OPERATING DEPARTMENT PRACTITIONER, OPERATION THEATRE

1) SUMMARY OF DUTIES

Operating Department Practitioner provide a high standard of skilled support during peri-operative care. Their broad knowledge and skill base, including management and communication skills, are used in the assessment, delivery and evaluation of peri-operative care.

2) JOB DESCRIPTION

Organization & Management

• Understands and carries out the care in line with Vision and Mission Statements, Goals and Objectives that suit the scope of the Operation Theatre  Services.
• Works shift duties or as assigned by Unit Manager according to Unit’s Operational Hours.
• Informs Unit Manager when change occurs in circumstances which affect standards of care. Eg: Incident or problems encountered.

Human Resource & Management

• Takes personal responsibility for own professional development and keeps up to date with professional change and growth by maintaining mandatory learning hours.
• Participates in the teaching program of the unit and orientation of new members of staff to the unit routine.
• Involves in the supervision of the lower categories of staff:

- Assistant Nurses, Trained Theatre Technician and Care Assistant.

- Student Nurses who are posted to the unit for their clinical experience and assist them to achieve their objectives of that clinical attachment.

• Assists the Unit Manager in appraising the job performance of the lower categories of unit staff by giving accurate feedback with no malice or prejudice.
• Supports and assists the Unit Manager in effective and efficient utilization of staff, supplies and services.

Policies & Procedures

• Contributes suggestions in periodic revision and upgrading of Policies and Procedures and relevant work instructions.
• Checks DDA drugs with Nurse In-charge.
• Participates in the care, custody and administration of medications in accordance with Hospital Policies and Procedures with supervision of Anesthetist.
• Check and audit resuscitation trolley daily and periodically as scheduled.
• Ensure all staff complies with Prevention and Control of Infection including implementation of surveillance activity in the unit and evidence of involvement.
• Maintain patient’s confidentiality at all times.

Facilities & Equipment

• Checks that all equipment in the unit are functioning well and service according to PPM schedule.
• Report to Biomedical personnel of any faulty equipments and takes necessary action accordingly.
• Assists in maintenance of instruments and equipment by proper cleaning, handling, disinfecting and utilizing as directed.

Safety & Quality Improvement Activities

• Fully receptive and supportive in activities that contribute towards continuous improvement of operation theatre service e.g. Quality Assurance, Infection Control and Fire and Safety Program.
• Conduct investigation and root caused analysis for any incident in the services, takes appropriate action and ensure completion of incident reports within stipulated time frame.
• Carries out duties as an employee as stipulated in Occupational Safety and Health Act and Regulations 1994:-

- To take reasonable care at work for the safety of yourself and other persons;

- To co-operate with your employer or any other person in the discharge of any duty;

- To wear or use any protective equipment or clothing provided by the employer;

- To comply with any instructions or measures on occupational safety and health.

• Ensures compliance of Patient safety goals as safety improvement measures recommended by World Alliance for Patient Safety.
• Ensures the policies on Patient and Family’s Rights are addressed at all times.
• Complies with Baby Friendly Hospital Initiatives, Breastfeeding Policies, protect, promote and support Baby Friendly Hospital activities.
• Participates in 5S activities and comply with the specified requirements.
• Ensures all staff adheres to Standard People Practice (SPP) at all times.
• Ensure all policies and procedures of ISO 37001 Anti Bribery Management System (ABMS) are adhered to and responsible for integrity principles, practice and activities at hospitals & companies if and when these programs are implemented.

Additional Duties and Responsibilities in the Specific Areas

i) IN OPERATION THEATRE

Perioperative Personnel in General:

• Assist Unit Manager in overseeing the smooth running of OT and CSSS daily.
• Checks the following:

- Damp dusting has been done.

- Gas supply in the anaesthetic machine cylinder.

• Prepares trolleys and standing by items to be used.
• Arranges with wards to prepare patients to arrive into OT according to the scheduled time.
• Receives and greets patient, checks patient with ward staff according  to the checklist.
• Notes for any abnormalities, refers to the surgeon and anesthetist if necessary.
• Escorts patient into the Operating Rooms and ensures patient’s safety at all times.
• Enters particulars of all cases in the system or Operation Theatre Record Book.
• Ensures proper care and handling of all specimens after each case – properly labeled and recorded before they are sent to the laboratory or pathology department. If in doubt, always ask and confirm with the surgeon.

Anesthesia Personnel:

• Supervises and prepares anesthetic equipment before anesthesia and surgery:

- Maintain sterility of equipment and working environment

- Ensure the laryngoscopes, suction machines, anesthetic masks, GA machine/ ventilator and circuits are cleaned and disinfected.

• Performs daily routine task, counter check:

- GA machine and ventilator;

- Adequate monitoring equipment and accessories in the GA trolley, e.g. syringes, endotracheal tubes, stoppers, etc.

• Reviews patient’s information:

- Age and weight.

- Surgical procedure to be performed.

- Type of anesthesia.

- Allergy or any other sensitive reactions.

- Site marking at surgical site as needed.

- Note any potential anaesthetic risks, hazards and complications.

• Prepares and obtain the necessary drugs and accountable for any Dangerous and Psychotropic drugs used in the OT.
• Remains with the patient prior to and during the induction of anesthesia.
• Assists the Anaesthetist in monitoring the patient and as required throughout surgical procedure.
• Maintains anaesthetisia records with complete, accurate and legible documentation.
• Observes safety measures in positioning the patient, paying particular attention to patient’s limitations. e.g.

- Positioning of limbs to facilitate adequate arterial and venous access to prevent nerve damage.

- Skin integrity and adequate protection of eyes and ears.

- Protection of patient’s airway.

- Secure cannula, catheters.

- Adequate co-ordination, communication and sufficient personnel to position the patient.

•  Pass over the patient with relevant information to the Recovery Unit team.
• Maintains the cleanliness of the room, anesthesia equipment and always ready for the next case.

Scrub Personnel:

• Prepares the operation room for operations:

- Assists in cleaning the Operation Rooms in the morning

- Prepares and counter checks trolley, ensures all required items are available for the case.

- Equipment required for the case is available and functioning

• Discuss with Surgeon the approach of surgery and any special preference.
• Verifies the correct patient identity, operative site and side and valid consent form.
• Reviews patient’s information and notes and communicates with team members for potential surgical, anaesthesia risks, hazard and complications.
• Provides privacy, comfort measures and supportive care to patient.
• Scrubs well ahead of surgeon adhering to aseptic techniques of scrubbing, gowning and gloving.
• Conduct swabs, instruments, and sutures counts with circulating personal prior to operation.
• Assists with draping of patient.
• Attach suction tubing and electrosurgical cord before knife is handed to surgeon.
• Participates in performing “Time-out” with the team before commencing the surgery. Anticipates and stays a step ahead of the surgeon. Asks quietly for additional supplies and avoid distracting the surgeon.
• Pass instruments decisively and positively that the surgeon knows he has it.
• Keeps instruments clean. Wipes blood and debris.
• Saves all specimens of tissues for laboratory examination.
• Maintains sterile technique:

- Keep hands at waist level when at rest, never below waist level.

- Keep and confine  to the sterile area after preparation and reduce traffic at all times.

- Never turn the back to the sterile field or to her colleagues.

- Do not reach behind the back of the operating team for instruments.

• Conduct swabs counts and instruments before:-

- Closing of any cavity

- Closing of skin

• Communicates with surgeon after each counting.
• In the event of incorrect count:

- Repeat the entire count and perform thorough search on and off the sterile field and in the wound is made immediately for the item.

• If the count is still incorrect, an x-ray must be taken before the patient leaves the theatre. The incident must be reported to the Unit Manager immediately, an incident report and the appropriate documentation must be done.
• Pass over to circulating/recovery nurse the correct and relevant information about collection of specimens.
• Keep voice down but loud enough to be heard.  Maintain respect for both the patient and the people who works with.
• Dispose sharps and used items safely into the appropriate container according to hospital policy to avoid accidental cuts, punctures, lacerations and prevent potential risks of infectious contamination.
• Clean used instruments and pass over to the CSSS staff, accounting for each instrument that had been used.
• Document the necessary information on the swab count form.
• Maintain cleanliness of the room and equipment, and ready for next surgery.
  

Circulating Personnel:

• Prepares the operating room for the appropriate surgical procedures according to the operation list.
• Checks and records the temperature and humidity of the Operation Room daily. Reports to superior if abnormality found.
• Prepares:

- Equipment for its designated purpose;

- Standby lotion, packs, sutures;

- Specimen bottle/Lab form, dressing;

- Lotions for warming.

• Checks:

- The potential hazards of operating table and its attachment.

- The mechanical adjuncts to the operating procedure such as electro-surgical unit, different electrode and radiological equipment for its safety.

• Recognizes safety policies, procedures and adhere to them by practice a “Time out” procedure.
• Adheres to:

- Aseptic techniques;

- Infection control policies at all times.

• Conducts surgical counts with the scrub personal in verifying accountable item (swab, needles, sutures and instruments). Records in the operating Swab Count Procedure chart.
• Co-operates and anticipates in getting items required for the surgery.
• Enters time when operation starts (incision is performed) and ending time (last stitch).
• Fills in peri-operative care form.
• Helps to position patient safely.
• Records or tags items that are used onto the patient charges form.
• Connects diathermy cable, suctions tubing to the machine and ensure it is ready for use.
• Helps to adjust operating light, big focus light first, then only small satellite light.
• Ensures collection of specimens is labeled correctly according to hospital and Operating Theatre policy.
• Discards all the used linen, clinical waste, general waste into the designated bins and bags.
• Never leave the operating room, unless there is another unscrubbed person in OT.
• Maintains cleanliness of the room and equipment, ready for use for the next surgery

Recovery Personnel:

Receives patient and report from Operation Room, carries out post-anaesthesia care:

- Maintenance of airway

- Check level of consciousness

- Administers oxygen as ordered

• Checks and records vital signs (blood pressure, pulse, respiration on Recovery Chart / GA chart).
• Checks and sees whether blood transfusion and / or intravenous drip is running as ordered.
• Carries out specific post operative instructions as ordered.
• Inform ward staff to fetch patient when patient is ready for discharge from the Recovery Room.
• Pass over correct and relevant information and reads out the Post Operative order for patient clearly to the receiving Registered Nurse.
• Ensures the recording of :

- Documentation is complete and  accurate.

- Time of arrival and departure of patient.

- Patient care is recorded in such a manner as to allow for easy retrieval communication, measurement and evaluation of patient care.

• Maintains general cleanliness of the room and always ready for next patient.
• Responsible for record, issue and indent of Dangerous Drug.

ii) IN THE CENTRAL STERILIZING SUPPLY SERVICE

CSSS staffs are tasked with the proper handling, cleaning, assembly, testing and packaging of many kinds of medical instruments.

Decontamination Room:

• Maintains the cleanliness of the working area.
• Receives and checks used sets from the wards/ operation theatre/clinics.
• Prepares disinfected solution for cleaning processes.
• Clean and disinfects all instruments/ sets manually or using mechanical machine. Pays special attention to delicate instruments and power motorized instruments.
• Operates and maintains equipment such as ultrasonic machines, washers, dryers, etc.
• Records any monitoring parameter data.

Packing and sterilizing:

• Maintain cleanliness of the working area and equipment.
• Check to ensure that instruments are in good condition, functioning and sets are complete upon assemble.
• Rejects instruments that are not properly cleaned.
• Packs and labels the sets before sending for sterilization.
• Records monitoring parameter data

Storage and Distribution:

• Maintains cleanliness of the sterile store and shelves.
• Checks and records Temperature and Relative Humidity of the sterile store as per schedule. Reports to superior if any abnormality.
• Maintains the integrity of sterile sets/items in storage.
• Follow the “First-In First-Out” system in issuing the sterile instruments and sets.
• Assist in inventory of instruments every week in sterile store and quarterly for other nursing services.

Autoclave Operator:

• Cleans the autoclave chambers and records in the autoclave cleaning book.
• Carries out test of autoclave machine efficiency by doing the Chemical test, Biological test, Mechanical test and Leak test before running the autoclave machine.

3) JOB REQUIREMENT

• Diploma in Higher Education Operating Department Practice Program.
• Fresh graduate in Diploma In Higher Education Operating Department Practice Program.
• Able to write and communicate in Bahasa Malaysia and English Language.
• Strong interpersonal and communication skills.
• Diligent and alert.
• Caring, honest and responsible.
• Willingness to work on scheduled hours, shift, and weekends, public holidays, on-call and anytime when called during emergency.
• Microsoft office literacy.
• Operating Department Practitioner (ODP) in Operation Theatre & Invasive services.
• Has good communication, counseling and interpersonal skills.
• Able to guide theatre staff, students and non nursing staff.
• Has the ability to improve knowledge and skill in teaching and supervision in the Operation Theatre Services.
• Possess the attitude to make the patient care the primary concern, treating every patient compassionately, demonstrating and an aspiration to altruism.
• Strive to provide high quality patient care; maintain patient’s dignity, privacy, autonomy and confidentiality.
• Prepared to work as a team member in the best possible manner.
• Maintain good, courteous and harmonies relationship with the co- worker, patient and families, visitors and other medical staff in the hospital.