OPERATING ROOM Performance Checklist for Nursing Students

Name_____________________________ Level _____ Section / Group__________ Affiliating Agency___________________ Inclusive Dates_________________ Shift_________

LEGEND: 4 Competent. (Consistently performs in an effective and efficient manners) 3 Progress is Acceptable. (Performance is usually effective and efficient but not always) 2 Needs Improvement. (Progress in performance is too slow to judge satisfactorily) 1 Progress Is Unacceptable. (No progress in prformance has been demonstrated and/or
performance is consisitenly ineffective and inefficient)

COMPETENCIES
I. SAFE AND QUALITY PATIENT CARE
1. Obtains and analyzes patient data concerning patients condition. 2. Determines and categorizes clinical assessment of the patient and Interprets prudently the physicians order. 3. Identifies patient and verifies procedure to be done. 4. Checks and accomplishes pre-operative checklist prior to surgical 5. Checks for clearance (cardio-pulmonary, pediatric) and diagnostic procedures. 6. Monitors vital signs immediately after surgery after the operation. 7. Evaluates effectively patients recovering from anesthesia.

3 2 1

REMARKS

II. MANAGEMENT OF RESOURCES AND ENVIRONMENT

1. Prepares and selects surgical supplies concerning the patients surgical procedure. 2. Checks the functionality of the operating room/delivery room equipments such as suction machine, lights and cautery machine. 3. Maintains sterility of the sterile field and the operating room. 1. Explains proper positioning for induction of anesthesia. 2. Demonstrates proper aseptic/antiseptic technique, sterile draping and handling of instruments. 3. Discuss appropriate health teaching (e.g. proper wound care) 4. Discusses the emergency resuscitative devices, equipment and emergency drugs in the recovery room.

III. HEALTH EDUCATION

IV. LEGAL RESPONSIBILITY

1. Checks and verifies informed consent for surgery is signed and documented. 2. properly Observes patients rights in the pre, intra, and post operative phase. V. ETHICO-MORAL RESPONSIBILITY 1. Ensures patients religious beliefs and practices are observed and respected.

VI. PERSONAL AND PROFESSIONAL DEVELOPMENT

1. Observes proper decorum and conduct during operation. 2. Participates actively in learning activities

VII. QUALITY IMPROVEMENT

1. Participates actively during post conference.

VIII. RESEARCH
1. Conducts necessary updates on current nursing trends in the operating room.

IX. RECORDS MANAGEMENT

1. Performs proper documentation and other important details as needed. 2. Ensures patients records are safe and secured at all times.

X. COMMUNICATION

1. Coordinates effectively with other members of the health care team (e.g. makes proper referral of service to appropriate person, relays deviations in vital signs to appropriate person).

XI. COLLABORATION AND TEAMWORK

1.

Demonstrates proper delegation of tasks to other member of the operating room team.

TOTAL

EVALUATED BY:
___________________________ Name and Signature of CI __________________________ Name and Signature of Student