DSU/ pre-admission Flashcards
Role of pre-admission/ DSU nurses
Manage the admissions process for all types of surgeries.
- handle pt assessment and preparations on day of surgery
- collaborate with doctors to evaluate pt needs, ensuring they are ready for procedure
Responsibilities of DSU nurse (FEVASC)
- First point of contact for pt preparing for DOS
- Ensure pt are fully informed about procedure and consent form signed
- Verify pt prepared and safe to proceed
_ Assess pt readiness for surgery, and confirm they followed correct preparations. - Substantiate relevant data regarding readiness for surg
- communicate essential information to team
Surgical journey process
admission to DSU, transfer to anaesthetic bay, transfer to OR, transfer from OR to PACU, once d/c criteria met, transfer back to DSU/ward.
Aim of preoperative assessment (MPPD)
- Maximise procedure specific interventions
- Patient education
- Patient focused preparation
- Discharge planning
What is a pre-operative assessment
Comprehensive evaluation of a pt physical, psychological and social health prior to surgery.
- Aim to identify and mitigate potential risks, optimise pt preparation, and ensure safe and effective surgical outcomes.
Components of pre-operative assessment (MLDAAAPSC)
- Medical hx and physical examination
- Laboratory tests
- Diagnostic imaging
- Anaesthetic assessment
- Assessment of co-morbidities
- Assessment of nutritional status
- Psychosocial assessment
- Skin integrity assessment
- Consent and patient education
Perioperative definition
Refers to the period of time encompassing preparation for an anaesthetic, surgery or other procedure and recovery from these interventions.
Laboratory tests
- FBC
- Biochemical profile - BGL, urea and creatinine and LFT
- Coagulation profile
- Blood group cross and match
ASA Physical Status Classification - a tool to evaluate pt risk for anaesthesia
- ASA1 - Normal healthy patient
- ASA2 - Mild systemic disease
- ASA3 - Severe systemic disease
- ASA4 - Severe systemic disease that is a constant threat to life
- ASA5 - Moribund pt who is not expected to survive w/o operation
- ASA6 - Declared brain dead, and organs are being removed for donor purposes is not applicable in these circumstances of classification
pre-op Checklist (BTPSRPIAN)
- Baseline obs
- time of last food and drink
- pre-med and prophylactic antibioitics
- Skin prep and removal of hair
- removal of jewellery, make up, nail varnish, personal items
- presence and documentation of loose teeth, dentures, capped teeth.
- Identification bracelet checked and insitu
- Allergies identified and documented
- Notes of ECG, bloods, X-ray collated
- Consent form signed and pt can tell you what procedure having
What is informed consent
A person’s decision, given voluntarily to agree to a healthcare treatment, procedure or other intervention that is made.
Types of consent
- Implied
- written
- verbal
Elements required to obtain valid consent
- given freely
- have capacity
- informed
- be specific to procedure
When is written consent required?
- All operations
- All procedures requiring GA, regional, spinal, epidural or IV sedation
- Invasive procedures posing significant risk to health
- Blood transfusions or transfusion of blood-like products
How long is consent valid for?
Until pt situation changes or it is withdrawn.
- completed by MO who is performing procedure.
