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- Perioperative Patient Assessment and Diagnosis
- Informed consent or waivers
- surgical
- anesthesia
- blood
- photographs
- visitors

- Collect, analyze, and prioritize patient data
- vital signs
- pain exam
- allergies
- lab values
- other medical conditions
- medical conditions for which they would need clearance
- previous relevant surgical management
- chart review
- NPO status
- family history of anesthesia problems

- Use age and sociocultural appropriate health exam techniques to evaluate patient status
- interview
- observation
- communication barriers
- Conduct medication reconciliation
- preoperative meds
- home meds
- alternative/herbal meds
- medical marijuana
- alcohol use
- recreational drug use

- Conduct physical exam
- skin integrity
- mobility
- body piercings
- implants/foreign objects
- Antibiotic stewardship
- Pain management
- ERAS
- multi-modal
- regional blocks

- Advance directives ( DNR, AND (Allow Natural Death) processes)
- Selection criteria
- BMI
- ASA
- sleep apnea
- infectious disease
- age

- Pre-surgery risk exam
- medications
- previoussurgeries
- special needs
- comorbidities
- preop instructions

- Discharge needs
- home care
- durable medical equipment
- transportation
- care giver
- medications
- rehab
- Approved nursing diagnoses
- North American Nursing Diagnosis Administration [NANDA]
- Perioperative Nursing Data Set [PNDS]

- Preoperative Plan of Care
- Physiologic responses: Risk of infection
- Physiologic responses: Altered tissue perfusion
- Physiologic responses: Thermal regulation
- Behavioral responses

- Transcultural nursing theory
- cultural and ethnic influences
- family patterns
- spirituality and related practices
- Identify and plan for expected patient outcomes/postoperative needs
- responsible supervision
- transportation
- sleep apnea

- Community networking and institutional resources
- supplies
- equipment
- patient transfer agreements
- courierservice
- emergency services
- Conduct site preparation
- hair removal
- skin antisepsis
- Preoperative patient preparation
- IV
- removal of jewelry
- hair removal

- Intraoperative Care
- Optimize physiological responses of the patient
- Normothermia
- Infection prevention/control
- Perfusion
- Surgical procedure
- Wound healing
- Monitor and maintain patient and personnel safety
- Maintain the dignity, modesty, and privacy of the patient

- Utilize ergonomics and proper body mechanics in performing patient care.
- Chemical
- Fire
- Hazardous materials
- Radiation
- Smoke plume
- Energy generating devices
- Positioning
- Potential complications
- Patient/personnel safety
- Ergonomics/body mechanics

- Optimize patient care based on behavioral responses
- comfort
- anxiety
- pain management
- sociocultural and/or ethical issues
- Select procedure-specific protective materials and equipment
- lead aprons
- laser goggles
- smoke evacuators
- extinguishers

- Identify and control environment factors
- humidity
- noise
- temperature
- traffic
- Maintain a sterile field using aseptic technique
- Ensure the sterility of surgical products and instrumentation
- expiration date
- package integrity
- Aseptic technique
- Wound classifications

- Verify and document specimens with surgical team
- Prepare, label, and transport specimens
- Confirm, present, and prepare implants
- Prepare explants for final disposition
- Monitor and evaluate the effects of pharmacological and anesthetic agents
- Assist with anesthesia management
- induction
- airway protection
- extubation
- cricoid pressure

- Adhere to Universal Protocol
- time out
- WHO checklist
- National Patient Safety Goals (NPSGs)
- Manage patient hemodynamic needs
- fluid replacement
- Prepare, label, and administer moderate and local sedation/analgesia with appropriate monitoring
- capnography
- pulse oximeter

- Communicate patientstatus and changes to interdisciplinary healthcare providers
- Utilize effective communication for continuity of patient care
- hand-off
- debrief
- Methods and requirements for reporting to interdisciplinary healthcare providers
- critical lab values
- medical condition
- medications
- allergies
- implants/implantable devices
- read back orders

- Information technology
- software applications
- security
- HIPAA
- Barriersto communication
- patient
- family
- team
- chain of command

- Interdisciplinary services for care coordination
- nutrition
- wound care
- social work
- referrals
- transportation
- convalescent center
- physical therapy
- Evaluate patient status to facilitate transfer to the next level of care
- PACU
- home
- rehab facility
- hospital
- 23-hour observation

- Document patient care
- Provide and document post-discharge follow-up communication according to regulatory guidelines
- Assist with management of:
- airway
- pain
- hemodynamic monitoring
- Pain management
- ERAS
- multi-modal
- regional blocks

- Select appropriate methods and products for processing
cleaning
disinfecting
packaging
sterilizing
transportation
storage
- Cleaning products and techniques
- manual washing
- ultrasonic
- Packaging techniques
- crates
- peel packs
- wraps

- Transportation of equipment, instruments, and supplies
- Perform and document disinfection procedures
- high-level disinfection
- decontamination
- Handle and dispose of hazardous materials
- chemo drugs
- radioactive materials
- Handle and dispose of biohazard materials
- blood
- tissue

- Perform and document sterilization procedures including biological and chemical monitoring
- load parameters
- steam sterilization
- low- temperature sterilization
- Perform and document immediate use steam sterilization (IUSS)
- Quality assurance testing
- washer-disinfector
- sterilizer
- Perform nursing interventions based on age-specific needs
- Coordinate members of the interdisciplinary healthcare team during internal/external emergency situations

- Preparation for and management of medical emergencies:
- Malignant Hyperthermia (MH)
- Preparation for and management of medical emergencies:
- Anaphylaxis
- Cardiac arrest
- Hemorrhage
- Roles ofthe interdisciplinary healthcare team during internal/external emergency situations
- triage
- FEMA
- EMS
- community resources

- Preparations for and management of environmental hazards and natural disasters
- fire
- toxic fumes
- natural disasters
- terrorism
- power outage
- active shooter

- Acquire equipment, supplies, and personnel
- Coordinate and document preventive maintenance of equipment
- Monitor availability and sterility of supplies
- Perioperative resource management
- equipment
- supplies
- staffing
- Supervise, educate, and mentor healthcare team members
- Delegate perioperative tasks to appropriate personnel within their scope of practice

- Supervise non-OR personnel
- vendors
- students
- visitors
- family
- Adjunct roles, assigned staff, and responsibilities
- medication safety
- laser safety
- employee health
- Privacy officer
- Facility officer
- Risk manager
- infection prevention

- Role of non-perioperative personnel
- vendor
- students
- visitors
- family
- medical records
- admissions
- Scope of practice for the interdisciplinary team per regulatory agencies: Nurse Practice Act
- Monitor and assist with implementation of cost-containment measures
- Implement environmental sustainability practices
- reprocessing
- recycling
- Waste management
- reprocessing to include single-use devices
- supply standardization

- Ensure use of Personal Protective Equipment (PPE)
- Oversee environmental cleaning
- spills
- room turnover
- terminal cleaning
- physical plant
- Track biological implants
- order
- reconstitute
- storage
- use/waste
- Radiation safety
- dosimetry badges
- time
- distance
- shielding
- lead protection

- Protect patient confidentiality
- Advocate for and protect patients rights
- Report unanticipated events and good catches
- Perform functions within scope of practice
- Comply with regulatory and accreditation guidelines
- life safety
- Local
- state
- federal regulatory requirements
- FDA
- CDC
- CMS
- OSHA
- DEA

- Demonstrate competency in perioperative nursing practice
- Acknowledge personal bias and limitations and seek assistance as needed
- Utilize standards and recommended practices
- AORN
- APIC
- AAMI
- IAHCSSM
- ASPAN
- Demonstrate evidence-based practice
- hand hygiene
- safe injection practices
- surgical attire

- Accreditation standards and organization guidelines
- AORN Guidelines for Perioperative Nursing
- Perioperative
- Explications for the ANA Code of Ethics for:
- Nurses
- ASPAN
- APIC
- AAMI
- EBP
- Hand hygiene
- Safe injection practices
- Surgical attire

- Identify and take appropriate action regarding behaviors that undermine a culture ofsafety
- disruptive behavior
- Participate in professional development activities
- shared governance
- staff education
- committees
- certifications
- advanced degrees
- professional Organizations

- Risk management
- eventreporting
- good catch
- disclosure of unanticipated events
- recalls
- Safe Medical Device Act
- Quality improvement processes
- research
- data collection
- evidence-based practice
- performance improvement
- CMS quality measure
- reimbursements