Perioperative Nursing Responsibilities

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Perioperative Nursing  is the care of a client or patient before, during and after and operation. It is a specialized nursing area wherein a registered nurse works as a team member of other surgical health care professionals.

Perioperative nursing entails a lot of responsibilities and here are some of them:

Preoperative Phase

Preadmission Testing

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

Admission to Surgical Center or Unit

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

In Holding Area

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

Intraoperative Phase

Maintenance of Safety

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

Physiologic Monitoring

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

Post Operative Phase

Transfer of Patient to Postanesthesia Care Unit

Communicates intraoperative information:

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

Postoperative Assessment Recovery Area

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

Surgical Unit/Ward

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

Home or Clinic

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