怎样做一个称职的巡回护士.pptx

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,2020/5/26,#,怎样做一个称职的巡回护士,一、巡回护士的定义,巡回护士（,Circulating Nurse,）是指被指派到固定手术间内、在无菌区以外，不直接参与手术操作、和器械护士、主刀医生及其助手、麻醉医生共同完成手术任务的护士,。,Definition,：,A circulating nurse is a registered nurse who works in the operating room environment.The circulating nurse does not scrub in,and performs job duties that cannot be done by staff that is scrubbed in.,What is a Circulating Nurse?,二、巡回护士的主要任务,circulating nurse is responsible for charting what is happening in the operating room,tracking supplies and equipment used,and may also act as an advocate for the patient,who is unable to act on their own behalf while under anesthesia.,The nurse may have additional responsibilities including keeping the operating room clean,managing other staff,preparing the patient for the procedure and helping escort the patient to recovery.,What Are the Responsibilities of Circulating Nurses?,三、巡回护士工作的争议,四、巡回护士应如何配合麻醉医生的工作,Operating Room Preparation,Anesthesia,As the main coordinator in the OR,the circulating nurses assists the anesthesiologist by correctly positioning the patient to receive anesthesia.The position depends on the procedure that will be performed.If spinal anesthesia is required,for example,the patient is positioned in a quasi-fetal position.After the anesthesia is administered,the circulating nurse follows the anesthesiologists instructions for repositioning the patient and places his arms in arm boards and restraints to prevent him from inadvertently injuring himself.To prepare for the operation,she exposes the patients skin and,if necessary catheterizes him.,Surgery,End of Surgery,Circulating Nurse Duties,整形外科医院住院手术室承担着医院各科室的手术,为保证每位患者手术安全顺利的完成,手术室护士担当着重要的职责,.,作为一名手术室护士除了要具备丰富的专业知识和娴熟的专业技术外,还要有应对各种突发问题的能力,最重要的是有高度的责任心和奉献精神,.,以下对手术室巡回护士的具体职责作了一下总结,:,五、巡回护士的职责,（一）术前访视,1.,术前访视病人是相当重要的环节,访视时应穿工作服,了解病情和所作手术，看病历并查看化验单是否齐全是否有问题；,2.,查看静脉情况和全身状态；,3.,对患者进行术前宣教,告知其术前禁食禁饮时间及注意事项,.,告知术日所做操作,消除患者恐惧和紧张心理。,1.,手术间的清洁工作：对操作台面、无影灯及手术床等用,75%,酒精擦拭，调解并维持室内正常温湿度；,2.,手术所需仪器的准备：电凝、吸引器和电刀等连接好并检查是否正常工作,3.,补充手术间内无菌物品和药品；,4.,铺好手术床,如需摆体位的要准备好体位垫；,5.,遵医嘱准备好静脉输液液体，如是两岁以下幼儿需输入,100ml,葡萄糖氯化钠注射液或者复方葡萄糖氯化钠注射液,。,（二）术日晨准备工作,（三）接患者进入手术室,1.,接患者前认真查对病室,床号,姓名,性别,年龄,手术名称和部位；,2.,再次检查化验单是否齐全和正常，查看体温单，手术同意书和麻醉同意书；,3.,询问术前禁食禁饮时间有无,药物过敏史，女病人是否在月经期以及身上有无贵重物品或金属物品；,4.,患者带药和物要与病房护士交接清楚；,5.,协助患者取舒适安全卧位,选择合适肢体输液；,6.,协助麻醉诱导和插管,局麻镇静患者要用约束带防止患者受伤；,7.,一般手术时间大于,4,小时的要给患者导尿，并在接患者时告知,8.,需要摆体位的要同麻醉医生和手术医生共同摆体位,并保证患者肢体处于安全舒适状态,防止挤压伤害，重点保护眼睛和骨隆突等处。,（四）手术开台的配合,1.,协助器械护士穿手术衣并清点器械和纱布；,2.,协助医生术区消毒和铺单；,3.,协助医生穿手术衣并安排器械护士和医生就位、调解无影灯；,4.,连接电凝和吸引器如用电刀应贴好负极板；,5.,遵医嘱配麻药,。,（五）术中配合,1.,术中密切观察病情及生命体征变化,及时供给所需物品；,2.,观察输液和尿量；,3.,与器械护士共同管理好切下的标本,皮和软骨等,病理及时送检,4.,准确执行术中医嘱,做到三查七对二人核对,口头遗嘱应复述一遍再执行,提醒麻醉医生记录；,5.,认真书写护理记录单部位确认单和记账单等,录入耗材；,6.,维持手术间的干净整洁,维持室内适宜温湿度；,7.,监督术中无菌技术执行情况,对违反者及时纠正,严格管理参观人员；,8.,遇有紧急情况要正确处理,及时通知护士长和麻醉科主任,；,9.,伤口关闭前与器械护士共同清点器械和纱布；,10.,准备包扎敷料协助包扎,适时通知下台手术；,11.,总结输液量和尿量,记录术毕时间；,1.,协助麻醉医生拔管,患者未清醒前应站在两侧不得离开,防止患者躁动；,2.,保护好静脉通路,尿管和引流管等；,3.,拔管后患者生命体征平稳遵医嘱与麻醉医生、手术医生一起将患者送入麻醉恢复室,局麻患者送回病房,与病房护士做好交接工作，保证患者安全；,4.,整理清洁手术间,为下一台手术做准备。,（六）术毕配合,怎样才能成为一名优秀的巡回护士,?,首先，做一个谨守南丁格尔誓言的护士；,其次，做一个忠实履行职责的巡回护士；,再次，做一个具有一定应急能力的巡回护士；,主动,积极,