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Post Operative Nursing

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Post Operative Nursing
A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional post-operative literature, with a critical thinking approach. This will allow me to arrive at best practice decisions and actions supported by a critical review of available literature. Mrs Hilton’s nursing plan following her open cholecystectomy will be individualised for her needs as each patient’s situation presents a unique set of clinical factors.

Mantras that has become ingrained from my nurse training are ‘assessment, assessment, assessment’ and ‘if it is not written it is not done’. In a post-surgical setting, assessment is also pre-emptive and communication and documentation is imperative. Assessment must extend beyond the vital signs to include a focus on pain, skin colour (for cyanosis/shock), respiratory rate (including depth and nature), skin temperature (for hypo/hyperthermia), pulse (rate volume and rhythm), conscious levels (presence of reflexes – swallowing/cough/tears) and signs of haemorrhage or infection (wounds/drains) (Starrit, 1999). Although most hospitals have checklists to help with assessment of the patient post surgery, I am responsible for thinking beyond this checklist to provide Mrs Hilton with quality care. Whilst Mrs Hilton’s surgery was uneventful, her age and medical history of symptomatic



References: Al-Benna, S. (2011). Periopertive management of morbid obesity. Journal of Perioperative Practrice, 21(7), 225-33. Arozullah, A.M., Khuri, S.F., Henderson, W.G., and Daley, J. (2001). Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery. Annals of Internal Medicine, 135, 847–857. Brown, Di., Edwards, H., Lewis, S.L., McLean Heitkemper, M., Ruff Dirksen, S., O’Brien, P.G., Bucher, L. (2008). Lewis’ Medical and Surgical Nursing: Assessment and Management of Clinical Problems. Sydney, NSW: Elsevier Australia. Bucknall, T., Manias, E., and Botti, M. (2001). International Journal of Nursing Practice, Acute pain management: Implications of scientific evidence for nursing practice in postoperative context, (7), 266-273. Crisp, J. and Taylor, P. (2009). Potter & Perry’s Fundamentals of Nursing. Care of Surgical Patients. Sydney, NSW: Mosby Elsevier. Duff, B., Gardiner, G. (2007). The impact of surgical ward nurses practising respiratory assessment on positive patient outcomes. Australian Journal of Advanced Nursing, 24(4). Graham, D., Faggionato, E., and Timberlake, A. (2011). Preventing Perioperative Complications in the Patient with a High Body Mass Index. Association of Perioperative Registered Nurses Journal, 94(4), 334-347. Hamlin, L., Richardson-Tench, M., and Davies, M. (2009). Perioperative nursing: an introductory text. Sydney, NSW: Mosby Elsevier, Australia. Scottish Intercollegiate Guidelines Network (SIGN). (2004). Postoperative management in adults: A practical guide to postoperative care for clinical staff, p. 1-14.Retrieved from www.sign.ac.uk/pdf/sign77.pdf Sharma, L Smetana, G.W. (2009). Postoperative pulmonary complications: An update on risk assessment and reduction. Cleveland Clinic Journal of Medicine, 76(4), S60-S65. doi: 10.3949/ccjm.76.s4.10 Starritt, T

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