Care at NUH

OT Nursing


Perioperative Nursing in NUH 


The three mainroles of nurses in the Operating Theatre: 

Perioperative Nurse 

Perioperative nurses assist the surgeon during procedures and ensure the smooth operation of surgical processes. They work alongside surgeons, anaesthetists, perfusionists, embryologists and other medical professionals. 

Key responsibilities of a perioperative nurse include: 

  • Completing surgical documentation and charging; 
  • Assisting surgeons in operations by maintaining patient safety through ensuring sterility of the procedure and performing checks on surgical items used intraoperatively; 
  • Monitoring patient condition during surgery, particularly in cases involving local anaesthetic and moderate sedation; 
  • Providing nursing care in the operating theatre to maintain a safe and comfortable environment; and 
  • Ensuring the availability of surgical equipment and necessary items for procedures. 

Operating theatre nurse

Anaesthetic Nurse 

Anaesthetic nurses are trained to provide support to both the patient and anaesthetist intraoperatively.  

Key responsibilities of an anaesthetic nurse include: 

  • Preparing anaesthetic equipment
  • Monitoring the patient's condition perioperatively; and 
  • Assisting the anaesthetist in managing the patient's airway. 

Post Anaesthesia Care Unit (PACU) Nurse  

PACU nurses oversee the care of patients as they awaken from anaesthesia. PACU nurses are responsible for ensuring the patient's postoperative condition remains stable by conducting regular observations. 

Key responsibilities of a PACU nurse include: 

  • Monitoring the postoperative recovery and consciousness of patients who are awakening from anaesthesia, providing updates to the surgical/anaesthetic team; 
  • Developing individualised care plans based on the patient's condition; and 
  • Administering and discharging patient from the PACU when appropriate. 


Nurse-led Initiatives @ NUH Operating Theatre  


Skin-to-skin Initiative 

The "Skin-to-Skin" programme for elective caesarean surgeries in the Operating Theatre (OT) ensures compliance with NUH's standards as a Baby-Friendly Hospital Initiative (BFHI). Traditionally, midwives in the OT were responsible for facilitating and maintaining skin-to-skin contact between mothers and babies. In this initiative, OT nurses take on the role of receiving the neonate from the surgeon and assisting the neonatal physician in providing initial care. One crucial aspect of improving the caesarean section experience involves avoiding the separation of mother and child by promoting immediate skin-to-skin contact after birth. 

Assistant Nurse Clinician Joyce Chai shares her experiences with this new initiative that started in 2019. 

"It has been a fulfilling journey thus far, coming out of my comfort zone and challenged with the certifications and situations of handling the care of neonates for elective caesarean sections.  Acting as an advocate and seeing the overjoyed smiles on the parents' faces when their baby is presented to them, brings me great job satisfaction." 

PACU Nurse-Controlled Analgesia 

Since 2012, registered nurses have had the authority to initiate and administer analgesia to post-surgery patients experiencing pain. In the PACU, the presence of just one anaesthetist can pose a challenge, particularly when attending to a patient, leading to delayed attention for others. By empowering nurses to titrate analgesia immediately, patients' pain is more promptly managed, allowing for earlier discharge to the ward for rest. This initiative has garnered positive feedback from both anaesthetists and nurses, benefiting the patients. 

PACU Nurse-led Discharge 

Introduced in 2002, this initiative aims to address delays in patient discharge from the PACU due to the unavailability of the anaesthetist. Trained and certified PACU nurses assess post-operative patients based on established guidelines and criteria for discharge. This initiative ensures that the majority of patients are discharged by PACU nurses, enabling anaesthetists to focus on managing more complex post-operative cases and reducing patient frustration and length of stay in the PACU. 

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