PROVIDE SAFE PATIENT CARE Knowledge of procedure Ensure the correct patient, correct site, and correct level. Knowledge of positioning Adhere to safe medication administration guidelinesERMTERUEL 2011 Surgical counts
WHO Safe Surgery Checklist JCAHO3 phases1.Sign in2. Time out3.Sign out
PROVIDE A SAFE ENVIRONMENT Adhere to asepsis Promote coordinated and effectiveERMTERUEL 2011 communication
Severity: benign or malignantLocation: location of the disease and the organ requiring surgeryDuration: length of the time the patient has been exposed to the illness dictates the degree of risk involved.
Operative risk is proportional with themagnitude ofthe operation
Based on health status and person’s mental attitude toward surgeryERMTERUEL 2011
a. Age infants and elderly have the lowest tolerance to the stressful effects of surgery.b. Nutritional status a well-nourished pre-op client is better prepared for surgical stress and return to optimal health after surgery. A. Obesity ERMTERUEL 2011 B. Malnutrition
c. Fluid and electrolyte problems fluid volume deficit leads to possible intra and post-op complications.d. Presence of diseases increases the operative risk
To stimulate blood circulation in the extremities to prevent thrombophlebitisLeg exercises To facilitate lung aeration and secretionDeep breathing and mobilization to prevent atelectasis andCoughing hypostatic pneumoniaExercises Done every two to four hours For circulation, stimulate respiration,Positioning and decrease stasis of gasAmbulation
Client has ID band and allergy bracelet Informed consent is signed and witnessed Diagnostic and laboratory test results Client voided Document height and weight Vital signs before exiting the ward
Purpose: allay anxiety produce amnesia reduce n&v dec resp secretions dec vagal nerve stimulations inc pain threshold inc effects of anesthetic agents
Peak effect is desired at thetime of inductionUsually given 45 min before induction
Pre-op Drugs Example PurposeAnti-anxiety Diazepam To decrease nervousness Promote relaxationAnti-cholinergic Atropine Decreases secretions Prevent bradycardiaMuscle relaxant Succinylcholine To promote muscle relaxationAnti-emetic Promethazine To prevent nausea and vomitingAntibiotic Cephalosporin To prevent infection
Pre-op Drugs Example PurposeAnalgesics Meperidine To decrease pain and decrease anesthetic doseAnti-histamine Diphenhydramine To decrease occurrence of allergyH-2 antagonist Cimetidine To decrease gastric fluid and acidity
Send entire medical recordor chart to the Operating roomwith patient
Direct proper waiting room. Doctor informs family immediately after surgery. Explain reason for long interval of waiting. Explain what to expect.
LEGAL document required for certain diagnostic procedures or therapeutic measures including surgery
1. Given voluntarily 2. Given to individual who have the capacity to understand. 3. Given information toERMTERUEL be the ultimate decision maker. 2011
Written consent made by the client. No signs of pressure No Sedation 24 hours before elective surgery emancipated minor Legal age and mentally capable 2 surgeon signed the consent in emergency. Authorized representative-minor, unconscious, psychologically ERMTERUEL 2011 incapacitated.