Pre-op/ day surgery unit Flashcards
role of pre-admission nurses in DSU
Collaboration between doctors, nurses and patients to evaluate patients’ healthcare needs, ensuring they are ready for their procedures.
Responsibilities of pre-admission nurses - FEVAS
- First point of contact for patients preparing for DOS
- Ensure pt are fully informed about their procedure and have completed informed consent forms
- Verify pt are prepared and it is safe to proceed with surgery
- Assess pt readiness for surgery and confirm they have followed necessary preparations.
- Substantiate relevant data regarding pt readiness for surgery
Communicate essential information to surgical team
Pt 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
Overview of assessments: surgical patients
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
Perioperative refers to the period of time encompassing preparation for an anaesthetic, surgery or other procedure and recovery from these interventions.
Pre-operative assessment and preparation
Pre-operative phase begins when the pt decides to have surgery and ends when they enter the perioperative environment
- Aim = ensure pt is in optimal health prior to surgical procedure
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-medication and prophylactic antibiotics (if applicable)
- Skin preparation/ hair removal
- Removal of make-up, nail varnish, jewellery, personal clothing, prosthesis
- Prescence of dentures, loose or capped teeth is documented
- Identification bracelet with correct details
- Allergies identified and documented
- Notes, x-rays, blood results, ECG are collated
Consent form is signed with correct procedure and the patient can explain in their own words the procedure
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
- Verbal
- Written
Elements required to obtain a valid consent
- Must have capacity
- Given freely
- Sufficiently specific to the procedure or treatment proposed
- Informed
when is written consent required?
- All operations (excluding minor procedures
- All procedures requiring general, spinal, epidural or regional anaesthesia or intravenous sedation.
- Any invasive procedure or treatment where there are known significant risks.
- Blood transfusions or the administration of blood products.
how long is consent valid for?
Consent is valid until it is withdrawn by the pt or until the pt circumstances change.
- Obtained by the MO or the practitioner who performs the procedure.
