Perioperative Care Part 1

Pre – Operative Care
Care may vary depending on type of surgery, eg. major or minor and if the surgery is elective or emergency

Reduction of anxiety
Give a warm personal welcome
Introduce yourself, other team members and other patients by name
Explain ward layout and nurse call system
Explain procedures before starting them
Encourage patient to express fears and anxieties
Encourage patient to ask questions
Give appropriate answers
Take time to communicate with significant others

Gain information
Complete admission documents
Record patients weight
Record baseline TPR BP
Note any significant medical history
Possible ECG
Carry out ward based urinalysis
Check for any allergies, clearly record on notes and drug charts

Patient education
Education may help prevent some post – op complications
Giving information may help reduce post operative pain
Teach how pain will be controlled
Teach deep breathing exercises
Teach how to hold the wound to cough
Teach importance of foot and leg movements
Involve MDT as appropriate

Fasting
Nil by mouth for 4 – 6 hours before operation

Patient Identification
Check out of ward – name, address, DOB
Check identity bracelet
Check site of operation is marked if appropriate
Send notes, X rays, blood results etc with patient

Consent
Patient must sign a consent form, consent must be informed

General measures
TED stockings and s/c heparin
Operation site preparation
Ask patient to empty bowels and bladder
Shower and gown
Give pre-medication
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Tape or remove jewellery
Remove nail varnish and make up
Remove prostheses spectacles/contact lenses and hearing aid
Note if dentures are in situ and any loose teeth or crowns, (all late removal)
Ensure any specific preparation is carried out eg. bowel preparation
Optimise the physical condition of the patient, eg good nutrition, lose weight, stop smoking, make sure the patient is not febrile