The procedure merely involves what can be considered as 'resurfacing' of the bones of the joint. The prosthesis implanted is placed on the surface of the bones that meet at the knee - the femur and tibia and cemented to the bones, while most of the ligaments and usually all of the tendons of the joint are spared (Soohoo et al, 2006). Reporting on the frequency of Total Knee replacement surgeries, Kane and others (2003) indicated that in 2001 alone approximately 171,335 primary knee replacements and 16,895 revisions were performed. Kane et al (2003) argue that due to the fact that Knee replacement surgery is an elective procedure and especially because the prevalence of arthritis is expected to grow as the population ages, the care for patients undergoing total knee replacement surgery becomes an increasing concern for the healthcare profession.
instruments, and assists the surgeon by passing instruments, sutures, and supplies. Therefore, the scrub nurse must have extensive knowledge of all surgical instruments and how they are used. On, the other hand, the circulating nurse serves as a liaison between scrubbed personnel and those outside of the operating room. The circulating nurse is free to respond to request from the surgeon, anaesthesiologist or anaesthetist, obtain supplies, deliver supplies to the sterile field, and carry out the nursing care plan. Other functions of the circulating nurse includes: initial assessment of the patient on admission to the operating room, helping monitoring the patient; assisting the surgeon and scrub nurse to don sterile gowns and gloves; anticipating the need for equipment, instruments, medications, and blood components, opening packages so that the scrub nurse can remove the sterile supplies, preparing labels, and arranging for transfer of specimens to the laboratory for analysis; saving all used and discarded gauze sponges, and at the end of the operation, counting the number of sponges, instruments, and needles used during the operation to prevent the accidental loss of an item in the wound (Mcewen, 1996). In the following pages, the organisation and layout of Total knee replacement surgery will be discussed using my experience with the surgical procedure of Mr. A as a yardstick.
Intraoperative care for Mr. A included all the activities performed by the health care team during surgery that ensured the patient's safety and comfort, implementation of the surgical procedure, monitor and maintain vital functions, and document care given. The intraoperative time period can vary greatly from less than one hour to 12 hours or more, depending on the complexity of the surgery being performed. Since the purpose of intraoperative care is to maintain patient safety and comfort during surgical procedures, decisions about patient positioning and other features of the operating room is influenced by a number of factors, especially conditions of the patient and potential risks or complications of the surgical procedure. The goals of intraoperative care include maintaining homeostasis during the procedure, maintaining strict