Preoperative and Perioperative Nursing, Essay Example

Introduction

Patient care in the preoperative and perioperative settings reflects a need to develop nursing-based strategies that will impact outcomes in a positive manner. It is important to determine some of the factors that impact outcomes and demonstrate a need to address the different perspectives to facilitate high quality care and treatment at these stages. Nurses must be proactive in their efforts to produce at high levels and to optimize the conditions under which they are able to provide care at a consistently high level. Nurses must be able to contribute and optimize their performance in order to effectively administer care and treatment to all patients facing surgery. These efforts must demonstrate a means of expanding knowledge to improve quality for all patients. The preoperative and postoperative care settings require a level of dedication and commitment to ensure that there are sufficient means of treating patients with the best possible resources that are available. However, many questions may be raised regarding the role of these issues and how they impact patients at a high level and in order to determine what is required to improve quality of care for all patients on a continuous basis. The following discussion will address these issues in greater detail and will emphasize preoperative and postoperative patient care more closely in order to determine the best possible approach that will have a lasting impact on outcomes and recovery for patients who require surgery.

Body

For patients who require treatment in the form of surgery, it is important to identify the tools and resources that are necessary to have a lasting impact on their wellbeing. As a result, issues such as safety indicators and other tools must be considered as part of a larger framework to provide high quality care and treatment for patients on a consistent basis, and this reflects a commitment by nurses to improve patient outcomes and overall performance (Emond et.al, 2015). These indicators are designed to determine how safety must be approached in the preoperative care environment and to determine what steps are required to facilitate effective patient safety at all times (Emond et.al, 2015). With these tools in place, it is possible for organizations to be proactive in their efforts to move forward and to create a practice environment where patients must be protected from unnecessary risk or harm at all costs, and this requires the input of nurses and other practitioners to ensure that patients are treated in an equal fashion and with the tools that are required to improve their ability to recover at a high level after surgery (Emond et.al, 2015).

The process of preoperative assessment requires an examination of new tools and resources that are available to be effective in meeting the needs of the patient population and in advancing the quality of care that is administered. This reflects a need to be proactive in working towards a set of solutions that will have a positive impact on quality of care at the preoperative stage, including the design of a decision support tool to impact patient outcomes in an effective manner to provide effective diagnostic assessments that will have a positive impact on patients over time (Flamm et.al, 2013). To be specific, “Preoperative assessment is performed to keep the risk for intra- and postoperative adverse events to a minimum. Therefore, according to international guidelines and advisories, testing should be structured, selective, and based on medical history, physical examination, and type of surgery” (Flamm et.al, 2013). As a result, it is necessary to administer any types of tests that will improve the likelihood of success once surgery has taken place and the next phase of treatment begins, thereby increasing the potential for success for these patients in order to improve their recovery (Flamm et.al, 2013). Therefore, any diagnostic assessments at the preoperative level must be appropriate and timely in order to provide evidence prior to surgery to ensure that a patient will be positively impacted by the surgical experience and that recovery will occur as expected without any complications (Flamm et.al, 2013). These analyses reflect a greater need to impact patient care and to demonstrate a need to improve outcomes through any assessment tools that are identified as useful at this stage.

With the assistance of the American College of Surgeons and the National Surgical Quality Improvement Program (NSQIP), potential predictors of patient mortality may be identified at the bedside (Vaid, Bell, Grim, & Ahuja, 2012). The program is based upon the following parameters: “The NSQIP mortality predictor (NMP) is calculated from 35 variables related to the patient’s physiologic status, demographic data, medical history, laboratory values, and American Society of Anesthesiologist (ASA) scores” (Vaid et.al, 2012). This requires an evaluation of each patient individually and a means of determining the level of mortality-related risk of each patient that may impact surgical decision-making as necessary (Vaid et.al, 2012). In this capacity, it is likely that decisions regarding surgery and monitoring will be made in accordance with these statistics in order to promote effective outcomes for patients. Furthermore, it will demonstrate a means of expanding knowledge and resources in order to effectively promote a culture of patient safety to protect patients from additional risk at the time of surgery. This also requires individual patients to be proactive in working towards a series of opportunities to improve patient care quality and to present a means of expanding the knowledge in the preoperative setting to improve data collection and the discovery of strategies to improve patient care quality that will preserve patient health as best as possible. With the use of the NSQIP, it is possible for physicians and nurses to evaluate the level of risk of each patient and to be proactive in making decisions regarding the need and timeliness of surgical procedures for different patients, particularly if they possess a high risk of mortality if surgery is the only viable option (Vaid et.al, 2012).

One of the most critical issues for consideration in this capacity is quality of life, which is perceived as a critical characteristic of the preoperative and perioperative states. Most importantly, patients must be placed into situations where their quality of life is preserved as best as possible at both stages, and this is best achieved through the work that is performed by healthcare teams in order to effectively promote positive outcomes for patients. Health-related quality of life (HRQoL) is an important and meaningful parameter that is likely to improve the lives of patients who require surgery and for those who have had surgery because it demonstrates the ability of patients to bounce back from surgery and to experience quality of life at the highest possible level (Maillard, Elia, Haller, Delhumeau, & Walder, 2015). In the postoperative state, for example, many patients are likely to experience some degree of inflammation and pain that will have an impact on their overall quality of life at this stage; therefore, these concerns must be addressed further, coupling with fatigue and other tools that will have a lasting impact on patient care outcomes (Maillard et.al, 2015). However, quality of life is also frequently disrupted at the preoperative state because patients who require surgery may experience high levels of anxiety and stress that impact their physical and psychological wellbeing at this stage (Maillard et.al, 2015). As a result, it is important to evaluate the conditions under which patients are able to recover and to optimize these circumstances in order to effectively promote positive results for patients who require surgery and who are able to manage their stress and anxiety in an effective manner (Maillard et.al, 2015). HRQoL is essentially contingent upon the ability of patients to manage an emerging surgical diagnosis without significant stress and to determine what steps are required to facilitate effective results that will improve a patient’s ability to prepare for surgery and to manage postoperative concerns as best as possible under the care of healthcare professionals (Maillard et.al, 2015).

Patient safety must serve as a critical priority in the development of new perspectives for care and treatment in the operating theatre, and this is best accomplished through the appropriate level of attention that is paid to patient care needs and quality. To expand on this premise, healthcare outcomes are largely contingent upon patient care needs and the overall ability of nurses and other healthcare workers to exercise protocols to promote patient safety at a consistently high level (Sevdalis, Hull, & Birnbach, 2012). There are a number of valid concerns regarding patient safety indicators and how they are implemented within healthcare organizations, and this reflects a need to further evaluate conditions to improve the lives of patients using these tools (Sevdalis et.al, 2012). One area of consideration to improve patient safety is the implementation of a checklist protocol, which may be beneficial but which may also contribute to negative outcomes if not managed effectively: “A checklist is not more than a technical solution: if used properly, it ensures that certain things will be reviewed at certain times. If the underlying problem, however, involves poor attitudes and lack of a culture of safety then it is doubtful that any checklist will make a positive impact on safety” (Sevdalis et.al, 2012). In this context, patient safety may be compromised even further with the use of a checklist if it is not surrounded by a culture where safety is considered to be a critical priority and a focus of the healthcare system (Sevdalis et.al, 2012). It is necessary to demonstrate a means of expanding knowledge and resources within the healthcare community that will impact the lives of patients and reflect a need to improve how patient safety is addressed in order to effectively promote a culture of caring and where safety is of the utmost importance in order to promote greater quality of life for patients who require surgery. The nursing environment, for example, must be fully aligned with the tools and resources that are available to improve outcomes and to optimize patient care conditions that will have a lasting impact quality of life.

From a perioperative perspective, it is important to demonstrate a means of expanding knowledge and resources to impact a patient’s entire state of recovery from start to finish. This is best accomplished through a combination of factors that will have a positive impact on outcomes, such as the perioperative surgical home, which is defined as follows: “The PSH is a patient-centered approach to the surgical patient, with a strong emphasis on standardization, coordination and transitions, and value of care, throughout the perioperative continuum, including the post discharge phase” (Vetter, Boudreaux, Jones, Hunter, & Pittet, 2014, p. 1131). In this capacity, it is important to identify the different tools and resources that are required to meet expectations and to optimize treatment standards for patients that will positively impact patient care and treatment (Vetter et.al, 2014). There must be a significant focus on patient care quality and the overall creation of opportunities to improve patient care outcomes at a high level. When the patient is the primary focus of all treatment-based decisions, there is likely to be a greater emphasis on improving quality and in working with a collaborative model in order to achieve successful outcomes. In addition, this model supports a greater understanding of how healthcare workers respond to change and in determining what is required to meet expectations to improve quality of care.

Although it appears that the patient should always serve as the focus of care, this is not always the case, thereby creating an environment in which financial priorities and other needs get in the way of high quality care with the patient in mind. As a result, it is necessary for organizations to refocus their priorities and to optimize conditions for patients so that they are able to make a difference in their lives. This also encourages the continued growth and development of the practice plan as a means of promoting the PSH as a primary means of making the patient the critical priority and in advancing the knowledge and resources that are available to impact patient outcomes at the highest possible level. These tools will enable healthcare workers to collaborate and to openly communicate regarding the needs of patients in order to positively impact outcomes and to optimize the utilization of resources that are available in this capacity. When the patient is the primary focus, it is possible for an organization to be more effective in moving forward to improve quality of life and to address surgical needs in order to promote a successful recovery and a continued focus on greater health and wellbeing for this patient population.

Conclusion

The development of new perspectives to impact patient care in the preoperative and perioperative settings requires nurses to be proactive in working towards solutions that will have mutually beneficial outcomes for patients. This requires an examination of the key principles that will have a lasting impact on patient care for the foreseeable future. Primary concerns for patients who require surgery include the need for comprehensive approaches to patient care that will have a lasting impact on outcomes and overall quality of life for these patients. All healthcare staff members who work in the perioperative or preoperative settings must be prepared to utilize diagnostic tools and resources appropriately in order to have a lasting impact on patients who require surgery. This will also impact how patients are observed and managed at the surgical level through the work that is performed by nurses and other staff members in this regard. The ability to promote patient safety through a positive work environment must provide additional resources to accommodate patients and to be proactive in working towards a successful framework to improve patient care quality. The ability to recover from surgery is contingent upon these factors and requires all healthcare workers to perform to the best of their ability under the circumstances that are available.

References

Emond, Y. E., Stienen, J. J., Wollersheim, H. C., Bloo, G. J., Damen, J., Westert, G. P., … & Wolff, A. P. (2015). Development and measurement of perioperative patient safety indicators. British journal of anaesthesia, aeu561.

Flamm, M., Fritsch, G., Hysek, M., Klausner, S., Entacher, K., Panisch, S., & Soennichsen, A. C. (2013). Quality improvement in preoperative assessment by implementation of an electronic decision support tool. Journal of the American Medical Informatics  Association, 20(e1), e91-e96.

Maillard, J., Elia, N., Haller, C. S., Delhumeau, C., & Walder, B. (2015). Preoperative and early postoperative quality of life after major surgery-a prospective observational study. Health and quality of life outcomes, 13(1), 12.

Sevdalis, N., Hull, L., & Birnbach, D. J. (2012). Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress. British journal of anaesthesia, 109(suppl 1), i3-i16.

Vaid, S., Bell, T., Grim, R., & Ahuja, V. (2012). Predicting risk of death in general surgery patients on the basis of preoperative variables using American College of Surgeons National Surgical Quality Improvement Program data. The Permanente journal, 16(4), 10.

Vetter, T. R., Boudreaux, A. M., Jones, K. A., Hunter Jr, J. M., & Pittet, J. F. (2014). The perioperative surgical home: how anesthesiology can collaboratively achieve and leverage the triple aim in health care.Anesthesia & Analgesia, 118(5), 1131-1136.