Operating Room Scientific Meeting

29 Nov 2003

By Dr Balaji Sadasivan

Venue: Marina Mandarin, Mandarin Ballroom

Mr Tan Tee How

Chief Executive Officer

National Healthcare Group

Mrs Lee Siu Yin

Director of Nursing

National University Hospital

Distinguished guests

Ladies and gentlemen

INTRODUCTION

It is my pleasure to be here with you at the Operating Room Scientific Meeting organized by the Department of Nursing, National University Hospital. First, let me extend a warm welcome to all our delegates from overseas.

HISTORY OF PERIOPERATIVE NURSING

Perioperative Nursing previously known as Operating Room Nursing, has a rich history. It is one of the oldest nursing specialties on record. Operating Room Nursing can trace its origin back to 1875, when the first lecture was given to a group of nurses at Johns Hopkins University in Baltimore, USA. Since then, Operating Room Nursing has evolved to encompass a wider scope of practice. In the 1970s, the emphasis on Operating Room Nursing shifted from the geographical boundary of the operating room to include pre-operative, intra-operative and post-operative care, and the term ?Perioperative Nursing? has gradually gained acceptance.

CHANGING TRENDS IN PERIOPERATIVE NURSING

In the practice of surgery, there has been a marked shift from inpatient to

outpatient procedures. The percentage of day surgeries in Singapore has increased from 38% in 1993 to 54% in 2002, and this figure is projected to increase in the years ahead. This shift of surgery from inpatient to outpatient settings will inevitably have an impact on Perioperative Nursing practice.

EXPANDED ROLE OF PERIOPERATIVE NURSES

Perioperative nurses have moved away from the emphasis on intra-operative care to divide their time between pre-operative patient assessment, education and counselling; intra-operative care and the immediate post-operative recovery. We see evidence of this expanded role occurring in day surgery settings where perioperative nurses are responsible for varying levels of pre-operative patient assessment, intra-operative care, post-operative recovery, and discharge follow-up. We can expect more broadening of perioperative nursing responsibilities for patient care, especially in major inpatient surgical settings, including assisting in minimally invasive surgeries and laser procedures.

Expanding the role of the perioperative nurse is as one way of ensuring that the patient receives holistic care. It also makes perioperative nursing more interesting and increases job satisfaction for the nurse. However, it means that perioperative nurses are required to have a wider set of skills. For example, during the pre-operative contact, the perioperative nurse is required to perform an assessment, explain the operative procedure, answer questions and provide reassurance if necessary. This was traditionally not the domain of the perioperative nurse, and in a busy surgical clinic, this function which is so important to the anxious patient is often neglected.

RISK MANAGEMENT IN OPERATING ROOM

In the intra-operative setting, besides the traditional role of ?scrubbed nurse? and ?circulating nurse?, perioperative nurses have an important role to play in risk management. Operating rooms are considered high risk areas because of the nature and type of activities that are carried out. It is the responsibility of perioperative nurses to ensure a safe environment for the patients. Work processes need to be constantly reviewed to leave no room for error.

Perioperative nurses play a critical role in infection control. They must ensure that even simple procedures like scrubbing, gowning and gloving are performed according to standards. Perioperative nurses often are the only individuals who witness suboptimal practices and can act to improve infection control practices. It is the responsibility of perioperative nurses to explain the concept of a sterile field to staff who are new to the operating room.

CONCLUSION

As advancements are made in the practice of surgery, perioperative nurses will need to keep abreast of these changes in order to remain relevant. A Scientific Meeting like this is a wonderful opportunity to keep updated and network.

I would like to congratulate the Organising Committee for assembling such a highly qualified group of medical specialists and nursing experts to speak at this meeting. I wish you a stimulating and enlightening meeting and I trust that the many collaborative networks established here will help you set the agenda for perioperative nursing in the 21st century. It is now my pleasure to declare the National University Hospital?s Operating Room Scientific Meeting open.