PREOPERATIVE NURSING CARE – Purpose, Preparation of the Patient before Surgery, Obtain Informed Consent, Preoperative Teaching, Preparation of Patient (evening and day of surgery) and Sending the Patient to Operating Room
UPDATED 2024
Preoperative nursing is based on the nurses understanding of several important characteristics including high quality multidisciplinary teamwork, effective and therapeutic, communication, and collaboration with the client, client’s family and the surgical team.
PURPOSE
- Preoperative nursing care is the care given to the patient before surgery
- Preoperative period for different type surgery is different, e.g. for emergency surgery preoperative period is very short; for a planned surgery time for surgery, is fixed with the mutual consent of the surgeon and the patient
- Preoperative care of the patient begins as soon as the surgeon make with diagnosis and decides that an operation is necessary for the patient
PREPARATION OF THE PATIENT BEFORE SURGERY
Psychological Preparation
The patient may tensed about his surgery because of ignorance, feet, etc. the nurses should give psychological support to the patient.
Discuss with the patient to give feel information about the surgery such as:
- Type of surgery
- Consequence of surgery
- The problems to be faced
- Expected duration of hospitalization
- Expected time of resuming duty
- Cost of surgery
- Treatment done before surgery and if purpose
Eradicate Fear of Operation from the Patient
The means surgery/operation itself make fear to the patient so for reducing that fear the nurses should:
- Allow the patient to ask questions and clear all his doubts
- Introduce the patient to some ones who has similar surgeries and successfully recovered from the symptoms
- Explain how to get rid of pain after surgery
- Tell the patient when he can have meals
- Answer all questions soaked by the patients in a language he can understand
- Let the patient see the persons, places and equipment involved in the operation
- Always short the procedures with an example
- For many patients, their admission to the hospital is an experience in their times. In such situation, the nurses should make them feel at home in by eradicating their fear
OBTAIN INFORMED CONSENT
- The nurses should get an informed consent from patient/guardian for each operation
- Never compel them to give their consent
- They should understand the language used in the consent form
- Explain the complications that may occur in the period of anesthesia
BUILD UP THE GENERAL HEALTH OF THE PATIENT AND CORRECTION OF THE DISEASE PROCESS FOR SPEEDY RECOVERY
- Assist the doctor to carry out thorough physical examination
- Collect all baseline dates
- Arrange for the blood donors
- Diet may be adjusted to correct underweight/overweight of the patient
PREOPERATIVE TEACHING
We should teach the patient to increase his health by giving advices like (a) stop smoking, (b) maintain personal hygiene, (c) deep breathing and coughing exercises: active and passive exercise
Surgical Preparation of the Skin
Skin preparation helps reduce the number of microorganism present on skin and thus reduce the possibility of wound infection. Shave the area and clean the area will spirit/swab
PREPARATION OF THE PATIENT ON THE EVENING BEFORE OPERATION
- Remove all jewelry and hand over them to the relatives
- Remove the lipstick and nail polish
- Shave the area to be operated
- Ask shaving, ask the patient to have a through bath and dress in clean clothes
- The patient should be reassured to prevent anxiety and fear of operation
PREPARATION OF THE PATIENT ON THE DAY OF SURGERY
- Help the patient to go to toilet and for mouth care
- Remove hair pins, clips, ornaments, false teeth, etc
- Comb and tie hair with a ribbon
- Remind the patient and his relative about the fasting before surgery
- Check the orders for bowel preparation
- Clean the operation site with soap and water thoroughly, dry the area with clean towel
- Cover the site with sterile towel and fix it by means of bandages
- Introduce nasogastric tube, urinary catheter if ordered
- Stop all medications unless specifically ordered by the surgeon
SENDING THE PATIENT TO OPERATING ROOM
- Administer the premedication to the patient one hour before surgery
- Check the vital signs
- Write the patients name, age, sex, ward, bed no, diagnosis, hospital number etc., on a identification card and fasten it on to the dress or as on arm to prevent mistaken identify
- Ask the patient on to void just before sending to operating room
- Transfer the patient on to a patient trolley and cover him with clean sheets to prevent draught
- Never leave the patient alone on trolley
- Always send the patients charts with all reports
- Always send the patient with an attended up to the operation theater
