MINISTRY OF HEALTH MALAYSIA

CREDENTIALING
IN

PERIOPERATIVE NURSING

LOG BOOK

1. NAME: ………………………………………………………………………………………
2. IC NO: ……………………………………………………………………………………..
3. POSITION & GRED: ……………………………………………………………………..
4. WORKING ADDRESS: …………………………………………………………………..
……………………………………………………………………………………………….
……………………………………………………………………………………………….
5. DATE OF JOINING THIS DEPARTMENT: …………………………………………….
6. POST BASIC TRINING & YEAR: .………………………………………………………
7. TRAINING FOR CREDENTIALING: Date start: ………………………………………
Date end: …………………………………………

I hereby confirm that the above information is true.

Signature: ……………………………………. …. Date: ………………………………

1
 CONTENT

NO PROCEDURES PAGE
1 General Information 3

2 Components In the Clinical Practice Record 3

3 List of Core Procedures 4

4 List of Optional Procedures 5

5 Core Procedures 6 - 36

6 Optional Procedures 37 - 38
7 Summary Of Progress On Clinical Practice Records 39 - 41

2
General Information
This Clinical Practice Record will help to monitor staffs activities in the respective
area. They are expected to complete all the procedures identified in Peri Operative
Nursing.

The procedures have been categorized as core list of procedures where the staffs
must obtain the minimum number of activities as stipulated for each procedure. The
other list of procedures are optional where the staffs should try to get experiences in
the clinical areas. However if they are not available, staff will stimulates the
procedures to ensure that they have been exposed.

This Clinical Practice Record is reserved only for the Ministry of Health, Malaysia.

Components in the Clinical Practice Record

The Clinical Practice Record covers three (3) student’s activities:

1. Observe - to observe procedures being done

2. Assist - assist or perform under supervision
3. Perform - perform

Assessor

Recording and Assessment of Clinical Practice will be carried out by appointed

personnel only. Any practice performed and certified by unauthorized personnel will
be consider null and void.

3
 LIST OF CORE PROCEDURES
NO PROCEDURE PAGE
1 Assessment Of Patient On Arrival To Operating Theatre 6
2 Preparation For General Anaesthesia 7
3 Assist During Induction Of General Anaesthesia 8
4 Preparation For Regional Anaesthesia 9
5 Assist During Regional Anaesthesia 10
6 Handling Of Electro Surgical Unit 11
7 Care Of Patient With Tourniquet 12
8 Care Of Patient In Supine Position 12
9 Care Of Patient In Lateral / Kidney Position 13
10 Care Of Patient In Lithotomy Position 13
11 Care Of Patient In Prone Position 14
12 Care Of Patient In Orthopaedic Extension Position 14
13 Care Of Patient In Trendelenburg Position 15
14 Surgical Scrub, Gowning & Gloving 15
15 Circulating In General Surgery 16
16 Instrument Nurse In General Surgery 17
17 Circulating Nurse In Gynaecology Surgery 18
18 Instrument Nurse In Gynaecology Surgery 19
19 Circulating Nurse In Obstetric Surgery 20
20 Instrument Nurse In Obstetric Surgery 21
21 Circulating Nurse In Orthopaedic Surgery 22
22 Instrument Nurse In Orthopaedic Surgery 23
23 Circulating Nurse In Neurosurgery 24
24 Circulating Nurse In Otorhinolaryngology Surgery 24
25 Instrument Nurse In Otorhinolaryngology Surgery 25
26 Circulating Nurse In Plastic & Reconstructive Surgery 25
27 Instrument Nurse In Plastic & Reconstructive Surgery 26
28 Circulating Nurse In Urology Surgery 26
29 Instrument Nurse In Urology Surgery 27
30 Circulating Nurse In Ophthalmic Surgery 27
31 Care Of Post Anaesthetic Patient 28
32 Sterilization – Steam Under Pressure 29
33 Sterilization – Chemical Active Gluteraldehyde High Level 30
Disinfection
34 Sterilization – Monitoring Of Sterilizers 31
35 Cleaning, Washing And Packing Of Instruments For 32
Sterilization
36 Decontamination Of Environment 33
37 Decontamination Of Spillage 33
38 Decontamination Of Clinical Waste 34
39 Decontamination Of Instrument & Equipments 34
40 Handling Of Use Drapes 35
41 Decontamination Of Electrical & Pneumatic Instruments 35
42 Clean And Care Of Fibre Optic Scopes 36
43 Handling Of Speciments 36

4
 LIST OF OPTIONAL PROCEDURES
NO PROCEDURE PAGE
1 Instrument Nurse In Neuro Surgery 37
2 Instrument Nurse In Opthalmic Surgery 37
3 Circulating Nurse In Vascular Surgery 38
4 Instrument Nurse In Vascular Surgery 38

5
 CORE PROCEDURE

NO. 1: ASSESSMENT OF PATIENT ON ARRIVAL TO OPERATING THEATRE

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

6
 NO. 2: PREPARATION FOR GENERAL ANAESTHESIA

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

7
 OPTIONAL PROCEDURE

NO.3: ASSIST DURING INDUCTION OF GENERAL ANAESTHESIA

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

8
 NO. 4: PREPARATION FOR REGIONAL ANAESTHESIA

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

9
 NO. 5: ASSIST DURING REGIONAL ANAESTHESIA

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM

10
 NO. 6: HANDLING OF ELECTRO SURGICAL UNIT

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM

11
 NO. 7: CARE OF PATIENT WITH TOURNIQUET

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM

NO. 8: CARE OF PATIENT IN SUPINE POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM

12
 NO. 9: CARE OF PATIENT IN LATERAL / KIDNEY POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM
9 PERFORM

NO. 10: CARE OF PATIENT IN LITHOTOMY POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

13
NO. 11: CARE OF PATIENT IN PRONE POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

NO. 12: CARE OF PATIENT IN ORTHOPAEDIC EXTENSION POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

14
 NO. 13: CARE OF PATIENT IN TRENDELENBURG POSITION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 ASSIST
3 ASSIST
4 PERFORM
5 PERFORM
6 PERFORM
7 PERFORM

NO. 14: SURGICAL SCRUB, GOWNING & GLOVING

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM
16 PERFORM

15
 NO. 15: CIRCULATING IN GENERAL SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM
16 PERFORM

16
 NO. 16: INSTRUMENT NURSE IN GENERAL SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

17
 NO. 17: CIRCULATING NURSE IN GYNAECOLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM
16 PERFORM

18
 NO. 18: INSTRUMENT NURSE IN GYNAECOLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

19
 NO. 19: CIRCULATING NURSE IN OBSTETRIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM

20
 NO. 20: INSTRUMENT NURSE IN OBSTETRIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

21
 NO. 21: CIRCULATING NURSE IN ORTHOPAEDIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM
16 PERFORM

22
 NO. 22: INSTRUMENT NURSE IN ORTHOPAEDIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 OBSERVE
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 ASSIST
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM
16 PERFORM

23
 NO. 23: CIRCULATING NURSE IN NEUROSURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM

NO. 24: CIRCULATING NURSE IN OTORHINOLARYNGOLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 PERFORM
7 PERFORM
8 PERFORM
9 PERFORM

24
 NO. 25: INSTRUMENT NURSE IN OTORHINOLARYNGOLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 PERFORM
7 PERFORM
8 PERFORM
9 PERFORM

NO. 26: CIRCULATING NURSE IN PLASTIC & RECONSTRUCTIVE SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 PERFORM
7 PERFORM
8 PERFORM
9 PERFORM

25
 NO. 27: INSTRUMENT NURSE IN PLASTIC & RECONSTRUCTIVE SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM

NO. 28: CIRCULATING NURSE IN UROLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

26
 NO. 29: INSTRUMENT NURSE IN UROLOGY SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

NO. 30: CIRCULATING NURSE IN OPHTHALMIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM

27
 NO. 31: CARE OF POST ANAESTHETIC PATIENT

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM
13 PERFORM
14 PERFORM
15 PERFORM

28
NO. 32: STERILIZATION – STEAM UNDER PRESSURE

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

29
 NO. 33: STERILIZATION – CHEMICAL ACTIVATED GLUTERALDEHYDE HIGH LEVEL
DISINFECTION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

30
 NO. 34: STERILIZATION – MONITORING OF STERILIZERS

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

31
 NO. 35: CLEANING, WASHING AND PACKING OF INSTRUMENTS FOR
STERILIZATION

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

32
 NO. 36: DECONTAMINATION OF ENVIRONMENT

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

NO. 37: DECONTAMINATION OF SPILLAGE

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

33
 NO. 38: DECONTAMINATION OF CLINICAL WASTE

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

NO. 39: DECONTAMINATION OF INSTRUMENT & EQUIPMENTS

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 ASSIST
8 PERFORM
9 PERFORM
10 PERFORM
11 PERFORM
12 PERFORM

34
 NO. 40: HANDLING OF USE DRAPES

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM

NO. 41: DECONTAMINATION OF ELECTRICAL & PNEUMATIC INSTRUMENTS

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

35
 NO. 42: CLEAN AND CARE OF FIBRE OPTIC SCOPES

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

NO. 43: HANDLING OF SPECIMENTS

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

36
 OPTIONAL PROCEDURE

NO. 1: INSTRUMENT NURSE IN NEURO SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM

NO. 2: INSTRUMENT NURSE IN OPTHALMIC SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 ASSIST
6 ASSIST
7 PERFORM
8 PERFORM
9 PERFORM
10 PERFORM

37
 NO.3: CIRCULATING NURSE IN VASCULAR SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 PERFORM
4 PERFORM
5 PERFORM
6 PERFORM

NO. 4: INSTRUMENT NURSE IN VASCULAR SURGERY

NO. MRN ACTIVITY DATE NAME OF ASSESSOR SIGN REMARK

1 OBSERVE
2 OBSERVE
3 ASSIST
4 ASSIST
5 PERFORM
6 PERFORM
7 PERFORM
8 PERFORM

38
 SUMMARY OF PROGRESS ON CLINICAL PRACTIC RECORDS IN
PERIOPERATIVE

REQUIRED Done REMARKS

NO CORE PROCEDURES
O A P O A P
Assessment Of Patient On Arrival To Operating
1 2 5 8
Theatre
2 Preparation For General Anaesthesia 3 4 8

3 Assist During Induction Of General Anaesthesia 3 4 8

4 Preparation For Regional Anaesthesia 3 4 5

5 Assist During Regional Anaesthesia 3 5 5

6 Handling Of Electro Surgical Unit 3 5 5

7 Care Of Patient With Tourniquet 2 2 4

8 Care Of Patient In Supine Position 2 4 5

9 Care Of Patient In Lateral / Kidney Position
2 2 5
10 Care Of Patient In Lithotomy Position
2 5 5
11 Care Of Patient In Prone Position
2 5 5
12 Care Of Patient In Orthopaedic Extension Position
2 5 5
13 Care Of Patient In Trendelenburg Position
1 2 4
14 Surgical Scrub, Gowning & Gloving
3 5 8
15 Circulating In General Surgery
3 5 8
16 Instrument Nurse In General Surgery
3 4 8
17 Circulating Nurse In Gynaecology Surgery
3 5 8
18 Instrument Nurse In Gynaecology Surgery
3 4 8
19 Circulating Nurse In Obstetric Surgery
3 5 5
20 Instrument Nurse In Obstetric Surgery
3 4 8
21 Circulating Nurse In Orthopaedic Surgery
3 5 8
22 Instrument Nurse In Orthopaedic Surgery
3 5 8
23 Circulating Nurse In Neurosurgery
2 5 4
24 Circulating Nurse In Otorhinolaryngology Surgery
2 3 4
25 Instrument Nurse In Otorhinolaryngology Surgery
2 3 4
26 Circulating Nurse In Plastic & Reconstructive
Surgery 2 3 4

39
27 Instrument Nurse In Plastic & Reconstructive
Surgery 2 2 4

28 Circulating Nurse In Urology Surgery

2 5 5
29 Instrument Nurse In Urology Surgery
2 5 5
30 Circulating Nurse In Ophthalmic Surgery
2 2 4
31 Care Of Post Anaesthetic Patient
2 5 8
32 Sterilization – Steam Under Pressure
2 5 5
33 Sterilization – Chemical Activated Gluteraldehyde
High Level Disinfection 2 5 5

34 Sterilization – Monitoring Of Sterilizers

2 5 5
35 Cleaning, Washing And Packing Of Instruments For
Sterilization 2 5 5

36 Decontamination Of Environment
2 4 4
37 Decontamination Of Spillage
2 4 4
38 Decontamination Of Clinical Waste
2 4 4
39 Decontamination Of Instrument & Equipments
2 5 5
40 Handling Of Use Drapes
2 2 2
41 Decontamination Of Electrical & Pneumatic
Instruments 2 4 4

42 Clean And Care Of Fibre Optic Scopes

2 4 4
43 Handling Of Speciments
2 4 4

COMMENTS BY ASSESSSOR / HEAD OF DEPARTMENT:

………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
Signature of Assessor: Verified by Head of Department:

…………………………………………. …………………………………………………
(Name / Stamp) (Name / Stamp)

Date: Date:

40
 SUMMARY OF PROGRESS ON CLINICAL PRACTIC RECORDS IN
PERIOPERATIVE

REQUIRED Done REMARKS

NO OPTIONAL PROCEDURES
O A P O A P
1 Instrument Nurse In Neuro Surgery 2 2 4
Instrument Nurse In Opthalmic Surgery
2 2 4 4

3 Circulating Nurse In Vascular Surgery 2 0 4

Instrument Nurse In Vascular Surgery
4 2 2 4

COMMENTS BY ASSESSSOR / HEAD OF DEPARTMENT:

………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………..
Signature of Assessor: Verified by Head of Department:

…………………………………………. …………………………………………………
(Name / Stamp) (Name / Stamp)

Date: Date:

41