Positioning patients is probably one of the most basic concepts that nurses must understand and incorporate into daily practice. It requires special attention, especially if patients are unable to move themselves. The purpose of this paper is to provide guidance to RN’s for positioning patients undergoing invasive procedures by describing one recommended guideline, benefits of this guideline and ways a nurse can implement this guideline into the professional nursing practice.
Guideline
The Guideline for Positioning the Patient has been approved by the AORN Guidelines Advisory Board. The guidelines can apply to any setting and are adaptable to any area where operative procedures may be performed. Of the twenty-two guidelines, the second is
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(Burlingame, 2017) Because of these limitations, the nurses care plan development prevents positioning-related injuries. There are four basic positions commonly used: supine, prone, lateral, and lithotomy. (Van Wicklin, 2017) When an RN places a patient in one of these positions, factors such as skin, musculoskeletal, and nerve injury are taken into account. The position depends on the type of procedure, though lack of patient assessment coupled with anesthesia may cause compression of tissues that can lead to reduced blood flow and skin breakdown. (Burlingame, 2017) Thorough patient assessment not only ensures the patient is correctly positioned and protected from injury, but also informs the nurse on the patient’s circulatory, respiratory, integumentary, musculoskeletal, and neurological complications that can occur. (Spruce, …show more content…
There are many factors perioperative RNs have to consider and several strategies that ensure success in their efforts to protect their patients. Education and competency verification is one way perioperative RNs can receive new information on any new positioning equipment or procedures. (Spruce, 2014) When positioning the patient, the perioperative RN not only should take measures to prevent positioning injury but also document all actions taken with regard to positioning and assess the patient for any signs of injury postoperatively. Another strategy is working collaboratively with other healthcare professional. This informs the RN on what type of procedure is scheduled, how long it will last, and what type of anesthesia will be administered. This information will ultimately help the perioperative RN determine which equipment is best suited and recognize patients at high risk. According to Spruce, “as an advocate for the patient, the perioperative RN should question any chosen position if he or she believes it may compromise the patient’s safety.” (2014)
The patient and family should be placed in a private room that is dimly lit and has minimal noise. There should be enough room to accommodate other family members as well. All unnecessary medical equipment such as ventilators and monitors should be removed from the patient. IV access should remain in place to give adequate medication for pain. Supplemental
and giving medicine and IVs. A RN makes sure the patient has knowledge of their situation and
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Depending on the time of surgery, the nurse may admit and discharge the same patient within the timeframe of his or her shift. The nurse obtains a history and physical (H&P) along with the progress notes from the operating surgeon or another licensed personnel written within the last twenty-four hours. The nurse sets the patient up with a peripheral intravenous line before surgery. He or she will interview the patient regarding the last time they ate and/or drank, what medications they take, and when the last medication dose was taken. The nurse also assesses the patient to see if he or she understands the procedure they are there for and asks if they have any questions or concerns. Depending on the health of the patient and what surgical procedure they will be subjected to, either a focused or full health assessment is performed. The nurse also makes sure that all labs pertinent to the patient have been obtained. These labs include a negative pregnancy test (or proof of a negative test within the last seven days) for any patient that could possibly be pregnant, even if the patient is currently menstruating, a finger-stick blood sugar test for all diabetic patients, a blood test for potassium levels for patients with end stage renal disease, and a prothrombin time or international normalized ratio test for patients on Coumadin. The nurse also makes sure that
It is very important that a patient is comfortable with and can trust the nurse anesthetists before going under anesthesia. On the micro level, nurse anesthetists interact with patients and their families every day. There are face to face discussions every day so it is important that the nurse anesthetist is outgoing and easy to talk to so that the patient is not uncomfortable before going into surgery (Nurse Anesthetists). Some important symbols that Nurse Anesthetists hold are comfort, health, and trust. If a patient is not comfortable with the nurse they see immediately before going into surgery, it could make for an increased heart rate, an increase in blood pressure, and other health complications. That is why it is very important that nurse anesthetists come in with a positive attitude. They symbolize health because they are the ones who monitor the patient, before, during, and after surgery so they have to know what is normal and abnormal for the patient. Trust is also an important symbol in the nursing anesthesia profession because a patient has to be able to trust they are certified and prepared to complete all of their duties. If a patient does not trust the nurse, then this could lead to complications, and even a procedure being postponed in order to find another nurse anesthetist that the patient is more comfortable with. Many words or phrases involved
“Technological advancements in anesthesia practice: Role of decision support system.” Anesthesia: Essays and Researches. January 8, 2014. Web. October 23, 2015. There have been many advancements in technology in the anesthesia field. A recent major advancement has been the decision support system (DSS). The decision support system acts similar to a second human central nervous system, and receives as well as relays information to and from the patient and the anesthesia information management system (AIMS). The DSS helps to maintain the data coming into and out of the patient during a medical procedure. The DSS also provides help during a medical crisis, giving the physicians a solution if an intra-operation (during the operation) crisis happens. The DSS can also design various scenarios for pre, intra, and post operation scenarios for the anesthesiologist to prepare for based on that patient’s medical history, information, and
...ing education courses and renew certification. When they are considered competent enough to deliver anesthesia, they must also be able to deal effectively with the daily changes and challenges that a hospital environment can create. They must also be able to “stomach” many types of sense triggers. Although they are one of the top paid nursing practices, they have to endure stress throughout their whole career, starting with the educational aspects.
With all of the different specialties in healthcare, some get overlooked or may be under the radar. An uncommon and often disregarded career choice in healthcare is that of a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice. Although not many people know about these healthcare careers, they play a vital role within the healthcare team. This field is growing rapidly and the likelihood of coming into contact with a nurse anesthetist during a hospital stay is on the rise. Knowing the history, education, responsibilities, and career outlook for a Certified Registered Nurse Anesthetist or a Doctorate of Nurse Anesthesia Practice can aide in understanding their very specific role in the care of patients.
As a medical / surgical RN, I provided care for the elderly, the infirm, the mentally challenged, the young, and the psychologically disturbed. The wide variety of patients exposed me to the effects of life style choices, health care choices, and the resulting impacts to the patient as well as to the family of the patient. This experience has fully matured my view of the awesome responsibility that we, as health care professionals, have been charged with, and it has furthered my desire to obtain the skills necessary to provide more advanced care for my patients. In addition to exposure, maturity and experience, my career as a medical / surgical RN has also sharpened my critical thinking abilities and provided insight on observing signs and symptoms that a patient may be unware of. Furthermore, as a charge nurse I learned the importance of collaborating with other health care professionals in order to provide the highest level of care available. In summary, my career as an RN has provided valuable experience, maturity, exposure to impact and outcome, enhanced my critical thinking abilities, and improved my collaboration
Westhead, C. (2007). Perioperative Nursing Management of the Elderly Patient. Canadian Operating Room Nursing Journal, 25(3), 34-41. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/274594603?accountid=13380.
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).