Chapter 1 (Part 4) Flashcards
Patient’s autonomous decision about whether to go surgical procedure.
Informed consent
Legal mandate
Informed consent
Purpose of Informed consent
- To protect the patient from unsanctioned/unauthorized surgery
- To protect surgeon from claims of an unauthorized operation or battery
- It helps to ensure that the patient understands the surgery to be performed
- To indicate that the patient’s decision was made without pressure.
Informed consent is necessary in the following
- Invasive procedure such as surgical incision
- Procedures requiring sedation or anesthesia
- Non-surgical procedures such as arteriography that carries more than a slight risk to the patient
- Procedures involving radiation
- Radiologic procedures, particularly if contrast dye is required
- Blood product administration
A valid informed consent includes:
- Voluntary (at least 18 yrs. old)
- Patient who is incompetent
- Informed subject
- Patient is able to comprehend
Individual who is not autonomous and cannot give or with-hold consent
Patient who is incompetent
Consent should be in writing; contains explanation of procedures, risk, description of benefits and alternatives
Informed subject
Goals:
1. Assessing and correcting physiologic and
psychologic problems as it may increase
surgical risk
2. Provide health teaching
3. Instruct & demonstrate exercises that will
benefit the patient during post op period
4. Planning for discharge & any projected
changes in lifestyle due to surgery
Preoperative phases (assessing to transferring)
PRE-ADMISSION TESTING
Initiate initial preoperative assessment
Initiate education appropriate to
patient’s needs
Involves family in interview
Verifies completion of preoperative
diagnostic testing
Verifies understanding of surgeon
specific orders
Discusses and reviews advance directive
documents
Begins discharge planning by assessing
patient need for post operative
transportation and care
Initiate initial preoperative assessment
Pre-admission testing
Initiate education appropriate to patients needs
Pre admission testing
Involves in family interview
Pre-admission testing
Verifies completion of preoperative diagnostic testing
Pre-admission testing
Verifies understanding of surgeon specific order
Pre-admission testing
Discusses and reviews advance directive documents
Pre-admission testing
Begins discharge planning by assessing patient need for post operative transportation and care
Pre-admission testing
ADMISSION TO SURGICAL CENTER
Complete preoperation assessment
Assess for risk of post-op complication
Report unexpected findings or any deviation from normal
Verifies that operative consent has been
signed
Coordinates patient education and POC,
with nursing staff, & other health team
member
Reinforces previous education
Answers patient’s & family questions
Complete pre-operation assessment
ADMISSION TO SURGICAL CENTER
Assess for risk of post-op complication
ADMISSION TO SURGICAL CENTER
Report unexpected findings or any deviation from normal
ADMISSION TO SURGICAL CENTER
Verifies that operative consent has been signed
ADMISSION TO SURGICAL CENTER
Coordinates patient education and POC with nursing staff, & other health team member
ADMISSION TO SURGICAL CENTER
Reinforces previous education
ADMISSION TO SURGICAL CENTER
Answers patient and family questions
ADMISSION TO SURGICAL CENTER
IN THE HOLDING AREA
Identifies patient using 2 identifiers
Assess patient’s status, baseline pain,
and nutritional status
Reviews medical records
Verify surgical site that has been
marked per institutional policy
Establish IV line
Administer medication if prescribed
Takes measures to ensures patient’s
comfort
Provides psychological support
Communicate patient’s emotional status
to the other appropriate members of
Health Care Team
Identifies patient using 2 identifiers
IN THE HOLDING AREA
Assess patients status, baseline pain, and nutritional status
IN THE HOLDING AREA
Reviews medical records
IN THE HOLDING AREA
Verify surgical site that has been marked per institutional policy
IN THE HOLDING AREA
Establish IV line
IN THE HOLDING AREA
Administer medication if prescribed
IN THE HOLDING AREA
Takes measures to ensures patient’s comfort
IN THE HOLDING AREA
Provides psychological support
IN THE HOLDING AREA
Communicate patient emotional status to the other appropriate member of the health care team
IN THE HOLDING AREA
PREOPERATIVE ASSESSMENT
- The goal is for the patient to be healthy
as possible - Presence of pain
- Nutritional & fluid & electrolyte balance
- Dentition
- Drug or alcohol use
- Cardiovascular function (X-ray, ECG)
- Pulmonary Function (X-ray, pulmonary
function test, Intensive Spirometry) - Renal & Hepatic unction (Creatinine,
BUN) - Endocrine Function (check for hormonal
imbalance) - Neurologic Function (prevent delirium)
- Hematologic Function (CBC)
- Use of medication
- Presence of trauma &infection
- Psychosocial factors
- Spiritual & cultural beliefs
The goal is for the patient to be healthy
as possible
PREOPERATIVE ASSESSMENT
Presence of pain
PREOPERATIVE ASSESSMENT
Nutritional & fluid & electrolyte balance
PREOPERATIVE ASSESSMENT
Dentition
PREOPERATIVE ASSESSMENT
Drug or alcohol use
PREOPERATIVE ASSESSMENT
Cardiovascular function (X-ray, ECG)
PREOPERATIVE ASSESSMENT
Pulmonary Function (X-ray, pulmonary
function test, Intensive Spirometry
PREOPERATIVE ASSESSMENT
Renal & Hepatic unction (Creatinine,
BUN)
PREOPERATIVE ASSESSMENT
Endocrine Function (check for hormonal
imbalance)
PREOPERATIVE ASSESSMENT
Neurologic Function (prevent delirium)
PREOPERATIVE ASSESSMENT
Hematologic Function (CBC)
PREOPERATIVE ASSESSMENT
Use of medication
PREOPERATIVE ASSESSMENT
Presence of trauma &infection
PREOPERATIVE ASSESSMENT
Psychosocial factors
PREOPERATIVE ASSESSMENT
Spiritual & cultural beliefs
PREOPERATIVE ASSESSMENT
