Patient-Centered Variables
Patient-centered variables can negatively impact perioperative care, particularly within the intraoperative and postoperative stages. Lifespan considerations, such as infants and older adults, put clients at increased risk for adverse outcomes, including perioperative hypothermia. Immature thermoregulatory functioning combined with the use of anesthesia are contributing factors for infants developing hypothermia intraoperatively, but recent studies indicate that the use of a forced-air warming system in operating rooms significantly reduces client risk (Witt, Dennhardt, Eich, Mader, Fischer, Brauer & Sumpelmann, 2013). Factors that impair thermoregulation in older adults include declining metabolic rates and decreased muscle mass (Pearson, 2015). Current perioperative nursing implications for maintaining thermoregulation in this high risk
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Clear communication is particularly important when considering perioperative nursing assessments and miscommunication has the potential for adverse client outcomes. Ineffective communication within perioperative care can result in negative outcomes, such as medication errors or wrong site surgery. In order to reduce this risk, the Universal Protocol calls for a time out, which occurs immediately before a procedure and the surgical team reviews information such as identifying the patient, the correct site for surgery and reviewing relevant data such as patient medications and laboratory results (Burke et al., 2016). Nonverbal communication is a critical skill in nursing and can enhance assessments by confirming or contradicting verbal messages from clients (Pearson, 2015). Interpreting nonverbal cues such as posturing, gestures and facial expressions enhances communication between the client and nurse and can be particularly useful in postoperative pain
Inadvertent perioperative hypothermia is a common anesthesia-related complication with reported prevalence ranging from 50% to 90%.(ref 3,4 of 4) The clinical consequences of perioperative hypothermia include tripling the risk of morbid myocardial outcomes and surgical wound infections, increased blood loss and transfusion requirements, and prolonged recovery and hospitalization.(ref 5)
As a post-anesthesia care unit (PACU) Registered Nurse (RN), I care for patients of all races, ages, gender and ethnic backgrounds. However, a majority of the people I care for are of advanced age. Therefore, one must be aware of changes in the body related to aging. The purpose of this discussion is to present a case that addresses the considerations and issues of the perioperative care of an elderly patient.
This essay will discuss the risks for patients during the preoperative, intraoperative and postoperative stages of the perioperative journey and how both patients and healthcare professionals involved in the perioperative stages can work together to prevent perioperative hypothermia.
...1, February). Preprocedure warming maintains normothermia throughout the perioperative period: A quality improvement project. Journal of Perianesthesia Nursing, 26(1), 9-14.
“A healthcare provider’s bedside manner encompasses their medical knowledge, personality, and ability to understand the patient and communicate their concern for them.” (Britt). Although some individuals don’t see the importance of communication and emotional connection with patients in the medical field, doctors who have problems properly interacting with their patients will have a lower chance of success in healing them. Doctors receive so much education but are never taught proper bedside manners, which is the way that physicians interact with patients. In order to ensure a patient’s comfort, psychological well-being, and physical health, a physician must truly understand their patient.
As a Nurse, one can choose which area and field of work they particularly like and would enjoy working in. For example, if someone struggles dealing with babies, children or child abuse cases, it would be strongly suggested to not work in pediatrics. Working in a hospital setting, it is unsure as to what type and class of patients are going to walk in the door. As a nurse, personal values, beliefs, and morals need to be set aside when it comes to patient safety and patient centered care. All patients are treated equal regardless of their socioeconomic status, race, gender, health history or physical limitations.
When I see a patient before they go into an operation, I like to speak to them to make sure they have an understanding of what surgery will be performed and what the process will be in regards to transporting them from the pre-operative area, to the operating room, and then to the recovery area. The environment of the operating room can be a scary place for patients, it is a cold, bright room with lots of equipment in it that patients have probably never seen before. I like to explain to my patients what the room will be like and let them know I will be with them the whole time if they need anything. The main topic is usually the temperature of the room, approximately 65 degrees, so I like to make sure the patients know we will have warm blankets waiting for them. Whether the surgery being performed is diagnostic or therapeutic, I like to be sure the patient has an understanding of what is being done for their health. I am very proud of being a nurse and do my best to be sure my actions prove it. I strive to do the best for my patients since one of the many responsibilities of being a nurse is to be their advocate, which I take very seriously as my patients cannot usually speak for themselves as they are under
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
Communication encompasses a wide range of processes such as the exchange of information, listening, posing of questions (Fleischer et al., 2009) or use of body language. In a healthcare environment where there are constant interactions among nurses, doctors, patients and other health professionals, professional and effective communication is important in ensuring high quality healthcare standards and meeting the individual needs of patients.
Patient-centered care (PCC) is a healthcare model focused on actively involving the patient in all aspects of planning, implementation and monitoring of care. It integrates respect for the patient’s needs, values and beliefs into the health care process. Important aspects of PCC are collaborative care, Family-centered care, and comfort. PCC allows the patient to have autonomy and a more collaborative role in making decisions regarding their treatment.
Augustine Medical, Inc. was founded by Dr. Scott Augustine, an anesthesiologist from Minnesota, in 1987. The company was created to develop and market products for hospital operating rooms and postoperative recovery rooms. The company provides innovative solutions to combat postoperative conditions such as hypothermia. Medical research indicates that 60 to 80 percent of all postoperative recovery room patients are clinically hypothermic. Hypothermia is caused by a patient’s exposure to cold operating room temperatures that are required by surgeons to control infection, and for the personal comfort of the surgeon. Hypothermia can also be a result of heat loss due to evaporation of the fluids used to scrub patients, evaporation from exposed bowel, and breathing of dry anesthetic gases. Dr. Augustine’s personal experience in the operating room convinced him that there was a need for a new system to warming patients after surgery. Dr. Augustine also realized that the market for this new product would be enormous! Statistics indicate that approximately 21 million surgical operations are performed annually in the United States, and that approximately 5,500 hospitals have operating rooms and postoperative recovery rooms that include 31,365 postoperative recovery beds and 28,514 operating rooms. Upon the realization of this need and existence of the market, Dr. Augustine went on to develop The Bair Hugger Patient Warming System then he acquired a patent. The Bair Hugger Patient Warming System consists of a heat source and a separate disposable warming cover that directs a gentle flow of warm air across the body. The Bair Hugger heat source uses a reliable high efficiency blower, a sealed 400W heating element, and a microprocessor based temperature control to create a continuous flow of warm air. The heat source complies with all safety requirements for hospital equipment. Augustine Medical, Inc. was able to find investors that contributed to the initial capitalization of $500,000. These initial funds that were collected were used for staff support, facilities, and marketing. The funds were also used to cover the fixed costs of the company while in its first year. The company subcontracted the production of the heater/blower unit and manufactured the warming covers in-house. The company only par...
In the provision of a high quality care, many factors influence the way it is provided; however, IC is crucial. A healthy work environment would result from open communication among the staff, it would increase the employees and patients’ level of satisfaction and sense of well-being. Good communication is the cornerstone for the IC, it is a complex process which requires to develop some skills to learn how to transmit some information. One of the most common factors leading to medical errors, are due to miscommunication, sometimes because the message is not clearly sent, and others because it is not clearly received or it is misunderstood (Danna, 2015). In terms of communication non-verbal communication must be taken into consideration as well; body language, facial expressions, use of space, and touch, entail conscious or unconscious movements and gestures, also impacts the communication among the staff and
...using words your patient is used to and will understand. Clarify your message with body language, tone of voice, facial expression touch and gestures.
I found the feedback the pharmacist gave me to be most effective in educating me and improving my clinical skills. The pharmacist’s comment about my lack of non-verbal communication was especially relevant. Mehrabian’s (1981) research shows that 55% of meaning is in facial expression, 7% in spoken words and 38% in tone of voice. Therefore, for more effective communication and patient education it is important that my body language is engaging and appropriate to the situation.
These are Verbal, Non-Verbal and Written communication. Verbal communication refers to spoken contact between individuals, Non-Verbal is unspoken communication such as body language and written communication that uses a different pathway such as a letter. The success of verbal communication is dependent on precise, well defined, clear and age appropriate contact (RCN 2015). For example, a paediatric patient’s diagnosis may be approached with a less detailed account of the illness, thus not to confuse the individual or provoke fear. Furthermore non-verbal communication constructs a large percentage of paediatric nursing cases, due to circumstances where verbal communication is not possible. Patient-oriented care is vital for growing an understanding of the individual’s non-verbal signs of pain, which expressed the importance of actively looking for distress signals (Mattsson 2002). Finally written communication acts as the record keeping and documentation element of nursing care, which is a fundamental skill for all medical staff (NMC 2002). Incorrect written communication can lead to individual missing key changes in a patient’s condition thus leading to a potential fall in a patient’s health (Inan and Dinc