To assure the safety of patients undergoing an operation the nurse should always have a perioperative care plan. Nursing care plans are a road map of tasks the nurse will perform to provide quality patient care through the surgical procedure. The perioperative phase is defined as the time the patient enters the operating room until the time the patient leaves. The nursing care plan may be divided into three phases: the time before the surgery begins, the time during the surgery and the time after the surgery finishes. Below is a brief description on develop the three phases and what they should include for common and general surgical procedures. Individual surgical procedure requirements may be inserted as needed.
Instructions
1. Be aware that before the operation begins the nursing responsibilities include positioning and securing the patient on the operating table and preparing them for induction of anesthesia. The nursing plan should include emotional care for the patient by explaining what is being done and what they can expect. Emotional care for the patient is an important part of the care plan during this phase. The nurse at this time should assure the patient's identity and operation they will be having. Known as the "time out," it is part of every perioperative nursing plan. Be available to assist the anesthesia provider with the induction phase.
2. Consider that after induction of anesthesia and before the operation begins, the nursing care plan includes preparing the patient for the surgical procedure to be performed. This may include further patient positioning, inserting urinary catheter, applying leg compression devices and attaching a dispersive electrosurgical pad. Utilizing patient warming devices should be part of the plan as well. At this point the plan will include exposing the surgical site and perform surgical skin prep.
3. Know that during the operation, the nursing care plan includes maintaining diligent perception of the progression of the operation, assuring all surgical devices are connected properly and in good working order, delivering appropriate supplies to the surgical field and caring for supplies that are removed from the surgical field. Completion of the perioperative record is performed during this period as well as creating a plan post operative care for the patient.
4. Be aware that during the completion of the operation, the nursing care plan includes performing all surgical counts including sponges, needles and instruments. Disconnect all surgical devices when appropriate. Applying sterile dressing and removing sterile surgical drapes are part of the plan. Perform proper procedures and care for any surgical specimen.
5. Know that after the completion of the operation, the nursing plan includes preparing the patient for transfer to the Post Anesthesia Care Unit (PACU). Maintaining patient comfort with warm blankets are necessary now. The plan will include any support the anesthesia provider may need during the patient's emergence from anesthesia. The nurse plans for a safe transfer of the patient from the operating table to the gurney for transport to the PACU.
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