional devices to
    Prepare Patient         patient to         monitor devices     psycho-social      induction of         patient for the    surgical site    sterile gowning   sterile draping    patient per procedure
D   for Surgical            operating room                         support prior to   anesthesia           procedure
    Procedure               suite                                  induction
                            D-10 Connect       D-11 Confirm
                            all equipment      consent with
                                               surgical team
                                               prior to incision
DACUM Research Chart for Operating Room Circulating Nurse                                                                                                                                      June 7 – 8, 2002
Job Description: The operating room circulating registered nurse is the member of the peri-operative
team who serves as a patient advocate by assessing. planning, implementing, and evaluating care of the
surgical patient during the intra-operative period to optimize peri-operative outcomes.
           Duties                                                                              Tasks
    Supervise               E-1 Supervise labeling of solutions   E-2 Monitor          E-3 Monitor          E-4 Manage            E-5 Perform all    E-6 Monitor for     E-7 Maintain        E-8 Monitor and document
E   Intra-operative         and medications on sterile field      need for             safe use of          handling of           required counts    potential hazards   environmental       additional procedures not consented
                                                                  additional sterile   equipment (e.g.,     specimens                                                    controls,
    Care                                                          supplies             fire safety)                                                                      including traffic
                            E-9                E-10 Communicate patient progress       E-11 Report          E-12 Monitor          E-13 Ensure
                            Troubleshoot       to family / significant other           progress of case     activities of non-    sterility of
                            equipment                                                  to front control     hospital personnel    instruments and
                                                                                       desk                                       equipment

    Provide Support         F-1 Provide additional medications,   F-2 Assist with additional                F-3 Respond to        F-4 Verify         F-5 Monitor         F-6 Provide         F-7 Assist with    F-8 Assist with
                            supplies, and equipment               procedures (e.g., spinal, blood           emergency             blood products     blood loss /        point of cave       extubation         transport of
F   to the Anesthesia                                                                                       situations
                                                                  draws)                                                          with anesthesia    urine output        testing (e.g.,                         patient from the
    Provider                                                                                                                      provider                               glucose, H&H)                          operating room

    Prepare                 G-1 Assist with    G-2 Assist with    G-3 Assist with      G-4 Evaluate patient outcomes (e.g.        G-5 Discharge      G-6 Provide
G   Patient for             application of     casting /          removal of           skin integrity related to pressure and     from operating     report to
                            sterile dressing   splinting          surgical drapes,     devices)                                   room               receiving unit
    Discharge                                  surgical site      supplies
                            H-1 Complete       H-2 Complete       H-3 Validate         H-4 Complete         H-5 Complete          H-6 Update         H-7 Report
  Complete Required                                                                                         flash sterilization
H Peri-Operative            pre-operative      intra-operative    use of               documentation                              preference cards   unusual
                            documentation      documentation      chargeable           for implants /       log requirements                         occurrences
  Documentation                                                   supplies             explants

    Supervise               I-1 Remove         I-2 Remove contaminated supplies        I-3 Facilitate       I-4 Inspect room
                            equipment and      and bio-hazardous waste                 room clean up        readiness for next
I   Room                                                                                                    case
                            supplies from                                              by ancillary
    Turnover                previous case                                              personnel
                            J-1 Review         J-2 Assess         J-3 Administer       J-4 Monitor          J-5 Monitor level     J-6 Complete conscience sedation
    Monitor Patients                                                                                        of pain
J                           medical record     patient vital      I.V. sedation        response to                                monitoring documentation
    Receiving Moderate      pre-operatively    signs and airway   medication           sedation & ad-
    Sedation/Analgesic                                                                 verse reactions
                            K-1 Maintain       K-2 Serve as a     K-3 Serve as a       K-4 Provide          K-5 Facilitate        K-6 Ensure cost    K-7 Monitor
    Maintain                                                                                                student rotation &
K                           professional       preceptor          mentor               inservice to staff                         containment        product quality
    Professional            competencies                                                                    experience in
    Responsibility                                                                                          operating room
General Knowledge and Skills                                        Worker Behaviors
Ability to translate complex        Knowledge of current trends     Desire to learn
     issues into layman’s terms          and developments in the    Flexible
Age- specific competencies               area of practice           Intuitive
Analytic skills                     Knowledge of lab values         Manual dexterity
Anatomy & physiology –              Knowledge of medical records    Mechanically inclined
Physics                             Knowledge of professional       Multi tasking
Aseptic practices                        organizations              Organized
Basic math – metric                 Knowledge of unit-specific      Patience
     system/conversion                   equipment                  Patient advocate
Microbiology                        Laser safety                    Personal appearance
Pharmacology                        Leadership qualities            Personal hygiene
Body mechanics                      Legal responsibilities/issues   Punctual
Chain of command                    Listening skills                Receptive
Communication skills                Mechanical skills               Reliable
Communication verbal//written       Medical terminology             Respectful
Computer skills                     Microbiology                    Responsible
Confidentiality                     Negotiation skills              Role model
Conflict management                 Nursing process                 Self directed
CPR                                 Organizational skills           Sense of humor
Cultural awareness                  Pathology of diseases           Stamina
Decision making skills              Patient rights                  Tactful
Hospital departmental P&P           Policies and procedures         Team player
Electrical safety                   Prioritization of work
Emergency codes                     Problem solving skills
Employee rights                     Professional behavior
English                             Professional State & Fed.
Equipment operation                      regulations – OSHA,
Ethics                                   CMS, DHS, AORN,
Fire safety                              APIC, AMMI
Hazardous materials                 Standard precautions
Infection control                   Sterilization methods
Interpersonal skills                Stress management skills
Interpret medical safety data       Surgical conscience
     sheet (MSDS)                   Surgical instrumentation
                                    Surgical positions
                                    Teaching skills
                                    Time management
                                    Tissue banking

                                                 Future Trends and Concerns
Aging of the OR nurse population                                    Managed care
Aging population                                                    Medical/ethical issues
Alternative sites for surgical services                             Minimally Invasive procedures
Bio terrorism                                                       Multi drug resistant - organisms
Brushless/scrubless scrub                                           National certification
Changing/expanded roles                                             Opportunities for professional growth
Complex technology                                                  Rapidly changing advanced technology
Computer technology                                                 Recycling of products by manufacturing
Cost containment                                                    Reduced reimbursement
Cross training                                                      Robotics
Declining employee benefits                                         Sharing manpower resources
Environmental awareness                                             Shortage of health care professionals
Health care reform                                                  Social/health issues
Increased outpatient surgery                                        Staffing ratios of RN
Legislation related to healthcare                                   Violence in the workplace
Less loyalty to institution
Tools, Equipment, Supplies and Materials

Air filtration systems            Drugs & solutions (cont’d)                   Pulse oxymetry
Anesthesia machine/monitors                 Irrigation solutions               Sentinel node monitor
Arthroscopic supplies                       Local anesthetics                  Stereotactic equipment
Auto-transfusion devices                    Radioactive materials              Smoke Evacuators
Beepers                                     Steroids                           Specialty trays
BIS monitor                                 Topical ointments                  Sponges
Bone bank                                   Vasodilator/constrictors                     4x4
Brain lab                         EKG                                                    Cottonoids
Catheter/drains                   Electro surgical units & related patient               Dental rolls
          Central venous                safety                                           Eye sponges
          Chest                   End Tital CO2 monitor                                  Kitner
          Cholangiocath           External fixators                                      Laps
          Embolectomy             Gamma knife                                            Swabs
          Foley                   Gloves                                                 Tonsil sponges
          Myringotomy             Gowns                                        Sterilizers
          Naso-gastric            Harmonic scalpel                             Suction equipment
          Penrose                 Hypo/hyper thermia units                     Surgical instruments
          Robinson                Implants                                               clamps
          Stents                            All specialities                             cutting
          T-tube                  Insufflators                                           dissectors/elevators
          Tubes                   Irrigation/pumps                                       endodscopes
          Urethral myringotomy    Isolettes                                              forceps
          Urethral                Laminar equipment and headgear                         graspers
          Vascular caths          Lasers                                                 ligating clips
          Ventricular cath                  Carbon dioxide                               needleholders
          Wound drain                       K.T.P./Yag                                   power equipment
Collection bag/devices                      Argon                                        probes/dialators
Compressed gases and regulators             Holmium                                      retractors
Coronary bypass pump                        Candella                                     suction tips
Crash Cart                                  Indigo                             Sutures
Cryo Units                        Latex allergy precautions & related safety             Absorbable
Defibrillator - pacemaker         Lights                                                 Non-absorbable
Doppler                                     Headlights                                   Staples
Drapes & packs                              Light sources                                Steri-strips
Dressings                                   Spotlights                         Tourniquets
          2 x 2’s                 Loupes                                       Trach tube, drains, suctions, etc.
          4 x 4’s                 Malignant hyperthermia cart                  Ultrasound
          ABD                     Masks                                                  C.U.S.A.
          Bio-adhesive            Microscopes                                            Lithotriptors
          Cast dressing           Needles                                                Emulsifier
          Eye pad                           cutting                            Vascular grafts
          Gauze                             taper                              Video/cameras, recorders, printers,
          Liquid dressings                  trocar                                       monitors
          Non-adhesive                      blunt                              Warming lights
          Packing                           “free”                             X-Ray, fluoroscopy
          Peri-pad                          pop offs
          Tapes                             reverse cutting
Drugs & solutions                 O. R. furniture
          Anti-coagulants         Phaco machine
          Antibiotics             Positioning equipment
          Antiseptics                       fracture table
          Disinfectants                     shoulder chair
          Dyes                              C-frame
          Hemostatic agents                 Andrews table

To top