Perioperative Nursing Responsibilities

Preoperative Phase

Preadmission Testing

1. Initiates initial preoperative assessment.
2. Initiates teaching appropriate to patients to patients needs.
3. Verifies completion of preoperative testing.
4. Verifies understanding of surgeon-specific preoperative orders (e.g. bowel preparation, preoperative shower)
5. Assess patient’s need for postoperative transportation and care.

Admission to Surgical Center or Unit

1. Completes preoperative assessment.
2. Assess for risk for postoperative complications.
3. Reports unexpected findings or any deviation from normal.
4. Verifies that operative consent has been signed.
5. Reinforce previous teaching.
6. Explain phase in perioperative period and expectation.
7. Develop a plan of care.

In Holding Area

1. Assess patient’s status, baseline pain and nutritional status.
2. Review chart.
3. Identifies patient.
4. Verifies surgical site and marks site per institutional policy.
5. Establishes intravenous line.
6. Administers medication if prescribed.
7. Takes measures to ensure patient’s comfort.
8. Provides psychological support.
9. Communicates patient’s emotional status to other appropriate members of the health care team.

Intraoperative Phase

Maintenance of Safety

1. Maintains aseptic, controlled environment.
2. Effectively manages human resources, equipment, and supplies for individualized patient care.
3. Transfer patient to operating room bed or table.
4. Position the patient: function alignment, exposure of surgical site.
5. Applies grounding device to patient.
6. Ensure that the sponge, needle, and instrument counts are correct.
7. Completes intraoperative documentation.

Physiologic Monitoring

1. Calculates effect on patient of excessive fluid loss or gain.
2. Distinguishes normal from abnormal cardiopulmonary data.
3. Reports changes in patient’s vital signs.

Post Operative Phase

Transfer of Patient to Postanesthesia Care Unit

Communicates intraoperative information:

1. Identifies patient by name.
2. States type of surgery performed.
3. Identifies type of anesthetic used.
4. Reports patient’s response to surgical procedure and anesthesia.
5. Describes intraoperative factors (e.g., insertion of drains or catheters, administration of blood, analgesic agents, or other medications during surgery, occurrence of unexpected events.
6. Describes physical limitation.
7. Reports patient’s preoperative level of consciousness.

Postoperative Assessment Recovery Area

1. Determines patient’s immediate response to surgical intervention.
2. Monitor patient’s physiologic status.
3. Assess patient’s pain level and administers appropriate pain relief measures.
4. Maintains patient’s safety(airway, circulation, prevention of injury)
5. Administer medication, fluid and blood component therapy, if prescribed.
6. Assess patient’s readiness for transfer to inhospital unit or for discharge home based on institutional policy.

Surgical Unit/Ward

1. Continues monitoring of patient’s physical and psychological response to surgical intervention.
2. Provides teaching to patient during immediate recovery period.
3. Assist patient in recovery and preparation for discharge home.
4. Determines patient’s psychological status.
5. Assist with discharge planning.

Home or Clinic

1. Provides follow-up care during office or clinic visit or by telephone contact.
2. Reinforce previous teaching and answer patients and family questions about surgery and follow-up care.
3. Assess patient’s response to surgery and anesthesia and their effects on body image and function.

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