CN must assist the sterile SN by providing the sterile supplies needed
A. After Scrub person/Nurse Scrubs
1. Fasten back of scrub persons gown.
2. Open packages of sterile supplies like syringes, sutures, sponges gloves if a sterile package
wrapped in porous material drops to the floor, DISCARD it. It can no longer be considered
sterile.
3. Flip suture packets onto the instrument table or open overwraps for scrub person to take
packets
4. Pour NSS into the round basin for sponges on instrument table
5. Count sponges, needles and instruments with the scrub nurse and record immediately
B. After the patient arrives
CN attends to the patient
1. Greets and identify patient. Check wristband
2. Heck NCP and patients chart for pertinent information including CONSENT
3. Be sure patients hair is covered with cap
4. Assist the patient in moving from the stretcher to the OR table.
5. Apply restraint straps over legs and arms. Keep patient covered with blanket for privacy and
provide warmth.
a. Patients legs should not be crossed
b. Put arm board on L or R arm if IV is to be infused
6. Help anesthesiologist, surgeon or assistant as needed
C. During induction of General Anesthesia
1. Stay in the room and near patient to provide comfort and assist anesthesiologist in the
event that the patient gets excited. Patient must be guarded during induction to prevent
possible injury or fall from OR table
2. Be quiet as much as possible
- excitement may occur during induction from tactile or auditory stimulation
1. Reposition patient only after the anesthesiologist say so
2. Attach anesthesia screen and other table attachments
3. Note patient’s position. All safety measures must be observed
4. If cautery is to be used, place inactive dispersive electrode plate in contact with patient’s
skin to ground the patient properly. Avoid scar tissues, hairy or bony areas.
5. Expose appropriate area for skin prep
6. Turn overhead spotlight over site of incision
7. Arrange sterile prep
8. Cover the prep tray immediately after use
E. After Surgeon and Assistant scrub
1. Be alert to anticipate needs of sterile team
- CN watches closely the operation and anticipate the needs without having the team ask for them
- Should know where all supplies are to facilitate time and get them quickly
3. Keep discarded sponges carefully collected, separated by sizes and counted. Sponges
forceps or gloves never bare hands are used to handle and count sponges
4. Assist in monitoring blood loss. Weigh sponges if requested by surgeon. Measure blood
volume from suction container
5. Obtain blood products for transfusion.
6. Know the condition of the patient at all times
7. Prepare and label specimens for transportation to lab
8. Complete the patient chart, permanent operating room records, and requisition for lab test,
etc.
9. Be alert to any break in sterile technique
F. During Closure
1. Count sponges, sharps and instruments with scrub nurse
- report counts as correct or incorrect to surgeon
- complete count records
a. CN should call the ward for the next patient at least 45 min before the scheduled time of
operation to request that pre-op medication be given
b. Ask transport aide to get patient from the ward 30 min before OR
G. After the operation is completed
1. Open neck and back closures of gowns of surgeons and assistants so they can remove
them without contaminating themselves
2. Assist with dressing. SN should roll drapes off patient before outer layer of dressing is
applied
3. Connect all drainage system as indicated
4. See to it that the client is clean – wash off blood, feces. Put on a clean gown and blanket
5. Have transport aide bring a clean RR stretcher
6. Help move patient to stretcher or bed. Place pt to stretcher with a 4 man carry
7. Be sure chart and proper records including NCP accompany patient
8. Final completion of the client chart should include documentation of:
a. assessment of patients skin condition prior to and at completion of operation
i.e. skin discoloration, rashes, pressure sores, burns
b. urine output and blood loss – I and O
c. type of dressing used
d. time patient was discharged from OR
9. Have nursing assistant help transport pt to RR
SCRUBBING, GOWNING and GLOVING
1. Washes hands, forearms and upper arms
2. Picks up brush and forceps
3. Rinses brush
4. Gets soap solution
5. Scrubs hand for 1 ½ minutes starting from fingertips
6. Scrubs forearms for 1 minute
7. Scrub upper arms for ½ minutes
8. Scrub other hands, forearms and arm for the prescribed time
9. Rinses brush hands, forearms and upper arms
10. Repeats scrubbing
Hands – 1 minute each
Forearms – ½ minute each
11. Rinses brush, hands and forearms
12. Repeat scrubbing
Hands – ½ minute each
13. Discards brush
14. Rinses hands
15. Keeps hands higher than the arms through steps 5-15
16. Dries hands and arms on hem and gown
17. Lets hem face below table level
18. Grasps gown at armhole
19. Puts arms through sleeves of gown
20. Allows assistant to tie laces at the back; bends sideward allow assistant to grasp belt of
gown
21. Opens packages of glove, transfers powder to the hand, and discard paper package of
powder
22. Powders hands seeing to it that the powder does not fall on gloves
23. Grasps one glove by the cuff and puts glove on
24. Inserts gloved fingers into the cuff of the other glove; puts on the other glove
25. Folds sleeve of gown to fit wrist and unfolds cuff of glove over sleeve
26. Repeats step 25 with the other sleeve
27. Inserts gloved hands into pouch of gown
28. Maintain asepsis throughout gloving and gowning
a. keeps hands above table level
b. does not turn back towards sterile field
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