Manual of Perioperative Care (eBook)

An Essential Guide

Kate Woodhead, Lesley Fudge (Autoren)

eBook Download: PDF

2012
John Wiley & Sons (Verlag)
978-1-118-30219-4 (ISBN)

Infos

Manual of Perioperative Care is a comprehensive manual of principles of care designed to support the clinical practice of perioperative practitioners, whether they are nurses or operating department practitioners. This book meets the needs of those studying perioperative practice as well as those who would like an up-to-date comprehensive reference on their bookshelf. It covers the fundamentals of perioperative practice, placing them within the wider context of modern surgical care.

With a practical, accessible focus, aided by full colour illustrations, this book follows the journey that the patient makes through their surgical care, with sections on:

• The foundation for safe and effective perioperative care
• Infection prevention and control
• Patient safety and managing risks
• Different patient care groups
• Approaches to surgery

This book is essential reading for all students on perioperative courses, as well as newly qualified perioperative nurses and operating department practitioners.

Kate Woodhead runs a Healthcare Consultancy business specialising in the perioperative field. She is a former President of the International Federation of Perioperative Nurses (2002-2006), and between 1998-2001 served as National Association of Theatre Nurses, Chairman.

Lesley Fudge is an Independent Consultant and past National Secretary of AfPP (formerly NATN) and is the Vice Chairman of the Latex Allergy Support Group. She was also a co-founder and past CEO of Friends of African Nursing and served as Treasurer of the International Federation of Perioperative Nurses.

Inhalt

Manual of Perioperative Care: An Essential Guide 5
Contents 7
About the Editors 10
Contributors 11
Foreword 1 Jane H. Reid 17
Foreword 2 Professor Lord Ara Darzi 19
Section 1 Foundation for Safe Perioperative Care 21
1 The Context of Perioperative Care 23
What is Perioperative Practice? 23
Where Does it Take Place? 24
The Patient’s Perspective – Consent and Competence 24
Evidence-Based Practice and Clinical Effectiveness 26
2 Preoperative Assessment 31
Patient Preparation for Anaesthetic and Surgery 31
Definition of Patient Preparation 31
Aims and Objectives of Patient Preparation 32
Inter-professional Teamwork 32
Enhanced Recovery 33
Collating the Patient Information 33
History Taking 35
Observations 36
Examination 37
Investigations 38
Medication and Allergies 38
Education 38
Discharge Planning 39
Determining the Outcome from Patient Preparation 39
Anaesthetic Consultation/Referral 39
Recording the Findings 40
External Factors Required at Time of Patient Preparation 40
Legal Issues Related to Patient Preparation 41
Summary 41
3 Communication 43
Introduction 43
Consent 43
Confidentiality 47
Documentation 48
Communication 49
Teamwork and Communication in Practice 50
4 The Perioperative Environment 53
Division of the Operating Theatre Environment 53
Core Functions of Each Area 55
Building Notes – Areas to Consider 56
Patient Flow 58
Waste 59
Section 2 Infection Prevention in Perioperative Care 61
5 Infection Prevention 63
Control of Substances Hazardous to Health 63
Risk Assessment in the Perioperative Environment 63
Standard Precautions 64
Ventilation 65
Staff Movement within the Perioperative Environment 66
Cleaning and Ventilation for ‘Dirty’ or Infected Cases 66
Cleaning Routines 66
Aseptic Technique 67
Theatre Attire 67
The Area of Sterility (the Sterile Field) 68
Setting the Instrument Trolley 68
Sharps Safety 68
Patient Preparation 70
6 Introduction to Decontamination and Sterilisation 76
What is Decontamination and Sterilisation 76
The Need for Decontamination and Sterilisation 77
A Brief History of Decontamination and Sterilisation 77
The Legislative Framework 78
Locations for Decontamination and Sterilisation 79
Decontamination/Sterilisation Methods 81
Inspection 83
Packaging Types 84
Sterilisation Methods 85
Transport and Distribution 85
Storage 87
New Instruments and Manufacturers Reprocessing Instructions 87
Prion Disease and vCJD 87
Tracking and Traceability 88
Should I Use the Instrument? 88
7 Wound Healing and Surgical Site Infection 90
Introduction 90
Principles of Wound Healing 90
Types of Wound Closure 93
Wound Infection 95
Definition of Surgical Site Infection 97
Surgical Site Infection Surveillance Schemes 99
Saving Lives Care Bundle to Reduce Surgical Site Infection 100
Summary 101
Section 3 Patient Safety and Managing Risks in Perioperative Care 103
8 Preoperative Care 105
Models of Surgical Care 105
Day-Case and Short-Stay Facilities 105
Inpatient Surgery and Day of Admission 107
Classification of Surgery Urgency and Implications for Care 107
Admission to the Ward or Department 109
Preoperative Care Assessment 109
Preparing for Discharge 110
Contemporary Modalities in Preoperative Care 110
Improved Patient Information and Expectation 111
Understating the Causes of and Management of Preoperative Anxiety 111
Optimisation of Clinical Condition Prior to Surgery 113
Medication Management Prior to Surgery 113
Modern Fasting and Nutritional Management Prior to Surgery 113
Fluid and Electrolyte Management Prior to Surgery in the Elective and Emergency Patient 115
Safe Transfer to the Theatre Environment 115
World Health Organization Surgical Checklist 118
Conclusion 118
9 Anaesthetic Care 121
Principles 121
Staffing 122
Environment 125
Equipment 125
Techniques 130
10 Medicines Management 137
Introduction 137
The Law Governing Medicines 137
Professional Practice and Medicines 138
Medicines Storage 140
Controlled Drugs 140
Pharmacology 141
Considerations when Administering Medicines 142
Medicines Administration 142
Sources of Information on Medicines 145
Conclusion 145
11 Fluid Replacement and Blood Transfusion 147
Crystalloid and Colloid Fluid 147
Assessment of Volume Status 147
Methods of Administration and Warming 149
Special Considerations 149
Blood Transfusion 150
Reasons and Criteria for Transfusion 152
Blood Product Checking and Administration 152
Jehovah’s Witnesses 152
Techniques to Reduce Need for Transfusion 152
12 Intraoperative Care 155
Patient Safety 155
Teamwork 155
Communication 156
Care and Dignity 157
Role of the Circulating Practitioner 157
Role of the Scrub Practitioner 158
Developing Role of Advanced Scrub Practitioner 159
Developing Role of Surgical Care Practitioner 159
13 Safer Moving and Handling and Patient Positioning 161
Key Principles of Moving and Handling 161
Risk Assessment of Patients in Relation to the Surgical Position 163
Key Surgical Positions 164
Complications Arising from Poor Patient Positioning and How to Minimise the Risks 166
Using Equipment and Weight Limits 168
When Something Goes Wrong with Patient Positioning 169
14 Pressure Area Care and Tissue Viability 171
Introduction 171
Definition of a Pressure Ulcer 171
Prevalence and Incidence 172
Pressure Ulcer Classification 172
Risk Assessment Tools 173
Risk Factors 173
Conclusion 174
15 Thermoregulation 177
Temperature Regulation 177
Hypothermia 178
16 Venous Thrombosis Prophylaxis 183
Background to Venous Thromboembolism 183
How does a Deep Vein Thrombosis Develop? 184
Risk Factors 184
How to Assess a Patient’s Risk of Venous Thromboembolism 185
Methods of Thromboprophylaxis 186
Mechanical Thromboprophylaxis 186
Pharmacological Thromboprophylaxis 188
Signs and Symptoms of Deep Vein Thrombosis 188
Summary 189
17 Care of Surgical Instruments 191
Introduction 191
Surgical Instrument Procurement 191
Training 192
Inclusion in Surgical Counts 193
Safety Aspects to be Considered 193
Accountability 195
Handling of Surgical Instruments 195
The Neutral Zone 195
Tracking and Tracing 195
18 Swab and Instrument Count 197
Aim of the Swab and Instrument Count 198
Roles and Responsibilities 198
Key Principles 199
The Swab Count – Checking Procedure 200
The Instrument Count – Checking Procedure 201
Managing a Discrepancy 202
Documentation 202
19 Care of Specimens 204
Introduction 204
Types and Testing of Specimens 205
Types of biopsy 205
Specimen Collection 205
Documentation of Specimens 207
Transport of Specimens 208
20 Managing High-Risk Equipment 210
Introduction 210
Responsible Authorities 210
Training 211
Incident Reporting 211
Accountability 212
Diathermy or Electrosurgery 212
Other Technologies 216
Surgical Tourniquets 219
21 Medical Imaging and Radiation 223
Chapter Overview 223
General Principles of Ionising Radiation 223
General Principles of Non-Ionising Radiation 230
22 Death in the Perioperative Environment 233
Definition of Death 233
The Role of the Coroner 234
Organ Donation 234
Death of a Child 236
Patient Care: Last Offices 236
23 Postoperative Care 239
The Clinical Environment 239
Equipment at the Bedside 240
Staff Training and Competence 241
Staffing and Skill Mix 241
Daily Equipment Checking 242
Patient Transfer from Theatre to PACU/Handover of Patient 242
Risk Assessment of Patient in Planning Care 243
Airway: the First Priority 244
Breathing: the Second Priority 248
Circulation: the Third Priority 251
Delayed Emergence 255
Postoperative Nausea and Vomiting 255
Discharge Criteria 256
Transfer to an Acute Setting 257
24 Pain Management 259
Introduction 259
Physiology of Acute Pain 261
Pain Assessment 262
The Biopsychosocial Model of Pain 264
Pharmacology 264
Perioperative Analgesic Medicines 264
Methods of Analgesia Delivery 268
Pain in Special Circumstances 269
Summary 269
Section 4 Different Patient Care Groups 273
25 Neonatal Surgery 275
Blood loss/Haemostasis and Fluid Requirements 276
Airway Management 277
Temperature Regulation 278
Instrumentation 278
Neonatal Emergencies 278
Conclusion 281
26 Paediatric Surgery 283
Consent 283
Children with Chronic Conditions 284
Gastrointestinal Endoscopy in the Paediatric Patient 285
Paediatric Emergencies 285
Advances in Paediatric Surgery 287
Conclusion 289
27 Care of the Adolescent in Surgery 291
Communication with Young People 292
28 Care of the Elderly Patient 299
Preoperative Assessment 301
The Cardiovascular System 301
The Respiratory System 302
Endocrine System 302
Inadvertent Hypothermia 302
Skeletal Considerations 303
Delivering the Appropriate Standard of Care for the Elderly in the Operating Theatre 303
29 Bariatric Surgery 305
Background 305
Bariatric Surgery Criteria 305
Surgical Treatment for Obesity 306
Anaesthetic Classification 307
Risks Associated with Obesity 307
Communication 308
Anaesthetic Management 308
Drug Pharmacokinetics 309
Anaesthetic Considerations for Laparoscopic Patients 310
Theatre Care Pathway – Risk Assessment 310
Surgical Intervention 310
Conclusion 311
30 Perioperative Care of the Pregnant Woman 313
Anatomical and Physiological Changes 313
Common Surgeries 315
Surgical Risks 316
Conclusions 317
Section 5 Different Approaches to Surgery 319
31 Key Principles of Laparoscopic Surgery 321
Preparing the Environment 321
Medical Imaging 322
Video/Imaging Systems 324
Laparoscopic Instrumentation 324
Care and Handling 325
Instrument Handles 325
Ports 325
Initiating and Maintaining the Pneumoperitoneum 326
Conclusion 327
32 Key Principles of Endoscopic Surgery 328
What does the Endoscopy Department Do? 328
What is an Endoscopy? 328
Why is Endoscopy Performed? 328
Who Refers Patients and Why? 328
Where is Endoscopy Performed and by Whom? 329
Day-case, Inpatient and Emergency Procedures 329
The Endoscope 329
Preparation of the Endoscopy Room 332
Setting up the Procedure Room 332
Supplementary Equipment 332
Medication 334
Resuscitation 334
Photography 335
Care of Patient 335
Assistants 337
Recovery and Discharge 337
Maintenance, Cleaning and Decontamination of Endoscopes 337
Complications 338
Index 340

Rezensionen

20.11.12 Review copy sent to Nursing Standard

Produkt-Details

• Erscheint lt. Verlag: 20.7.2012
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Pflege ► Fachpflege ► Chirurgie / OP-Pflege / Orthopädie
• Schlagworte: Book • Care • Chirurgie u. chirurgische Spezialgebiete • Clinical Specialities • Comprehensive • Department • Discipline • Diversity • Excellent • federation • Foreword • Industry • international • Jane • Krankenpflege • Manual • Medical • Medical Science • Medizin • nurses • nursing • perioperative • Practitioners • President • Principles • Reference • resource • Seeking • Spezialaufgaben i. d. klinischen Krankenpflege • Surgery & Surgical Specialities
• ISBN-10: 1-118-30219-2 / 1118302192
• ISBN-13: 978-1-118-30219-4 / 9781118302194