This document describes the three phases of surgical nursing care: preoperative, intraoperative, and postoperative. The preoperative phase involves assessing and preparing the patient before surgery. The intraoperative phase is when the patient is in the operating room undergoing the surgical procedure. The postoperative phase covers recovery after surgery, from admission to the recovery room through discharge and follow up care.

2. - Used to describe the nursing care provided
in the total surgical experience of the patient.

3. o PREOPERATIVE PHASE
o INTRAOPERATIVE PHASE
o POST OPERATIVE PHASE

4. It extends from the time the patient
is admitted in the surgical unit, to
the time he/she is prepared for the
surgical procedure, until he/she is
transported in the operating room.

5.  extends from the time the patient is
admitted to the OR, to the time of
administration of anesthesia,
surgical procedure is done, until
he/she is transported to the
Recovery Room/PACU.

6. Extends from the time the patient is
admitted to the recovery room, to
the time he is transported back into
the surgical unit, discharged from
the hospital, until the follow up
care.

8.  PREOPERATIVE ASSESSMENT
OBTAINING INFORMED CONSENT
PREOPERATIVE TEACHING
PHYSICAL PREPARATION OF PATIENT
PSYCHOLOGICAL PREPARATION OF
PATIENT

9.  PREOPERATIVE
ASSESSMENT

10.  OBTAINING INFORMED
CONSENT

11.  PREOPERATIVE
TEACHING

12.  PREOPERATIVE
TEACHING

13.  PREOPERATIVE
TEACHING

14.  PHYSICAL
PREPARATION

15.  PSYCHOLOGICAL
PREPARATION

16. PREOPERATIVE
CHECKLIST

18.  Verify correct patient against OR call slip and patients ID Band
and by asking patients full name and checking the patients
medical record
 Assist patient on to stretcher ensuring privacy while
transferring from bed
 Raise side rails and secure patient by use of stretcher straps
 Document patient status on transfer from unit to OR
 The nurse who had completed the OR checklist is responsible
to accompany the patient to OR with the OR orderly during
transportation of the patient

20.  All nursing department are responsible for compliance with
this procedure.
 The nurse administering pre-operative medication is
responsible for ensuring that the consent and all other
requirements have been met before the medication is given.
Documentation of pre-medication administration will include
time, date and RN signature.
 The nurse endorsing patient to OR is responsible for final
check of the patient and chart.

23.  Appraise the air exchange status of the patient and note his
skin color
 Note swallowing/gag reflexes, LOC, including patient’s
response to stimuli
 Monitor vital signs
 Determine and evaluate any lines, tubes, or drains, estimated
blood loss, condition of the wound, medications used, infusions
including transfusions, and output.
 Evaluate patients level of comfort and safety by indicators such
as pain and protective reflexes
 Evaluate activity status; movement of extremities.

24.  Position patient in bed as ordered or position of comfort.
 Administer analgesics and document efficacy.
 Encourage patient to take deep breath to aerate lungs fully and
prevent hypostatic pneumonia. Use incentive spirometer as
ordered.
 Re-orient patient once conscious to his/her room, call light, and
therapeutic devices. Place call bell within patients reach.
 Leave all side rails in the up position and put the bed in low
position, ensuring bed wheels are locked.
 Instruct patient not to ambulate without assistance and to use
call bell when assistance is needed.
 Perform on going assessment and interventions.

25.  Review po and administer prescribed medications. Monitor
signs related to nature of surgery.
 Perform safety checks to verify that side rails are in place and
restraints properly applied as indicated.
 Maintain accurate intake output record and replaced fluids as
ordered.
 The cardiovascular, respiratory, skin, gastro intestinal and
genitourinary system must be reassessed every 4 hours for the
first 24 hours post operatively
 If patient’s status is stable after 24 hours, then reassess the
required system each shift and review care plan initiated.

27.  Any deviation from normal should be
documented in the nurses notes.
 Document pain medication
administered and note effectiveness.
 Record V/S, IV fluid, I&O etc. on
appropriate forms
 Document nursing intervention and
patient tolerance or response to
intervention on nurses notes.
 Review care plan each shift and
update as necessary.