Department :OPERATINGROOM Datelssued: 05.06.

2023 Page 1 of 3

@*,xt lndex Number : SH.IPP.OR-G.009,03 Policy Status: Revised

Effective Date: 10.06.2023 Applies to:

INTERNAL POLICY & OPERATING ROOM LIST. SCHEDULE OF
PRoCEDURE (rPP) Revision Date: 05,06,2026 Operating Rooms
OPERATION
KINGOOM OF SAUOI ARAAIA

SAUMAT GENERAL HOSPlTAL

l. POLICY:
o The list should be made and submitted to Operating Room department at 8:30pm a day before
and must be accepted by head nurse or charge nurse to arrange surgical instrument needed.
o The list must be signed by the head of Operating Room department. And medical director
o The notification must be fulfilled completely.
o will be fully responsible for the patient.
The list should indicate the name of surgeon who
o Operating Room notification should be made of two copies and filled by treating surgeon
himself and signed by him.

) PURPOSE:
o To provide proper coordination among ward staff, surgeons, and operating room staff.
o To allow the nurse to have the time to prepare needed instruments and equipment
3. SCOPE:
o Operating Rooms
o Outpatient Clinic
o Inpatient ward

4. DEFINITIONS:
o Operating Room List
o The collection of daily Operating Room notifications for elective cases posted in the OR.

5. FORM & EQTIIPMENT:

o OR Daily Schedule List
o OR Notification form

6. RESPONSIBILITIES:
o Head of OR
. Surgeons
o OR Head Nurse
o OR Charge Nurse

1 PROCEDURES:
o Operating Room notifications should be submitted to and received by the
secretary (extension number 316).
 Department
G*s
:OPEMTINGROOM Datelssued: 05.06.2023 Page 2 of 3
lndex Number : SH,IPP.OR-G.009,03 Policy Status: Revised

Effective Date:'10.06.2023 Applies to:

INTERNAL POLICY & OPERATING ROOM LIST. SCHEDULE OF
PROCEDURE (rPP) Revision Date: 05.06.2026 Operating Rooms
OPERATION
KINGDOM OF SAUDI ARABIA

SAUMAT GENERAL HOSPIIAL

A complete Operating Room notification consist of the following:

o Part to be filled by the surgeon:
. Patient's full name
. Medicalrecord number
' Age
. Sex
. Weight of the patient
. Pre- Operative Diagnosis
. Operative procedure(s)and its site
r Any special preferences of surgeon that requires preparation.
. The surgeons name and his assistant(s)
. Proposed operation time
. Operation status(elective or urgent)
o Part to be filled by the anesthesia doctor:
. The name of the anesthesia doctor
. The anesthesia type
o Part to be filled by the OR head:
. Acceptance or not for the operation
. Approved operation time
. Number of the OR room
o The head of OR must sign the OR notification form as well as the OR list
o In the interest of the patient, necessary arrangement and adjustment will be made complete
all listed cases.
Special consideration:
o Aged, diabetic patients and children should be the'priority to avoid long time of fasting
o Infected cases must be done at the end of the list unless are urgent and emergency
After a final list has been made, signed and approved by OR head it will be posted in operating
room.
The head nurse begins to make daily staffing assignments based on knowledge and skills and
experience of the staff members.
Residents and anesthetist notify operating room for any cancellation in patients who are
expected to be admitted for further investigations and preparations.
o The cancellation cause must be known and documented and sent to the TQM.
Emergencies will be on a first come, first serve basis or according to the
the patient's condition, it will be arranged between surgeon and anesthesia
-\

o #rt
 Department :OPEMTINGROOM Date lssued: 05.06.2023 Page 3 of 3
lndex Number : SH,1PP.0R.G.009.03 Policy Status: Revised

INTERNAL POLICY & OPERATING ROOM LIST. SCHEDULE OF Effective Date: 10.06.2023 Applies to:
PROCEDURE (rPP) OPERATION Revision Date: 05.06.2026 Operating Rooms
KINGDOM OF SAUDI ARABIA

SABMATG€NERAL HOSP TAL

o Day Surgery- day surgery patients are posted the same manner as in patients. must have the
following in his file:
o Valid consent
o History and physicalassessment form
o Result of all latest blood investigation required to him or her
o The Morning Surgery
o Case shall arrive on time to OR according to the OR schedule
o If a case is to start at an earlier time; coordination will be made between surgeon and
anesthetist and patient will be called on a requested time that they have agreed upon after
coordination with the Head of OR.
o If a case is to be delayed or cancelled;the head nurse must be notified as soon as possible
in order that the room may be utilized for other cases.

8. REFERENCES:
o Arthur D. Smith (2007) Operating Room Set Up and Patient Preparation. 2nd Edition.
o Seymour Schwat'z (2008) Principles of Surgery. 8th Edition: McGraw-Hi11 Professional.

Prepared by: Approved by

;t]';f"-- Dr Rawani Frehan

OV
Anesthesia / OR Head

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