Duties and Responsibilities of Circulating Nurse

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Duties and Responsibilities of Circulating Nurse
1. Purpose
1.1.To assist scrub nurse by providing sterile items as needed according to surgeon preference and
surgical requirements procedure.
1.2.To anticipate the needs of the sterile team members for the smooth flow of events before, during
and after the operation.
1.3.To observe vigilantly in safeguarding the sterility of the operative field.
1.4.To maintain patient’s safety and comfortable environment throughout the operation.
2. Definition
2.1.A person who is responsible to assist the scrub nurse by providing the sterile supplies needed for
the operation, maintaining the integrity of the sterile area and safety of the patient throughout the
operation. He/she is the bridge between the sterile and non-sterile field.
3. Policy
3.1.All circulating personnel shall safety practice and apply strict aseptic to provide optimum care for
the surgical patient.
Prepared by: Reviewed by: Recommending Approval: Approved by:
Juan Dela Cruz, RN Dr. Peter San Pedro Dr. Gabriela Silang Dr. Jose Rizal
ORDR Head Nurse Department Head Medical Director President

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3.2.To confirm surgical procedure as according to written consent obtained from patient before any
surgical procedure preparation.
3.3.The operating room must be checked and prepared for the cleanliness, functioning of the
electrical machines and other equipment’s according to standard of practice before start of
surgery.
3.4.The Universal Precaution standards of practice must be complied at all times.
3.5.All instruments and surgical procedures supplies are provided in anticipation, to the scrub nurse
according to surgeon’s preference and the requirements of surgical procedure.
3.6.All circulating nurse shall perform surgical count as per standard of practice.
3.7.Plan, organize and maintain neatness and tidiness of the operating room at all times.
3.8.Patient’s safety is to be observed at all times.
3.9.All medication or drugs that are required in the procedures must be checked for correct drug,
dosage and expiry date with the Scrub Nurse prior to use.
3.10. All specimens must be handled correctly and confirmed with Scrub Nurse per standard of
practice.
3.11. Aseptic technique must be maintained strictly throughout the surgical procedure.

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3.12. Always remain in the operating room and ensure there is always a replacement if have to leave.
Keep the whole surgical team inform when leaving.
3.13. It is the responsibility of the Circulating Nurse to do skin preparation (in-all-specialties), in-order
to preserve the sterility of the whole surgical team, except in procedures of ophthalmic
surgeries.
3.14. It is the responsibility of the Circulating Nurse and Scrub Nurse to do the following:
3.14.1. Cleaning the room with appropriate hospital approved disinfecting agents the assigned
room before starting the list, in-between cases, and after the list.
3.14.2. Taking into consideration to the mentioned below:
3.14.2.1. OR Table
3.14.2.2. Operating Lights
3.14.2.3. Back Table
3.14.2.4. Trolleys
3.14.2.5. Cabinets & Racks
3.14.2.6. Instruments store room
3.14.2.7. All medical equipment’s

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3.14.2.8. Furniture inside the allocated room

3.14.3. The hospital cleaner’s only responsibility is to clean the floor, ceiling and wall.
4. Procedure
Procedure Rationale
Confirm the type of surgery as according to
4.1.
O. R List prior to induction of patient.
4.2. Assess for:
Correct patient with written consent
according to type of surgery.
Patient’s history of any allergies.
Correct preparation of patient
according to documentation of patient’s
OR check list.
Functioning of Electrical Surgical

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Unit, suction machine, operating table

and other necessary machines and
equipment that may require.
4.3. Prepare for the completeness of operating
room, materials & equipment according to
the required surgery, surgeon reference
and standard of practice.
Prepare the correct position of
operating table and always check that
operating table is always locked. Gather
all the necessary operating table’s
accessories as needed in the patient’s
positioning.
Ensure operating light for focus,
intensity and movement.
Ensure functioning of suctioning

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apparatus, Electrical Surgical Unit and

other electrical equipment.
Arrange machines and equipments
to maintain the integrity of sterile field.
Fasten the Scrub Nurse, surgeon and other
4.4.
sterile team member's gown.
Check the sterile equipment for its expiry
4.5. date, sterility and integrity of package
before opening to the Scrub Nurse.
Assist the Scrub Nurse in the preparation of
4.6. sterile field by providing sterile supplies and
opening of sterile package as required.
4.7. Provide the required solutions or
medication as required and check with
scrub nurse or surgeon to confirm the

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correct drug, dosage and expiry date.

Perform 1st surgical count with Scrub
4.8. Nurse as per standard of practice. Check
the count board for correction of count.
Perform surgical count with the circulator
4.9.
personnel, as per standard of practice.
Collect the right patient when the operating
4.10.
room is prepared.
Assist in the safe transfer of patient on to
4.11.
the operating table.
Remain with patient during induction and To anticipate for any emergency that may
4.12.
intubation. arise.
4.13. Assist in the positioning of patient as The anesthetist is in charge of patient’s
accordance to the type of surgical airway management. Change of position
procedure and standard of practice. may dislodge the ETT.

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Position the patient upon the anesthetist‘s

approval.
Place the Electrical Surgical Unit
4.14. conductive pad on the patient as according
to standard of practice.
Assist in the application of the tourniquet to
4.15. the patient if required and as standard of
practice.
4.16. Expose the operative site.
Turn on the operating light and assist in the
4.17.
focusing on the operative site.
Connect suction and Electro Surgical Unit
4.18.
cord to the machine as required.
Place stools and kick bucket in the suitable
4.19.
place.

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Be alert and anticipate the needs of sterile

4.20.
surgical team.
Collect and separate discarded sponges by
using forceps or glove. Place on moisture
4.21.
proof surface and where visible to scrub
nurse.
Wear gloves to handle any blood-stained
4.22. equipment/items or body fluids according to
universal precautions.
Stay in the operating room all the time and
ensure there is always a replacement when
4.23.
have to leave. Inform Scrub Nurse upon
leaving.
4.24. Monitor the operating room traffic flow and
observe any unauthorized personnel in and

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out of the operating room. Limit the number

of personnel inside the operating room.
Check that operating room doors are kept
4.25. closed at all times. Keep noise and
conversation to a minimum.
Observe the sterile field for any break in
4.26. aseptic technique. Report immediately if
detected.
Anticipate the requirements of Scrub Nurse
4.27.
and Surgeon throughout the procedure.
Perform 2nd surgical count sponges,
sharps and instruments with scrub nurse
4.28.
when surgeon begins closure of any open
cavity.
4.29. Attend to the surgical specimen according

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to the standard of practice.

Perform final count of sponges, sharps and
4.30. instruments with circulating nurse when
surgeon starts the wound closure.
Assist in the connection of drainage
4.31. equipment if used on completion of surgical
procedure.
Check that patient’s dressing and drainage
4.32.
tubes are well secured if any.
Assist in removing the drapes from the
4.33.
patient.
Put on the patient’s gown and cover with
4.34.
blanket.
4.35. Remove the Electrosurgical conductive
plate and tourniquet if used. Check for skin

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integrity.
Open neck and back closure of sterile gown
4.36.
of surgeons and scrub nurse.
Check and complete the recording of all
4.37.
necessary documents.
Supervise and assists with safe transfer of
4.38. patient to recovery room or intensive care
unit
Pass over complete information to the
recovery room nurse or intensive care unit
nurse regarding the patient’s intra –
4.39.
operative care. Check that all charts, X-ray
folders and other records are completely
endorsed.
4.40. Send specimen to laboratory as per

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standard of practice.
5. References
5.1.Arthur D. Smith (2007) Operating Room Set Up and Patient preparation. 2nd Edition.
5.2.Nancy Marie Phillips (2007) Berry and Kohn's: Operating Room Technique. 12th Edition: Mosby.
5.3.Seymour Schwat'z (2008) Principles of Surgery. 8th Edition: McGraw-Hill Professional.

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NURSING SERVICE By:

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

3.14.2.8. Furniture inside the allocated room

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Unit, suction machine, operating table

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

apparatus, Electrical Surgical Unit and

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

correct drug, dosage and expiry date.

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Position the patient upon the anesthetist‘s

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Be alert and anticipate the needs of sterile

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

out of the operating room. Limit the number

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

to the standard of practice.

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

NURSING SERVICE By:

Prepared by: Reviewed by: Recommending Approval: Approved by:

ORDR Head Nurse Department Head Medical Director President

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