Lecture Notes: Perioperative Nursing - Part 1

Mindful Moment

• Begin lecture with mindful breathing exercise
• Sit straight, feet on floor, hands in lap, gaze down
• Guided breathing: inhale (count 4), hold (count 7), exhale (count 8)
• Focus on physical presence and release tension

Overview of Perioperative Nursing

Topics Covered

• Perioperative Overview
  • Classification of surgical procedures
  • Surgical settings: patient vs. ambulatory surgery
  • Factors affecting surgical risk
  • Optimal surgical outcomes
• Upcoming Discussions
  • Part 2 & 3: Pre-operative Nursing
    • Patient interview
    • Nursing assessment
    • Patient education
    • Patient preparation
    • Pre-op medications
  • Part 4: Intraoperative Care
    • Review of prep work
    • Nurse's role
  • Final Parts: Post-operative Nursing Care
    • PACU (Post-Anesthesia Care Unit)
    • Post-op complications and fever
    • Discharge procedures

Important Highlights

• Infographic: Overview of perioperative nursing care
• Common surgical specialties: Ophthalmology, Gynecology, Plastics, Orthopedics
• Increasing demand for surgeries like cataract and joint replacements

Surgical Procedure Suffixes

• Ectomy: Excision/removal (e.g., Appendectomy)
• Otomy: Incision (e.g., Tracheotomy)
• Understanding suffixes aids in patient chart comprehension

Surgical Care Improvement Project (SCIP)

• National quality partnership: WHO, Joint Commission, CMS
• Aim: Reduce surgical complications
• SKIP Initiatives
  • Improve surgical care by reducing complications

Antibiotic Use Guidelines

• INF1: Prophylactic antibiotic within 1 hour prior to incision
• INF2: Selective antibiotic usage based on patient type
• INF3: Discontinue antibiotics within 24 hours post-surgery
• Common antibiotics: Cephalosporin (dosing: q8h times three)

Other Measures

• INF4: Blood glucose control in cardiac patients (high sugar = infection risk)
• INF6: Appropriate hair removal (avoid shaving to reduce skin trauma)
• INF9: Catheter use minimized to prevent UTIs
• INF10: Perioperative temperature management to prevent hypothermia

Cardiac and VTE Measures

• Card2: Maintain beta blocker therapy perioperatively
• VTE1 & VTE2: Venous thromboembolism prophylaxis (TED hose, SCDs, heparin)

Conclusion

• Background on initiatives to improve surgical outcomes
• Introduction to the complications addressed by current practices
• Next steps: Post questions for WebEx discussion and continue to Part 2

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Note: Additional materials and handouts available on Canvas.