Role Description

At MBHS, we have a full operating theatre department especially dedicated to providing a high standard of skilled surgical care, including theatre admission, preoperative, surgery and post-operative care.
The theatre scrub nurse is a member of the theatre team undertaking roles in preoperative, scrub and recovery nursing, and is often in charge of the nursing staff contingent in an operating theatre. The MBHS theatre scrub nurse must provide patient-centred, compassionate, competent and quality care. He/she must adhere to the General Nursing Council of Zambia’s Code of Conduct and must practise safe, ethical and evidence-based nursing care at all times.

Key Role Accountabilities

• Ensure that MBHS standard operating policies and procedures (SOPs) are read, signed and adhered to with regards to theatre nursing, infection prevention and control and general nursing care. All perioperative nursing care is provided in line with the Zambian nursing scope of practice and MBHS Standards.
• Responsible for assessing, planning, implementing and evaluating individual plans of care for patients in the perioperative environment.
• Provide timely, skilled and effective assistance as a member of the theatre team, rotating through the roles such as scrub and recovery nurse, as and where needed.
• Provide nursing care that is respectful, ethical and professional at all times and adhering to MBHS Values
• Demonstrate ability to work competently in theatre and observe key principles like maintaining a sterile environment, aseptic technique, infection control and prevention, anatomy and physiology, proper surgical technique and equipment, health and safety etc.
• Maintain effective communication with patient’s families and carers, and members of the theatre team to ensure smooth progress of each theatre list.
• Ensure that individual nursing knowledge, skills and practice is up-to-date to perform all required duties effectively.
• Demonstrate awareness and compliance with legal and ethical aspects of perioperative nursing.  Must be accessible at all times when rostered to be ‘on call’ for shift work or in case of emergencies.
• Maintain patient dignity and confidentiality at all times. Any breach in patient confidentiality will result in disciplinary action per the MBHS Disciplinary Code of Conduct and Grievance Procedure.

Key Responsibilities
Theatre Services

• Assist with coordinating the smooth and safe flow of patients throughout the surgical process.
• Support the Theatre Unit Leader with creating theatre lists according to surgeon/hospital priorities, patient emergencies and waiting lists, and ensure appropriate theatre staff are scheduled for surgery.
• Coordinate with MBHS departments to ensure the safe transfer of patients to and from the operating theatre room.
• Prep the operating room for patients/procedure.
  Prepare all surgical instruments, swabs, gauges and other equipment required for the surgery and maintain sterile fields at all times.
• Perform the surgical count (instruments, swabs, gauges, sutures, needles etc.) with the theatre circulating nurse according to MBHS standard procedure and report on the same to the surgeon prior to surgery. With all prep, counts and lists, there should be a report that binds it all together as well as inventory.
• Ensure all surgical equipment (oxygen tanks, suction machine, laryngoscope, emergency defibrillator etc.) is turned on, checked and in good working condition prior to surgery.
• All medical equipment must be checked preoperatively and cleaned post operatively.
• Demonstrate best practice knowledge and compliance with cleaning, disinfecting and sterilising reusable medical and surgical instruments.
• Ensure all sterilising techniques are carried out per MBHS policy and all surgical equipment are autoclaved, as mandated.
• Assist in compiling and completing the operating theatre register.
• Ensure that appropriate stock levels are maintained in the theatre department. Maintain proper checklists for monitoring stock levels and usage.
• Ensure proper handover of patient and patient’s medical folders (including surgery consent forms, laboratory results, diagnostic scans, preoperative medical note etc.) prior to admission to the theatre department.
• Ensure that proper patient identification checks are carried out to ensure the correct patient, correct procedure and correct site.
• Ensure the safe keeping of patients’ belongings and valuables in accordance with MBHS policy.
• Conduct pre- and post-operative patient education.
• Prepare the patient for surgery and take and monitor vital signs.
• Prepare, administer (oral, subcutaneous, IV etc.) and record prescribed medications. Report on any adverse reactions to medications or treatments to the surgeon immediately.
• Maintain accurate and legible nursing records during the entire procedure.
• Ensure all preoperative and intraoperative checks are completed and properly recorded on the MBHS preoperative forms and patient chart.
• Continually demonstrate adherence to the Infection Control Policy, especially maintaining proper hand washing technique prior to surgery.
• Use and maintain correct personal protective equipment (PPE) such as sterile gloves and gowns, face masks and eye protection glasses.
• Ensure that procedures are understood by other nursing staff and carried out according to standard procedures.
• Comply with all national legal regulations as set out by the GNC and HPCZ. Report to the Theatre Coordinator or Clinic Manager any incidents or accidents, complaints, or defects in supplies or equipment as soon as possible.
• Carry out any other duties assigned by the Theatre Coordinator, Surgeon or Clinic Manager within the nursing scope of practice.

During surgery, the theatre scrub nurse takes on the following additional duties: 

• Understand and recognise each stage of the surgery (operation) and identify instruments that the surgeon may require.
• Ensure inventory of all items- pre and post-surgery.
• Act as a link between the surgical team and other theatre staff (i.e. theatre circulating nurse/ runner/cleaner).
• Ensure safety of the patient and assist the surgeon.
  Select and handle surgical instruments and supplies used for the operation, passing them to the surgeon. Responsible for surgical instruments, equipment and swabs.
• Pass and retrieve instruments safely and manage the introduction and disposal of items.
• Provide for accurate handling of specimens.
• Must take responsibility and identify any safety issues relating to the use of equipment such as diathermy, screening of x-rays, blood transfusion etc.
• Direct the theatre circulating nurse as required to promote the smooth running of the surgery.
• Enforce strict standards of aseptic technique.
• Assist the surgeon with controlling bleeding.
• Provide wound exposure.
• Assist the surgeon with suturing patients after the surgery, only within nursing scope of practice.
• Ensure relevant patient information is captured and recorded correctly on patient operative records for medico legal purposes.
• Ensure that records are kept of all surgical supplies (i.e. gauges, sutures, swabs, specific dressings etc.) for accurate billing of stock/supplies used during surgery. Make sure all billing sheets are completed accurately, signed and submitted to the ward clerk or billing clerk for proper patient billing

Customer Care

• Be polite and respectful to patients and staff at all times.
  Establish a good rapport with all patients and maintain a good bedside manner at all times.
• Report any evidence of poor customer service (i.e. bullying, rude behaviour, yelling etc.) to the Clinic Manager or HR Manager.
• Ensure all incident and adverse event reporting is carried out according to the clinic’s standard operating procedure. An Incident and Adverse Event Form must be completed for every incident at the clinic.

Administration Reporting

• Daily drug counts are recorded in the drug registers.
• Daily checklist completed of all stock in the recovery cupboards.
  Postoperative trolleys and emergency trolleys to be checked and recorded on MBHS Control Sheets.
• Ensure that patients are billed accurately for all operations, medications and surgical supplies utilised (billing charts completed on time and handed to appropriate person)

Skills, Experience and Qualification

• Must have a RN qualification Diploma in Registered Theatre Nursing (essential). Bachelors in Nursing is desirable but not essential.
• Must have a current licence to practise nursing in Zambia from the Nursing and Midwifery Council of Zambia. BLS training (essential).
• Must have 3 to 5 years’ experience working as a theatre scrub nurse in a hospital setting.
• Must demonstrate compassion and caring attitudes and behaviours towards patients and families.
• Able to demonstrate initiative and a proactive approach to problem solving.
• Demonstrates effective teamwork with other members of the MBHS healthcare team.
• Must have a basic level in computer literacy.