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Journal of Clinical Nursing Apr 2017The aims of this integrative literature review are to define the role of a preoperative nurse and to describe the main components and hypothetical outcomes of a... (Review)
Review
AIMS AND OBJECTIVES
The aims of this integrative literature review are to define the role of a preoperative nurse and to describe the main components and hypothetical outcomes of a preoperative nursing care structure before a surgical patient arrives to an elective procedure.
BACKGROUND
The development of medical care has impacted surgical processes, and patients are now spending less time in hospital settings. Patients often enter the hospital on the day of a procedure and are discharged as soon as it is medically safe, creating challenges for nursing care. Preoperative clinics have been opened, and the importance of preoperative nursing care has been widely understood. Previous literature has provided descriptions about the roles, tasks and outcomes of preoperative nurses; however, the terminology is heterogeneous, and the optimal model remains unknown.
DESIGN
A systematic procedure for searching, selecting, and evaluating the literature was followed. The data were collected from PubMed and CINAHL between 1 January 2004 and 20 September 2014. In total, 41 articles were included in the study and were analysed by qualitative inductive content analysis.
RESULTS
The data provided seven main tasks of a preoperative nurse, tools to support preoperative nursing and outcomes of structured preoperative nursing care.
CONCLUSION
A preoperative nurse is a specialised coordinator of patient care, and the main purposes of this role are to meet the patient's and the family's needs individually and to prepare them for the scheduled procedure and postoperative recovery. By following the structure of the seven main tasks and using different supportive tools, preoperative nursing can positively impact patient and provider satisfaction, patient safety, quality of care and cost savings.
RELEVANCE TO CLINICAL PRACTICE
A preoperative nursing care structure should be implemented in clinical practice and then evaluated to measure whether the hypothetical outcomes reported in this literature review can be achieved.
Topics: Clinical Competence; Humans; Patient Care; Practice Patterns, Nurses'; Preoperative Care
PubMed: 27325370
DOI: 10.1111/jocn.13448 -
Anesthesiology Clinics Dec 2018The article reviews frequently encountered preoperative concerns with a goal of minimizing complications during administration of pediatric anesthesia. It is written... (Review)
Review
The article reviews frequently encountered preoperative concerns with a goal of minimizing complications during administration of pediatric anesthesia. It is written with general anesthesiologists in mind and provides a helpful overview of concerns for pediatric patient preparation for routine and nonemergent procedures or interventions. It covers unique topics for the pediatric population, including gestational age, respiratory and cardiovascular concerns, fasting guidelines, and management of preoperative anxiety, as well as the current hot topic of the potential neurotoxic effects of anesthetics on the developing brain.
Topics: Anesthesia; Anxiety; Child; Child, Preschool; Health Status; Humans; Infant; Infant, Newborn; Pediatrics; Preoperative Care
PubMed: 30390788
DOI: 10.1016/j.anclin.2018.07.016 -
Anesthesiology Clinics Sep 2015The elderly preoperative patient benefits from an assessment that includes more than a routine physical examination and electrocardiogram. Such an assessment includes... (Review)
Review
The elderly preoperative patient benefits from an assessment that includes more than a routine physical examination and electrocardiogram. Such an assessment includes domains likely to affect the elderly: cognition, functionality, frailty, polypharmacy, nutrition, and social support. This fosters decisions based on functional age rather than chronologic age and on each patient as an individual. One such assessment is that promulgated by the American College of Surgeons National Surgery Quality Improvement Program/American Geriatrics Society Best Practice Guidelines. We should not miss any opportunity to improve results in this growing population of surgical patients.
Topics: Aged; Aged, 80 and over; Geriatrics; Humans; Perioperative Care; Preoperative Care; Surgeons
PubMed: 26315633
DOI: 10.1016/j.anclin.2015.05.012 -
Anesthesia and Analgesia Mar 2022In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and...
In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care. The medical and anesthesia evaluation before surgery has pivoted from the model of "clearance" to the model of risk assessment, preparation, and optimization of medical and psychosocial risk factors. Assessment of these risk factors, optimization, and care coordination in the preoperative period has expanded the roles of anesthesiologists and hospitalists as members of the perioperative care team. There is ongoing debate regarding which model of preoperative assessment provides the most optimal preparation for the patient undergoing surgery. This article hopes to shed light on this debate with the data and perspectives on these care models.
Topics: Anesthesiologists; Hospital Administration; Hospitalists; Humans; Perioperative Care; Preoperative Care; Risk Assessment; Surgical Procedures, Operative
PubMed: 35180163
DOI: 10.1213/ANE.0000000000005877 -
British Journal of Hospital Medicine May 1978With a subject as vast as preoperative care its is impossible in an article of this length to do more than sketch in the broad outlines of assessment and preparation,...
With a subject as vast as preoperative care its is impossible in an article of this length to do more than sketch in the broad outlines of assessment and preparation, using a few examples to illustrate certain aspects. Unfortunately the pressure of work in most hospitals is such that the standard of preoperative care is not as high as it might be. Many authors have stressed its values not only in making anaesthesia safer but especially in reducing the incidence of postoperative morbidity--a field that has received too little attention for too long.
Topics: Anemia; Anesthesia, General; Cardiovascular Diseases; Diabetes Mellitus; Drug Incompatibility; Food Deprivation; Humans; Hyperthyroidism; Medical History Taking; Physical Examination; Preanesthetic Medication; Preoperative Care; Respiratory Tract Diseases
PubMed: 656681
DOI: No ID Found -
Anesthesiology Clinics Jun 2018To successfully deliver greater perioperative value-based care and to effectively contribute to sustained and meaningful perioperative population health management, the... (Review)
Review
To successfully deliver greater perioperative value-based care and to effectively contribute to sustained and meaningful perioperative population health management, the scope of existing preoperative management and its associated services and care provider skills must be expanded. New models of preoperative management are needed, which rely extensively on continuously evolving evidence-based best practice, as well as telemedicine and telehealth, including mobile technologies and connectivity. Along with conventional comorbidity optimization, prehabilitation can effectively promote enhanced postoperative recovery. This article focuses on the opportunities and mechanisms for delivering value-based, comprehensive preoperative assessment and global optimization of the surgical patient.
Topics: Comorbidity; Humans; Perioperative Care; Preoperative Care; Quality of Health Care; Risk Assessment
PubMed: 29759287
DOI: 10.1016/j.anclin.2018.01.006 -
Best Practice & Research. Clinical... Jun 2020Preoperative laboratory testing is often necessary and can be invaluable for diagnosis, assessment, and treatment. However, performing routine laboratory tests for... (Review)
Review
Preoperative laboratory testing is often necessary and can be invaluable for diagnosis, assessment, and treatment. However, performing routine laboratory tests for patients who are considered otherwise healthy is not usually beneficial and is costly. It is estimated that $18 billion (U.S.) is spent annually on preoperative testing, although how much is wasteful remains unknown. Ideally, a targeted and comprehensive patient history and physical exam should largely determine whether preprocedure laboratory studies should be obtained. Healthcare providers, primarily anesthesiologists, should remain cost-conscious when ordering specific laboratory or imaging tests prior to surgery based on available literature. We review the overall evidence and key points from the Choosing Wisely guidelines, the identification of potential wasteful practices, possible harms of testing, and key clinical findings associated with preoperative laboratory testing.
Topics: Cross-Sectional Studies; Diagnostic Tests, Routine; Humans; Practice Guidelines as Topic; Preoperative Care; Retrospective Studies; Societies, Medical
PubMed: 32711836
DOI: 10.1016/j.bpa.2020.04.006 -
Journal of Clinical Nursing Jul 2017To explore the issues and challenges of care transitions in the preoperative environment.
AIMS AND OBJECTIVES
To explore the issues and challenges of care transitions in the preoperative environment.
BACKGROUND
Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there.
DESIGN
Qualitative descriptive design was used.
METHODS
Semistructured interviews were conducted in a 975-bed academic medical centre.
RESULTS
A total of 30 providers and 10 preoperative patients participated. Themes that arose were as follows: (1) need for clarity of purpose of preoperative care, (2) care coordination, (3) interprofessional boundaries of care and (4) inadequate time and resources.
CONCLUSION
Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence postoperative patient outcomes.
RELEVANCE TO CLINICAL PRACTICE
Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes.
Topics: Academic Medical Centers; Adult; Female; Humans; Patient Care Team; Perioperative Care; Preoperative Care; Qualitative Research; Quality of Health Care; Time Factors; Transitional Care
PubMed: 27706872
DOI: 10.1111/jocn.13610 -
AANA Journal Apr 2015This article discusses the importance of individualizing the preoperative anesthesia assessment. Establishing trust between the interviewer and patient results in a...
This article discusses the importance of individualizing the preoperative anesthesia assessment. Establishing trust between the interviewer and patient results in a positive, calming effect from preoperative period through to PACU. An interviewing technique can eas- ily be developed to alleviate anxiety and still make patients aware of risks and potential outcomes.
Topics: Anesthesia; Anesthesia, General; Anxiety; Humans; Nurse Anesthetists; Patient-Centered Care; Practice Guidelines as Topic; Preoperative Care; Professional-Patient Relations; Risk Factors
PubMed: 26016164
DOI: No ID Found -
Polski Przeglad Chirurgiczny Dec 2015
Review
Topics: Humans; Practice Guidelines as Topic; Preoperative Care; Risk Assessment
PubMed: 26963061
DOI: 10.1515/pjs-2016-0018