Lesson 1Time-out process: components, team communication strategies, and documentationExplains the surgical time-out process, including required parts, role clarity, communication methods, and documentation, stressing how planned pauses prevent wrong-site surgery and unite the team on patient, procedure, and safety issues.
Core elements of the surgical time-outRoles of nurse, surgeon, and anaesthesiaVerbal confirmation and closed-loop talkAddressing discrepancies before incisionDocumenting time-out and late entriesLesson 2OR admission and identification procedures: patient transport, monitoring hookup, and baseline vitalsReviews safe OR admission processes, including patient identification, transport from pre-op, transfer to the OR table, monitoring setup, and baseline vital sign recording to ensure care continuity and prevent identification or handover errors.
Verification of patient identity and consentSafe transport and handover from pre-opTransfer techniques and fall preventionInitial monitoring setup and lead placementBaseline vitals and pre-induction assessmentLesson 3Intraoperative monitoring priorities for patients with HTN and T2DM: BP trends, glucose monitoring, temperature controlCovers intraoperative monitoring priorities for patients with high blood pressure and type 2 diabetes, including blood pressure changes, sugar control, temperature handling, and early spotting of blood flow or sugar instability during laparoscopic procedures.
Baseline assessment for high blood pressure and type 2 diabetes risksNoninvasive and invasive blood pressure change monitoringIntraoperative sugar checks and insulin useTemperature monitoring and warming strategiesRecognizing blood flow and sugar warning signsLesson 4Skin prep and antisepsis specific to upper abdominal laparoscopyDetails evidence-based skin preparation and antisepsis for upper abdominal laparoscopy, including site check, hair removal, antiseptic choice, application method, drying times, and ways to prevent contamination during draping and port placement.
Pre-assessment of skin, scars, and infection riskHair removal methods and timingChoosing appropriate antiseptic agentsApplication patterns and required dry timesMaintaining prep integrity during drapingLesson 5Communication with surgeon and anesthesia: reporting, escalation, and crisis resource managementCovers structured communication between circulating nurse, surgeon, and anaesthesia provider, including routine reporting, raising concerns, and crisis resource management principles to support coordinated, safe intraoperative care.
Standardized intraoperative reportingNotifying changes in vitals and trendsEscalating equipment or safety concernsClosed-loop communication in crisesUsing crisis resource management principles during emergenciesLesson 6Sterile field maintenance: gowning/gloving, sterile draping for laparoscopy, trocar sites, and smoke plume managementFocuses on maintaining a sterile field during laparoscopy, including proper gowning and gloving, sterile draping methods, trocar site handling, and safe management of surgical smoke to protect patient and staff from contamination and exposure.
Assisted and self-gowning and glovingDraping sequence for upper abdomen casesMaintaining sterility at trocar insertion sitesHandling and passing laparoscopic instrumentsSmoke plume evacuation and filter useLesson 7Instrument and device management: laparoscopic instrument sets, electrosurgery, insufflation equipment, and portsExplores safe handling of laparoscopic instruments, electrosurgical units, insufflators, and ports, focusing on setup, function checks, troubleshooting, and teamwork with the surgical team to prevent injury, burns, or equipment delays.
Laparoscopic tray components and inspectionElectrosurgical unit setup and safety checksInsufflator setup, alarms, and pressure limitsPort selection, placement, and fixationCable, tubing, and cord organizationLesson 8Management of common intraoperative events: hypotension, bleeding, equipment failure, retained item protocolsAddresses spotting and nursing response to common intraoperative events, including low blood pressure, bleeding, equipment failure, and retained item risks, stressing quick communication, documentation, and following safety and escalation protocols.
Assessment and response to low blood pressureRecognition and control of intraoperative bleedingTroubleshooting critical equipment failuresRetained item risk factors and preventionEscalation pathways and event documentationLesson 9Counts protocol: sponge, instrument, and needle counts—timing, documentation, and discrepanciesOutlines standardized counting procedures for sponges, instruments, and sharps, including timing, documentation, and steps for resolving discrepancies, to prevent retained surgical items and support accurate, legally sound records.
Initial, intraoperative, and final count timingRoles and communication during countsDocumentation requirements and count sheetsManaging count discrepancies and searchesUse of adjunct technologies for countsLesson 10Positioning for laparoscopic cholecystectomy: supine with Trendelenburg/tilt, padding, pressure point protection, and hemodynamic implicationsDescribes safe positioning for laparoscopic gallbladder removal, including flat on back with tilt variations, padding and pressure point protection, securing the patient, and understanding blood flow and breathing effects of position and gas in the abdomen.
Pre-positioning assessment and planningFlat on back and reverse tilt setupSide tilt and table adjustmentsPadding, straps, and nerve protectionBlood flow and breathing implications
