7/28/2019 Or Checklist
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OPERATING ROOMPerformance Checklist for Nursing Students
Name_____________________________
Level _____ Section / Group__________ Inclusive
Dates_________________Affiliating Agency___________________
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/orperformance is consisitenly ineffective and
inefficient)
COMPETENCIES 4 3 2 1 REMARKSI. SAFE AND QUALITY PATIENT CARE
1. Obtains and analyzes patient data concerning patients
condition.
2. Determines and categorizes clinical assessment of the patient
andInter rets rudentl the h sicians order.
3. Identifies patient and verifies procedure to be done.
4. Checks and accomplishes pre-operative checklist prior tosur
ical
5. Checks for clearance (cardio-pulmonary, pediatric) and
diagnostic
6. Monitors vital signs immediately after surgery after the
operation.
7. Evaluates effectively patients recovering from
anesthesia.
II. MANAGEMENT OF RESOURCES AND ENVIRONMENT
1. Prepares and selects surgical supplies concerning the
patientssurgical procedure.
2. Checks the functionality of the operating room/delivery
roomequipments such as suction machine, lights and cautery
machine.
3. Maintains sterilit of the sterile field and the o eratin
room.III. HEALTH EDUCATION
1. Explains proper positioning for induction of anesthesia.
2. Demonstrates proper aseptic/antiseptic technique, sterile
drapingand 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.
IV. LEGAL RESPONSIBILITY1. Checks and verifies informed consent
for surgery is signed and
2. Observes patients rights in the pre, intra, and post
operative
V. ETHICO-MORAL RESPONSIBILITY1. 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 IMPROVEMENT1. Participates actively during post
conference.
VIII. RESEARCH1. Conducts necessary updates on current nursing
trends in the
operating room.
IX. RECORDS MANAGEMENT1. Performs proper documentation and other
important details as
needed.
2. Ensures patients records are safe and secured at all
times.
X. COMMUNICATION
