Operating department practitioner

Operating Department Practitioners (ODPs) are specialist allied healthcare professionals^[1] or clinicians involved in the planning and delivery of Perioperative Care.^[2] They are primarily employed in Surgical Operating Departments but may also work directly within or further their training to facilitate working within a variety of acute clinical settings. These include; pre-hospital emergency care, emergency departments, intensive care units (ICUs), endoscopy suites, interventional radiology, cardiac catheter suites, obstetric theatres and reproductive medicine.

Operating Department Practitioners may be employed directly as or may further their training to become Resuscitation Officers, Advanced Critical Care Pactitioners, Research Practitioners, University Lecturers, Vascular Access Practitioners, Radiology Specialist Practitioners, Blood Transfusion Practitioners, Education and Development Practitioners, Departmental Managers, Perioperative Team Leaders, Surgical Care Practitioners or Quality Improvement Facilitators.^[3] ODPs are commonly employed as cardiac arrest, medic emergency, obstetric emergency and inter-hospital transfer team members.

Operating Department Practitioners make up 1 of the 14 Allied Health Professions as defined by NHS England and are professionally autonomous practitioners who hold a Protected Title within the United Kingdom (UK). As of 2004 the profession has been regulated by the Health and Care Professions Council (HCPC)^[4] and thus falls under the remit of the Chief Allied Health Professions Officer (CAHPO). Since 2017 there have been upwards of 13,000 registrants added to the HCPC's register.^[4] ODPs are also supported and advised by their professional body the College of Operating Department Practitioners (CODP). The College represents practitioners in various aspects of professional, educational and workplace matters, entering into its 75th year of existence in 2020.^[5] ODPs work as members of multi-disciplinary teams that include Anaesthetists, Surgeons, Nurses, Radiographers, Physician Assistant and TSWs (Theatre Support Workers).^[6]

National Operating Department Practitioner (ODP) day, in the UK, is the 14th of May and the inaugural celebration was 2018. This day provides an opportunity for ODPs across the country to highlight their role within healthcare.^[7]

Scope of Practice[]

Operating Department Practitioners are subject to profession-specific standards of proficiency as laid out by the Health & Care Professions Council.^[8] Alongside this, their professional role is also broadly defined by the College of Operating Department Practitioners (CODP)'s Scope of Practice document as published by the College in 2009. The College went on to publish a national cirriculum document in 2018 which demonstrated the revised BSc (Hons) Operating Department Practice Curriculum.^[9]

• Anaesthetic (Pre and Intra-operative)^[10]
• Perioperative (Peri-operative)^[11]
• Post-Operative^[12]

Anaesthetic Practitioner[]

Anaesthetic Practitioners (APs) are highly skilled and dynamic healthcare professionals who make up part of the multidisciplinary clinical workforce. Their primary role is to function in tandem alongside their colleagues in order to establish a team which can effectively provide and maintain safe anaesthesia during surgery. This role requires the application of evidence-based practice and critical thinking alongside a range of professional and clinical abilities.

Prior to surgical intervention the anaesthetic practitioner will be tasked with completing a thorough and detailed diagnostic check of the anaesthetic machine, ensuring it has met its safety requirements and is fully operational. This includes the correct function and availability of essential medical gases and associated ventilatory equipment and breathing apparatus. The AP is also responsible for ensuring that critical controlled and emergency medications are accessible prior to the induction of anaesthesia. They are also routinely charged as being custodians of the controlled drugs/scheduled medications held within their dedicated theatre, being assigned security keys which remain on their person throughout the day.

The AP is responsible for conducting a pre-operative assessment of the patient prior to their admission to the department. These assessments may vary and are institutionally dependant, but may include assessment of the mouth opening, protruding or unsecure dentition, range of movement in the cervical spine, current pregnancy status, fasting status, past medical history, known medication/food allergen status, history of communicable diseases or blood born viruses, history of post-operative nausea and vomiting or individual/familial adverse reaction to anaesthetic agents. During an emergency clinical scenario where immediate treatment and response is required, the Anaesthetist (Medical Practitioner), may verbally request that the Anaesthetic Practitioner administer prescribed medications in response to the situation.^[13]

Perioperative Practitioner[]

ODPs prepare sterile instruments, swabs, consumables and any other equipment required throughout an operation. They work alongside the surgeon(s) within the sterile field. The ODP is accountable for the swabs, instruments and consumables used throughout an operation, to ensure nothing is left inside the patient or is missing.

ODPs may also be the first assistant to the surgeon assisting throughout the operation.

Rarely, ODPs may assist in a circulating role during the surgical stage of a patient's care. In this role, they pass extra materials to the surgical practitioner, help position the patient on the operating table, and plan ahead to supply what the surgical team may need.^[14] They may also set up extra equipment and act as a link between the surgical team and the rest of the hospital.

Postoperative Practitioner[]

When the operation has finished, the patient is taken to the recovery unit, where an ODP will monitor his or her condition, providing airway management if needed and recognise and record the patient's physiological signs. The ODP may administer treatments such as, the administration of prescribed drugs, enabling the patient to fully recover from the effects of anaesthesia. The ODP will liaise with other departments and staff such as, the ward staff, porters, consultants, to safely discharged the patient back to a ward environment.

Training[]

A Diploma of Higher Education (DipHE) is the minimum standard of training required to work as an ODP in the UK. An undergraduate degree BSc (Hons) in Operating Department Practice is a more common standard for entry into the profession.^[15] A DipHE usually takes two years to complete, with a BSC (Hons) requiring three. By 2010 there were 27 universities and colleges in the UK offering a qualification in operating department practice.^[16]

Apprenticeships programmes have recently been introduced, as an alternative pathway for individuals to train as ODPs. Apprentices are required to complete a HCPC approved BSc (Hons) degree in Operating Department Practice, whilst additionally meeting the required 15 standards set out in the Care Certificate within 3 months of commencement. The duration of ODP apprenticeship courses, typically takes 4 years to complete.^[17]

Once qualified, ODPs can further their clinical and professional development by obtaining additional training and/or competencies related to their role. Courses are usually provided by their individual trusts or national providers such as universities or related colleges, RCOA. Additional skills including of but not limited to venepuncture, intravenous drug administration, peripheral venous cannulation, electrocardiography, peripherally inserted central catheter (PICC and midline) training and urinary catheterization.

As healthcare professionals, ODPs can also obtain certifications in cardiopulmonary resuscitation courses from the Resuscitation Council (UK), including: Immediate life support, paediatric immediate life support and advanced life support. ^[18]

Role Expansion[]

With localised training within NHS trusts, ODPs can expand on their roles outside the traditional theatre setting. This has seen Operating Department Practitioners being utilised, in other specialist roles and critical care settings within the hospital environment.

Qualified and experienced ODPs can apply and undertake approved training by the Royal College of Surgeons. Progressing to surgical care practitioners, assisting in some surgical procedures under the supervision of a consultant surgeon.^[19]

ODPs with a minimum of three years clinical experience with a degree level qualification, can apply for training to become an anaesthesia associate. Upon successful completion of an Anaesthesia Associate Postgraduate Diploma, practitioners are invited to become an affiliate of the Royal College of Anaesthetists.^[20]

Titles[]

As an entry level or continuous band 5 practitioner, the Operating Department Practitioner title is usually stylised as either RODP (registered operating department practitioner) or simply ODP. With progression to a band 6/7 position, SODP (senior operating department practitioner) is commonly utilised. Band 8 ODP roles typically use the title of principle (PODP), manager, or any managerial variant.

Historically, the title of Operating Department Assistant (ODA) was frequently used. The early 1990’s saw an advancement of education and training, as a reflection the adoption of a practitioner title became more appropriate. The ODA designation after this time, fell out of common practice. However some ODPs who trained before this transition, continue to refer to themselves by their former title.

Areas of Employment[]

With advancements in training, demand for staffing and recognition for their skill sets. ODPs are becoming more commonly employed, in other areas found within the clinical settings. This however is not just limited to the hospital settings, where traditionally the role has flourished. The clinical environments where the ODP can operate are including but not limited to; Theatre departments, mobile theatres, ITU, cadiac ITU, endoscopy, interventional radiology, obstetric theatres, reproductive medicine, mental health clinics (ECT), A&E departments, clincial training departments, cardiac arrest and medical emergency teams, blood transfusion practitioners, hospital transfer teams, general practice practitioners, academic university staff, operational team management, research departments, cardiac catheter suites, pre-surgery clinics, armed forces, recovery units, vaccination and screening teams, vascular devices teams and clinics (hopsital based).

Professional organizations[]

The HCPC recognises two professional bodies for ODPs:^[4]

• The College of Operating Department Practitioners (CODP),^[21] previously known as the Association of Operating Department Practitioners (AODP)
• The Association for Perioperative Practice (AfPP)^[22]

ODPs are also eligible to apply for associate membership with the Difficult Airway Society.^[23]

See also[]

• Anaesthetic Technician in New Zealand healthcare
• Surgical technologist in United States healthcare
• Clinical officers in sub-Saharan Africa
• in

References[]

External links[]

• College of Operating Department Practitioners (CODP)
• The Operating Theatre Journal
• Association for Perioperative Practice