Presentation on theme: "Preoperative Patient Care ST210 Concorde Career College, Portland."— Presentation transcript:
Preoperative Patient Care ST210 Concorde Career College, Portland
Preoperative Patient Care Objectives: Identify reasons for surgical intervention List and describe the elements of the preoperative patient care routine and state the rationale that relates to each element State the purpose of proper patient identification and describe the identification process in the surgical setting
Preoperative Patient Care Objectives: List the type of information that must be contained in the patient’s chart and describe the importance of each item Define the term informed consent, list the contents of the consent form, and describe guidelines that apply to obtaining informed consent Review basic handwashing and perform skills assessment
4 There are many indications as to why thousands of people in the United States, as well as the world undergo surgery every year. Surgery and the way it is conducted today, takes an aim at faster recovery through the advancement of technology. Though this is true, surgery is only considered as a last resort when all conservative investigative measures or treatment of any disease process have failed. The goal of surgery is to assist the body with the healing process, either by removing something, repairing a defective structure within the body, or by cleaning out a wound.
5 Prophylactic (preventive) – To prevent the occurrence of a disease or illness. Restorative (curative) – To regain patient’s health and strength. Palliative – To relieve or alleviate symptoms, without curing the underlying cause or disease. Diagnostic – To investigate and identify the cause or nature of a condition, illness, or disease. Goals of Surgical Intervention
8 Diagnosis – Direct visualization may be needed, within a body cavity, orifice, or joint (endoscopy). Pathological specimens may need to be taken either by endoscopy or an open incision. An example would be Exploratory Laparotomy (an opening into the abdomen to determine the cause of a problem not evident by other methods.)
9 Trauma – Also defined as injury, trauma can be caused by burns or accidents. Procedures may include repair of broken bones, removal of foreign bodies, debridement of burns, or reimplantation of limbs.
10 Metabolic Diseases – Removal of tissues or organs which are malfunctioning, are often a good indication for surgery. Some examples are splenectomy for thrombocytopenia, or a thyroid gland that is over producing.
11 Infection – Some infections, such as appendicitis, cholecystitis, or abscesses that do not respond to conventional therapy may require surgery.
12 Congenital Defects – Birth defects that require or are helped by surgery call for such procedures as herniorrhaphy, cleft lip repair, or a condition known as talipes equinovarus just to name a few.
13 Neoplasms – Surgical procedures may be performed for both benign and malignant neoplasms. Cancer may be treated by irradiation, chemotherapy, or en-bloc (as a whole) resection.
14 Obstruction – Tubes, vessels, ducts, or intestines can become obstructed by stones, growths, blood clots, twisting (volvulus), or intussusception (telescoping in on itself).
15 Reconstruction – Body parts may be reassembled to make them more functional or attractive. Degenerative disease of a joint may be corrected by arthroplasty, or breasts may be enlarged by augmentation mammoplasty.
Preoperative Case Management Prepare the OR Assemble necessary supplies Don PPE Prepare and maintain the sterile field Scrub, gown, and glove Organize supplies and equipment Count Drape
Intraoperative Case Management Maintain the sterile field Anticipate Pass instruments, supplies as needed Prepare and handle medications Specimen care Dressings
Postoperative Case Management Maintain sterile field until patient is transported Transport used instruments and equipment to decontamination area Prepare OR for next patient Dispose of sharps
Five Steps to Critical Thinking Identifying the goal or problem Gathering and evaluating information Use A POSitive CARE Approach Generating one or more responses Implementing the best response Assessing the results
A POSitive CARE Approach CARE Caring attitude Application Role Environmental concern A POSitive Anatomy Pathology Operative procedure Specific variations
Preoperative Patient Care Routine Patient Preparation Psychological - usually occurs prior to admission to the health care facility Physiological - usually begins upon admission to the health care facility
Preoperative Patient Care Routine Routine Procedures Diagnosis - often occurs prior to admission to the healthcare facility for surgical intervention Signs/symptoms H&P Diagnostic tests
Preoperative Patient Care Routine If surgery is necessary… Informed consent must be obtained Patient is admitted for surgery (if not already admitted) and ID band is applied Patient information is obtained and chart assembled Patient changes to hospital attire and belongings are cared for
Preoperative Patient Care Routine If surgery is necessary (continued)… Patient is placed in a bed or on a gurney Patient’s vital signs are obtained Preoperative education occurs Physician’s orders are carried out (e.g., enema, shave) Patient is transported to the OR and transferred to the operating table
How to Control Hypothermia Warmed blankets Warming blankets (water circulating) Forced-air Blankets
Basic Handwash NOT the same as the surgical scrub Handwash lasts 30-60 seconds Used MANY times per day to: Mechanically remove transient bacteria Chemically reduce and prevent growth of resident bacteria