Perioperative nursing

Question	Answer
Purposes of surgery	diagnostic ablative palliative reconstructive transplantation constructive
Surgical settings	hospital, freestanding surgical centres, clinics
classification of surgery	elective, elective (add on), emergency
degree of risk	major - invasive, minimally invasive minor - invasive, minimally invasive, non-invasive
incidence of surgical treatment	per client initiation per physician recommendation implications for nursing inpt, opt, home care, teaching, followup
experience of the client	effects - biophysical, intellectual, spiritual influences- developmental age, environmental support systems
Legal implications of surgery	liability - physician, RN responsibility - client, legal guardian
perioperative patient focused model	assessment, nursing diagnosis, outcome identification, planning, implementation, evaluation
standards of nursing practice - ACORN	NR1, NR2, NR4, NR6
NR1 -	anaesthetic nurse - competence, accountability, systematic and planned approach,nursing care via administration of anaethesia, analgesia, iv sedation appropriate monitoring, support throughout procedure assessment prior to, during, following anaethesia act as patient advocate reviewed and evaluated regularly according to quality improvement program of HCF deliver comprehensive handover ongoing personal and professional development
NR2 -	circulating nurse systematic and planned approach, ongoing professional development, accountability for own actions, act as patient advocate, review and evaluated
NR4 -	Instrument nurse can be registered or enrolled systematic and planned approach, ongoing professional development, maintain accountability, patient advocate, reviewed and evaluated
NR6 -	PARU nurse demonstrate competence,nurse in charge insitu, responsible for development, coordination, provision of ongoing education, maintain accountability, systematic and planned approach, nursing practice and processes reviewed and evaluated regularly, patient advocate, vigilance in assessment and management of patient, utilise range of avaliable resources to provide effective analgesic comfort, patient temp should be maintained, ensure discharge criteria, incorporating ACORN standards, safe transfer of patient to receiving unit, continual observation of patient and provision of emergency equipment during transfer, ie oxygen, suction, hand ventilation, assembly * written criteria of policies, care, management of paediatric patients
Standards of professional performance	patient and family education patient and family discharge planning performance improvement professional growth
Roles and phases	preoperative phase - day surgery RN Intra phase - anaesthetic nurse Intra phase - theatre scrub/scout Post op phase - recovery RN
PreAn clinic duties	staffed with RNs gives instructions for NPO arrange times for arrival to surgery center preop teaching - on phone or in person -surgical events, process, sensations -post op period - pain management -deep breathing and coughing preop testing -labs -x-rays -ECGS
Day of surgery	client arrives records with complete tests, verbal nursing assesssment has been sent to surgery centre, avaliable in holding room, client has support person with them, or a contact person
Holding room	client is taken back to changing room dressed in gown they are led in stretcher to holding room RN completes assessment heart and lung sounds -clarification of data on assessment sheet - ID band place, consent form signed, orders, checked, allergies, IV inserted, support person can wait until OR
Pain assessment	orientate client to pain measurement scales reassure them about medications introduce complementary pain control techniques discuss perceptions of post op pain management
Summary of pre op role	preparation of client for surgery duties for the pre-op RN assessment, diagnosis, planning, intervention, evaluation
Intraoperative phase anaesthetic nurse	prepares client for pending anaesthetic assists anaethetist with induction, maintenance, emergency phases of anaethestic acts to stabilise patient in emergency
Anaesthetic nurse- preparation of client	performs final checklist escorts client to theatre gets client into position porvide physical/emotional support stays with client until they are asleep/stable airway
Anaethesthetic nurse duties	prepares and check anaesthesia equipement plans and gather stock for types of anaethesia reviews client history for special considerations assistance patient positioning assists anaesthestist with administration of anaesthesia, induction, maintenance, emergency phases accompany client to recovery, give handover to RN, decontaminate and clean used equipment, setup for next case
In theatre - anaesthetic nurse assessment	client is taken to theatre dressed in gown and operating table anaesthetic nurse completes assessment verbal checking -data on assessment sheet, ID band, consent signed, orders checked, allergies, iV inserted, stay with patient
Summary of anaesthetic nurse role	preparation of client duties assessment, diagnosis, planning, intervention, evaluation
Intraoperative phase -scrub/scout	instrument/circulator professional vs technical role unique body of knowledge and skills prepares pt for surgery prepares operating theatre
duties of scout (circulator)	prepare or,conduct pt interview, transport pt, transfer pt, positioning, assisting, prepping, connecting monitoring, counting, documenting, providing items on sterile field, maintain pt operative record, caring of specimens, dressings
Duties of scrub nurse (instrument nurse) PREOP	duties preop -donning, prepare theatre, gathering equipment, maintaining sterile field, scrubbing and donning PPE, organising field, counting, assiting, exposing operative site
Duties of instrument nurse(scrub) INTRAOP	maintain sterile field passing instruments, supplies assessing and predicting the needs of the patient preparing and handling medications counting, caring the specimen, preparing and applying the dressing
The scrub (instrument nurse ) POST OP	maintaining sterile field, disassembling sterile field, removing instruments, equipment, caring for equipment, preparing the theatre for next use
postoperative phase	PARU nurse -cares for the client, prepares the client to transfer to the next level
Recovery unit	PARU nurse will assess client, monitor, check patient, drains, bleeding, skin integrity, other manage PONV and pain
Pain assessment	reassurance, assess, intervene, pain control measures, introduce complementary pain control techniques, discuss perceptions of pain management
PARU nurse duties	- receive handover, assess client, manage PONV, manage pain, manage any other factors (wounds, drains), prepare client for transfer to next level of care
the WHO checklist	safe surgery checklist, identifies three areas before induction (sign in) before incision (sign out) before patient leaves the OR (time out) Surgical team completes all checklists before commencement of surgery

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Perioperative nursing

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	Created by Elizabeth Then over 6 years ago