Chapter 2 The Patient in Surgery

Introduction Patient-centered care Basic physiological aspects Social aspects Psychological aspects When performing an evaluation of a patient, the surgical technologist must obtain data from a number of sources to make a thorough evaluation. Discuss methods to determine the unique needs of a patient. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Introduction Patient-centered care Aeger primo—The patient first Patient is a unique individual Application of critical thinking skills Why did the Association of Surgical Technologists (AST) choose the slogan “Aeger Primo”? What is critical thinking, and why is it important? Give examples from your own clinical experience. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Introduction Patient-centered care (cont.) Direct care Care that is delivered from the health care worker directly to the patient Hands-on; touch involved Requires knowledge of the body Provided by surgeon, nurse, and surgical technologist Defined by state professional practice acts and rules of delegation Surgical technologists participate in direct and nondirect patient care. What are some examples of direct patient care? Nondirect patient care? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Introduction Patient-centered care (cont.) Indirect care—Care that is in support of health care workers’ providing direct patient care Requires preventive and collaborative skills Can be link to direct care Usually does not involve hands-on care May be provided by ancillary departments What are some examples of indirect patient care that the surgical technologist would participate in? How do these activities relate to patient health and safety? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Maslow’s Hierarchy of Needs Who was Maslow? What are the basic human needs according to Maslow? Why are they depicted in a triangle? Is the shape significant? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Maslow’s Hierarchy of Needs Most basic needs must be met before fulfilling other needs Symbolized by triangular hierarchy Physiological (most basic) Security and safety Love Self-esteem Self-actualization Also model for patient care Why do surgical technologists need to study his hierarchy of needs? Is Maslow still relevant in this more modern, technical society? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Maslow’s Hierarchy of Needs Physiologic domains Respiration Nutrition Temperature control Mobility Rest Elimination What are examples of basic physiological needs? How can the surgical technologist assist the patient in meeting them? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Maslow’s Hierarchy of Needs Protection domain Safety and security (fear) Anesthesia Death Pain Disfigurement Helplessness Sharing of private information Relational and personal domains Love and belonging Personal domain Self-acceptance Provide examples of the physical security needs of patients. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Therapeutic Communication Characteristics Goal-directed Unique to each patient Requires active engagement Requires excellent observation and listening skills What is therapeutic communication? Provide examples. Refer to Box 2-2, “Guidelines for Therapeutic Communication,” in the student text. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Therapeutic Communication Therapeutic response Cue giving Clarification Restatement Paraphrasing Reflection Touch What is therapeutic touch? Describe examples of appropriate therapeutic touch. Have students practice therapeutic communication techniques on each other. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Cultural Competence Abilities involved To communicate To interact How can the surgical technologist overcome a language barrier with the patient? Provide examples of alternative communication techniques. Have the class complete a set of directions using only gestures, no verbal communication. Reflect on how successful they were in completing the task. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Spiritual Needs Spirituality Not necessarily religion An understanding of something more profound than humanity Not perceived by the physical senses Awareness of belief in a higher power of entity What are some spiritual needs of patients and how can the surgical technologist assist in meeting them? Give examples of things that have happened to you in your clinical experience that are relevant to spirituality. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The pediatric patient Infant Birth to 18 months Toddler 19 months to 3 years Preschooler 4 to 6 years School-aged 7 to 12 years Adolescent 13 to 16 years What are the developmental stages of infants and children? What can the surgical technologist do, based on the child’s developmental stage, to assist in the child’s care? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The pediatric patient Physiological considerations Developmental stages and surgery Discuss the risks associated with pediatric patients. Discuss the specific needs and possible behaviors of infants, toddlers and preschoolers in the operating room environment. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The elderly patient Risk related to coexisting disease Normal physiological alterations Changes in cardiovascular function Changes in kidney function Skin problems Joint problems Muscular problems Refer to Table 2-2, “Physical Changes that Occur with Age,” in the student text. What are the signs of aging? How can the surgical technologist ensure the aging patient’s safety while in the operating room? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The elderly patient Communication Do not use clichés Do not use diminutives Do not assume impairment Do therapeutic communication techniques differ with the geriatric patient? If so, how? Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The impaired patient Speech Hearing Movement The malnourished patient Lacks necessary nutritional reserve to heal How can the surgical technologist communicate with a sensory-impaired patient? Why is the malnourished patient at high risk? Discuss some of the conditions that can result in malnutrition. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.

Special Patient Population The diabetic patient Vascular and neurological risk Wound healing prolonged Immunosuppressed patient Greater risk for nosocomial infection Trauma patient High risk for many reasons HIV/AIDS patients Multiple barriers to postoperative recovery Review examples of high-risk patients. Elsevier items and derived items © 2010, 2007 by Saunders, an imprint of Elsevier Inc.