Surgical Standards in the Operating Room

There are many standards that are maintained in an operating room. With the onset of organ transplants and robotic surgery, the look of the typical OR suite may have changed but keeping sterile techniques foremost, has not. The first thing a student of medicine learns about the operating room is maintaining sterile integrity. High standards must be upheld to protect the patient and the staff from disease and infection.

The Circulating Nurse (CN)

• You might think that the doctor is in charge of the OR but not so. It is the responsibility of the "circulating nurse" (CN) to assure sterile technique is followed and all protocol for that particular surgery is maintained. The CN is a registered nurse, licensed by the state. The CN is usually the first person the patient sees while in the waiting room. She escorts the patient to the OR suite and secures the medical records.

  During surgery, the CN keeps a watchful eye to make sure that the sterile field is not compromised. If it is, the CN will notify the surgical team and direct the necessary corrections.

Surgical Team

• The surgical team consists of the surgeon, assistants, scrub nurse and anesthesiologist. With the exception of the anesthesia team and CN, all of the surgical team is considered sterile. They have scrubbed with an anti-bacterial soap, and donned sterile garb. They are the only members that can touch the patient once the sterile field is in tact. The anesthesia team sits at the head of the patient behind a sterile curtain. If a member of the team breaks sterile technique and contaminates themselves, they must leave the field and correct the contamination. This is not uncommon and usually happens when a glove is torn and the member needs to re-glove.

Anesthesia

• The anesthesia team may consist of the anesthesiologist, or anesthetist. The anesthesiologist is a medical doctor and must be present when the patient is prepared for surgery. The anesthetist in an RN that has received specialized training in the field and licensed by the state

Many Standards

• There are many standards that work together to maintain a surgical department. All of the following play a part in the operating room.

  Instruments: Cleaning and sterilizing; there are several types of sterilization according to the type of instrument

  Staff uniforms: From shoe covers, to hats, to gloves, to gowns and masks, all make up the standards for uniforms.

  Equipment: Radiology, microscopes, tables, anesthesia and power tools have to be maintained according to certain guidelines.

  Pathology: All tissue removed goes to pathology for identification.

  Transplants: Artificial and tissue

  OR department and suites: Cleaning materials and disposal of wastes as well as temperature regulation are standardized as well as other areas of the OR.

  Record Keeping: Patient files, infection and incident reports, and employee records are regulated by law.

  Training: Continuous training program for all staff members is mandated.

  Staff: Certified and licensed members are governed by certain standards of the trade.