Perioperative Nursing and Allied Health Professionals

Operating Environment in Perioperative Nursing

• Definition: Perioperative environment focuses on patient safety during surgical interventions.
• Design Features:
  • Special air filtration systems.
  • Temperature & humidity controls.
  • Restricted zones to minimize contamination.
  • Strict cleaning and safety protocols.

Zone Definitions

• Unrestricted Zone: Street clothes allowed; limited access.
• Semi-Restricted Zone: Authorized personnel in surgical attire only.
• Restricted Zone: Operating and procedural rooms; PPE required.

Nursing Responsibilities in Perioperative Care

• Primary Focus: Identify and manage real/potential patient risks.
• Key Tasks:
  • Maintain surgical standards.
  • Assist in risk management strategies.
  • Conduct patient assessments before and after surgery.

Roles in the Operating Room

• Anaesthetic Nurse:

  • Prepares patient and verifies ID/procedure.
  • Monitors vital signs and assists during anaesthesia.

• Circulating (Scout) Nurse:

  • Manages OR environment and monitors team activities.
  • Initiates Surgical Time Out and ensures sterile conditions.

• Instrument (Scrub) Nurse:

  • Maintains aseptic technique and prepares instruments.
  • Assists the surgeon and performs item counts during surgery.

• Recovery/PACU Nurse:

  • Monitors post-operative patient condition.
  • Manages pain and potential complications post-surgery.

Pharmacological Management in Anaesthesia

• Drug Classes:

  • Opioids: e.g., fentanyl, morphine.
  • Benzodiazepines: e.g., midazolam.
  • Neuromuscular Blockers: e.g., suxamethonium.
  • Antiemetics: e.g., ondansetron.

• Administration:

  • Initial bolus to induce anaesthesia, followed by continuous infusion.

Post-Operative Nursing Care

• Monitoring Protocols:

  • Vitals assessed every 15 mins, then flexibly (up to 4 hours).
  • Assess nausea, pain, mobility, and cognitive function.

• Patient Recovery:

  • Shift focus from physiological care to encouraging self-care post-anesthesia.

Allied Health Roles

• General Roles: Support patient function in clinical settings.
• Examples:
  • Social Workers: Counsel and assist with social well-being.
  • Physiotherapists: Improve mobility and manage physical pain.
  • Occupational Therapists: Enhance independence in daily activities.
  • Speech Pathologists: Address communication and swallowing issues.
  • Dietitians: Manage nutritional needs and dietary assessments.
  • Pharmacists: Ensure safe medication administration and patient education.

Referral Justification in Nursing

• Assessment Before Referring: Nurses must assess patient needs before referrals.
• Collaborative Care: Justify referrals based on collected data and patient condition.
• Examples of Referrals:
  • Refer patients needing physiotherapy post-surgery based on mobility assessments.
  • Monitor and document dietary intake before referring to dietitians for issues.