Operating Theatre Staff Roles and Responsibilities

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It takes a lot of people to run a successful operating theatre. The most efficient operating theatre is one in which everyone knows their own role and responsibilities, as this means that everyone can depend on everything being done that needs to be done.

In this post we’ll explore the various operating theatre staff roles, and the key responsibilities for each member of the team.

Outline of Operating Theatre Staff Rolls

Please note that this is a general list of operating theatre staff roles. Specific theatres might have specific roles, and many members of the team will share responsibilities as the situation demands. So please don’t treat this list as a definite hierarchy so much as an example of the sort of roles that could exist in your average operating theatre.

Operating Theatre Manager

The operating theatre manager oversees the theatre’s day-to-day operational issues. They will often manage multiple sites. Their responsibilities involve managing budgets and resources, as well as implementing risk management and health and safety policies.

As well as providing professional leadership to all theatre staff, they might lead on research projects and assess, develop, and implement new evidence-based programmes of care.

You can read our full guide to an operating theatre manager’s roles and responsibilities.

Operating Theatre Team Leader

Supporting the theatre manager, the team leader will directly lead the multidisciplinary theatre team, both professionally and clinically.

Their responsibilities will involve planning and organising workload and supervising the nursing staff. They may also provide clinical advice, and ongoing training and development in the use of specialist instruments and equipment.

The team leader will also oversee the maintenance of operating theatre equipment, which will include keeping on top of stock levels.

Theatre Practitioners

Nurses, surgeons, anaesthetists and other specialists. Responsible for undertaking or assisting in the highly skilled invasive medical procedures that take place in the controlled theatre environment.

As they carry out such delicate, high-pressure procedures, many would argue that the theatre practitioners are the most important of all the operating theatre staff.

However, as we’ll see, the practitioners depend on a huge team of support staff to ensure they can deliver the highest possible quality of care.

In an operating theatre, communication is key, and each member of the team must feel like they can depend on every other member of the team at all times.

Operating Department Practitioners (ODPs)

ODPs have a diverse range of skills across three main areas of the theatre:

  • Anaesthetics – While the anaesthetist works, the ODP will usually interact with the patient – talking to them and giving them whatever support they need to stay calm.
  • Scrub – While the theatre team is operating, the ODPs will ensure that all surgical equipment is readily available and adequately sterilised.
  • Recovery – ODPs will provide a lot of recovery support, including airway management, pain relief, and supervising patients as anaesthesia wears off.

Surgical Care Practitioners

Registered non-medical healthcare professionals who work with the surgical team to ensure the best outcome for the patient.

Before the operation, they will gather the patient’s medical history and perform an assessment. Throughout this process, they will liaise with the surgical team so as to inform them of any of the patient’s special requirements.

During procedures, they may be responsible for certain surgical interventions. These may include prepping the patient, assisting in haemostasis, and carrying out wound closure procedures.

Following the operation, they’ll assist in the patient assessments, and contribute to any meetings to discuss the patient’s ongoing care.

Recovery Practitioner

As the name suggests, recovery practitioners are there to oversee the patient’s recovery. Though their responsibilities begin before the procedure, as they usually assist the anaesthetist and ODP in supervising the patient.

Following the procedure, they’ll oversee advanced pain and airway management, and the ongoing monitoring of the patient for post-operative complications.

Support Workers

Finally, a team of support workers will carry out all the essential housekeeping duties and assist in any other activities essential to the smooth running of the operating theatre.

This might include maintaining the cleanliness of the theatre itself, as well as all ante rooms, changing rooms, kitchens, and sterilisation suites. They will also assist in stock management, keeping tabs on stock levels and ensuring that the team will always have everything they need, exactly when they need it.

Indeed, a good operating theatre support worker will be able to anticipate the requirements of the operating team, so they can give them the support they need before they even realise they need it.

Running an Efficient Operating Theatre

As we’ve seen, it takes a huge team of people to run a successful operating theatre.

Each member of the team needs to be in exactly the right place at exactly the right time. They should have fast access to exactly the equipment they need, and they should be able to depend on this equipment being in a safe and reliable condition.

Good communication is vital if such a large, multidisciplinary team is to function. Effective leadership can help create a culture in which each member of the team is perfectly aware of their role and responsibilities. But this is just one aspect of an efficient operating theatre.

Read our full guide to improving quality and efficiency in operating theatres.

Get Expert Advice Today

Whether you want a consultation on effective infection control, or some advice on improving operational effectiveness in the theatre, our experts are here to help.

Get in touch to talk to one of our expert consultants today.

What is Surgical Steel & What’s The Difference From Stainless Steel?

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You have to be able to rely on your surgical instruments. The size and the function are important, but just as important is the quality of the steel.

This is your essential guide to surgical steel. We’ll explore how it differs from standard stainless steel, before addressing some of the most commonly asked questions people have about surgical steel. Finally, we’ll let you know how you should choose the right steel quality for your surgical purposes.

What Is Surgical Steel?

Surgical steel is a low-carbon steel containing high concentrations of chromium. This chromium reacts with oxygen in the air to form a stable oxide bond that helps prevent rust. Surgical steel is also nonporous, making it more hygienic for use in clinical environments. And as it’s chemically inert, you can safely sterilise surgical steel with no risk of corrosion or degradation.

What Are The Differences Between Surgical Steel and Stainless Steel?

This is where it can get confusing. For while almost all surgical instruments are made from stainless steel, not all stainless steel is suitable for medical use.

Stainless steel comes in a variety of grades. Medical grade stainless steel – that is, surgical steel – tends to have a higher concentration of chromium. Surgical steel will contain at least 13% chromium, compared to standard stainless steel’s 10.5%.

Surgical steel can also contain a higher concentration of Molybendum, to further reduce corrosion, and nickel, which reduces its brittleness. However, surgical devices designed for use as implants will usually have a lower nickel content, to prevent infection in the patient’s body.

Does Surgical Steel Rust?

No – the oxide bond produced by the chromium coats the surgical steel like a film. This means that even if you damage the steel’s exterior, the film will heal itself, making it impossible for rust to take hold.

Is Surgical Steel Self-Healing?

This self-healing quality is crucial for healthcare applications. Small fissures in the surface of steel can work as a breeding ground for bacteria. With surgical steel, any fissures will close themselves before bacteria can take hold. This, combined with ongoing sterilisation, helps keep surgical steel suitably hygienic for medical use.

Does Surgical Steel Stain?

Surgical steel is a form of stainless steel. But the name “stainless steel” can be misleading. It’s not “stainproof steel”. It’s “stainless steel”. It’s less likely to stain, but stains are still possible.

In time, all types of stainless steel corrodes and stains. Surgical steel is no exception – though the higher chromium content can make it a lot more durable than standard stainless steel.

The correct cleaning procedures can greatly prolong the lives of surgical steel instruments. For example, using deionised water with high-quality cleaning chemicals can reduce water spotting while helping avoid mineral deposits forming in the wash cycle.

But unfortunately, no surgical instrument can be used indefinitely. Your surgical instrument supplier will be able to advise you on how long you can expect to use your instruments before they need replacing.

Is Surgical Steel Magnetic?

Many grades of surgical steel are magnetic. The steel’s chemical composition determines whether or not it’s magnetic. A large quantity of ferrite will make surgical steel magnetic. Also, surgical steel that’s been heat-treated for extra durability is usually magnetic owing to an abundance of iron.

However, surgical steel containing particularly high chromium content – at about 30% – along with nickel is more likely to be non-magnetic.

If you need more information on whether the surgical steel you need should be magnetic or non-magnetic, get in touch to talk to one of our experts today.

How To Choose The Right Steel Quality for Surgical Purposes

There are many different grades of surgical steel, and each is suitable for a different range of applications.

Some grades offer increased sharpness, flexibility or durability. Others are more resistant to corrosion, and some are designed to be used as implants, either permanently or temporarily.

We offer one of the most comprehensive ranges of surgical instruments on the UK market, and our experts are always on-hand to discuss your needs. So if you’d like some guidance on the right steel quality to choose for your application, get in touch to talk to an expert today.

Types of Surgical Instruments – Names and Instrument Selection

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If we classify them according to their function, there are three main types of surgical instruments:

  • Cutting surgical instruments – Such as blades, knives, scissors and scalpels.
  • Grasping surgical instruments – Anything you use to hold something in place, such as forceps.
  • Retracting surgical instruments – For holding incisions open, or for holding organs and tissues out of the way while you operate.

Types of Surgical Instruments For Cutting

These are some of the most common surgical instruments for cutting:

Blades, Knives and Scalpels

We categorise scalpels by their size and shape, and each type is good for a different sort of application. For example, surgeons usually choose a number 10 blade for making smaller incisions in skin and tissue. Whereas a number 15 blade, with its small curve, is better for making short and precise incisions, such as when removing a skin lesion or opening a coronary artery.

Surgical Scissors

Surgical scissors come in a huge range of sizes. At the top end of the scale are heavy-duty surgical scissors, which can cut through thick tissue, muscle, and even bone. Mid-size surgical scissors use a combination of sharp and serrated blades to give precise cuts with minimal tissue damage. Surgical scissors with curved blades help you to make clean cuts without hitting any underlying tissue.

Smaller scissors include Vannas scissors and Castroviejo scissors, both of which are good for delicate applications such as ophthalmic and neurosurgical procedures. Finally, small sapphire blades can create precise cuts while applying a minimum of pressure, making them perfect for microsurgery.

Types of Surgical Instruments For Grasping

Like scissors and scalpels, surgical forceps come in a range of styles and sizes, each one suitable for different applications. Forceps can either have straight tips or curved tips. Straight tips provide more grip and precision, while curved tips provide more visibility.

Thumb Forceps

Some forceps you squeeze to open. These are thumb forceps, and they’re good for dressing wounds, removing dressings, and tying sutures.

Reverse Forceps

Other forceps you squeeze to close. These are reverse-forceps, and their design provides uniform tension for added precision, especially when you’re wearing gloves.

Locking Forceps (Haemostats)

Some forceps resemble scissors. These are called haemostats or locking forceps, and surgeons use them to securely hold tissues during delicate operations, and to compress blood vessels to obstruct the blood flow when operating on organs.

Types of Surgical Instruments For Retracting

In surgery, retractors can either hold a wound or incision open, or hold an organ or tissue out of the way so you can work underneath.

Hand Retractors

Hand retractors require someone – or something – to hold them in place for the duration of a procedure. Surgical assistants usually undertake this role.

Self-Retaining Retractors

As the name suggests, self-retaining retractors do not require anyone to hold them throughout procedures. They can use screws, ratchets or clamps to hold tissue in place. Alternatively, wire retractors use a spring system to keep things secure.

Choosing The Right Surgical Instrument For Your Application

Some surgical instruments are versatile. You can use them in a range of applications. But certain applications will demand more specific surgical tools – smaller, sharper, or more precise, for example.

Your surgical instrument supplier should help you choose the right instrument for your specific application. But here are some things you should consider to help narrow down your choice:

  • What procedure are you performing? Almost every procedure you could conceivably perform over the course of your surgical career will have been performed before. This means that there’ll be published research papers about almost every procedure. These papers will often list the surgical equipment used during the procedure. They may even make clear recommendations for which equipment to use for best results.
  • How often will you use the surgical equipment? Of course you’ll keep your surgical instruments clean between use. But it’s also important to remember that surgical equipment doesn’t stay sharp forever. If you intend to make heavy use of your surgical equipment, look for those made with more durable materials, as they’ll stay sharp for longer.

Need more advice in choosing the right surgical equipment for your application? We offer one of the most comprehensive ranges of surgical instruments in the UK, and our experts are always on hand to help you choose the equipment you need. Find out more about our surgical instruments.

Lawton Brand Values

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Tips for Surgical Instrument Care & Handling

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Tips for Surgical Instrument Care

Use as intended

Misuse of instruments can lead to stress and irreversible damage.

Handle with care

Poor handling can lead to contamination, corrosion and fractures.

Avoid dried residue

Blood and other secretions can cause discolouration and corrosion

Avoid leaving wet

Instruments left in liquid can cause a galvanic current that can lead to galvanic corrosion

Avoid mechanical stress

This can lead to misalignment of instrument parts as well as tension corrosion

Stick to processes

Ensure that routines in the Central Sterilisation Department are strictly followed

Clean as advised

Always adhere to manufacturers instruments for cleaning and sterilisation

Avoid poor servicing

Always use a certified repair facility: inexpert servicing can ruin valuable instruments

8 useful tips for surgical instrument care

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High quality surgical instruments can be an amazing investment. Offering exceptional performance and durability, some studies have shown such instruments can last for well over 30 years.(1)

However, even the finest surgical instruments will only last if they are carefully handled, properly maintained and professionally serviced. Follow these 10 tips to help ensure your instruments last for as long as possible:

1.      USE AS INTENDED

Never use a surgical instrument for anything other than the purpose for which it was designed. By misusing instruments, you can cause irreversible damage by stressing the parts and damaging the surface.

2.      HANDLE WITH CARE

Poor handling of surgical instruments is a sure-fire way to damage them, so don’t start throwing them around or leaving them in unsuitable conditions. If you do, you may quickly find that your instruments suffer fractures or become contaminated and corroded.

3.      AVOID DRIED RESIDUE

Clean used instruments quickly to avoid any residue drying onto the surface. This is because, blood and other secretions can cause discolouration and corrosion.

4.      AVOID LEAVING WET

Once cleaned, make sure the instruments are dried properly. Instruments left in liquid cause a galvanic current that can lead to galvanic corrosion.

5.      AVOID MECHANICAL STRESS

Don’t stress an instrument beyond its capabilities as this can lead to misalignment of instrument parts. It can also cause tension or stress corrosion: the spontaneous cracking of instrument parts subject to high tensile pressure, such as screws and welded sections.

6.      STICK TO PROCESS

Make sure that routines in the Central Sterilisation Department are strictly followed. This includes ensuring that instruments are cleaned at the correct temperature, using the correct detergent and that they are stacked and dried correctly.

7.      CLEAN AS ADVISED

Always adhere to manufacturer’s instructions for cleaning and sterilisation. In particular, it is important to stick to dosage and duration guidelines for the detergent you are using.

8.      AVOID POOR SERVICING

Always use a certified repair facility, as inexpert servicing can ruin valuable instruments. By having your surgical instruments professionally inspected, refurbished and realigned, you can help ensure that they are restored to top condition.

If you found the above tips useful, you can click here to view and download our handy infographic for surgical instrument care. 

WANT MORE SURGICAL INSTRUMENT CARE TIPS?

For ongoing tips on how to maintain your valuable surgical instruments just click here and follow our LinkedIn page. As well as tips on instrument care, we also post news on upcoming surgical events, advances in surgical technology and new product updates.

REFERENCES:

(1)   Dahl G, Ölveback T, Wiklung L. Quality surgical instruments best investment. Presented: SEORNA, Swedish Operating Nurse Association Conference Meeting, 29-30 November 2012

Poor quality instruments put patients at risk

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Fears that contaminated surgical instruments are causing unnecessary illness and deaths because of the risk of infection continue to hit the headlines.

From Alzheimer’s proteins to HIV, Hepatitis B or C and many more dangerous diseases, there seems to be a steady stream of stories about how patients’ health has been put at risk.

What is not often mentioned in conjunction with these stories however, is the fact that poor quality surgical instruments are often to blame for poor standards of infection control.

What’s more, despite a BBC documentary “Surgery’s Dirty Secrets” revealing several years ago that large numbers of surgical tools used in the NHS failed to meet quality standards, the problem of poor quality instruments is still rife.

In fact, Tom Brophy, a lead technologist with Barts Health NHS Trust went on record at the time to say that about 20% of all the instruments that he received were rejected because of flaws that could put patient’s health at risk.

So why do poor quality surgical instruments pose a risk?

Poorly manufactured surgical instruments can risk patient health for a number of reasons:

·         Micro-punctures in surgeons’ gloves

Poor quality surgical instruments are often machine-made and finished, leaving metal fragments and sharp burs that can lacerate surgical gloves.

As these punctures can be miniscule, they can easily go undetected during a surgical procedure, creating an easy pathway for infection to be transferred to the patient.

·         Defects that are invisible to the naked eye

In addition to revealing sharp burs and microscopic shards of steel, an inspection of a poor-quality instrument under a microscope will often reveal numerous other defects that can pose a risk to patients.

This is because by using low-grade steel, such instruments can easily become corroded or pitted and even develop hairline fractures.

This means that whilst an instrument might seem perfectly clean to the naked eye, a look under a microscope can reveal numerous areas that could be harbouring dangerous bacteria and viruses.

·         Unclean manufacturing facilities

Although Swedish craftsmanship and German-quality stainless steel may come to mind when one thinks of surgical instruments, two-thirds of the world’s instruments are actually made in Pakistan.

While some of these manufacturers adhere to high standards of manufacture, others have been found to operate in dust-filled environments near to open sewers, piling newly made instruments on the floor and failing even to carry out a visual inspection with a magnifying glass before marking their wares with a CE quality stamp.

Clearly this then begs the question just how clean these brand-new instruments are by the time they get into the hands of our UK surgeons.

·         Low grade materials

It is clear to see why both UK surgeons and NHS procurement teams would want to avoid poor quality instruments that pose such risks of infection and harm, even when the pricing can differ so significantly between high-quality and poor-quality instruments.

Of course, German stainless steel is recognised as the very best material for making surgical instruments, but in a time of ongoing budgetary pressures on the NHS, surely it makes sense to buy less expensive ‘German’ instruments than recognised brands?

However, due diligence is needed here as well, as the ‘Dirty Secrets’ documentary also revealed Pakistani representatives offering to sell tools made with Pakistani and French steel that are stamped “Made in Germany”.

The result is that hospitals may still end up paying a lot for substandard instruments that pose a risk to hygiene and health.

·         Design limitations that affect cleanliness

Another issue with poorly manufactured surgical instruments is that they have not been designed to be dismantled for cleaning and inspection.

As infection is harder to eradicate around instrument joints, being able to fully separate parts can significantly reduce the risk of cleaned instruments continuing to harbour germs.

LOOKING FOR HIGH QUALITY SURGICAL INSTRUMENTS?

Why not browse our range of Stille and Lawton quality surgical instruments by clicking here?

You can also contact the Cairn instrument team on 0845 226 0185 to discuss individual instruments, recommended instrument sets or to arrange for a demonstration of specific instruments.

Surgical Instrument Care Infographic

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