Peri Operative Nursing Assignment Paper

Peri Operative Nursing
Peri Operative Nursing

Peri Operative Nursing

Peri Operative Nursing

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15 APA REFERENCES IN TOTAL NOT OLDER THEN 5 YEARS. JOURNALS AND ARTICLES ONLY. ALL RESEARCH SHOULD BE VALID IN AUSTRALIA.

NOTE; MY NURSING SPECIALITY IS PERIOPERATIVE NURSING

AS IN EXAMPLE I AM ATTACHING ANOTHER STUDENTS WORK IN SAME SPECIALITY (PERIOPERATIVE) NURSING.

PLEASE GO THROUGH THE DOCUMENTS ATTACHED FOR ALL THE INFORMATION.
ONE FILES HAS QUESTIONS AND MARKING GUIDE.

SECOND FILE HAS READING AND ACTIVITIES FOR THE ASSESSMENT

THIRD FILES IS NNMBA WHICH TELLS THE LEGALITIES WHICH NEEDS TO BE CONSIDERED WHILE MAKING THE ASSIGNMENT

MAKE SURE TO FOLLOW THE MARKING GUIDE.

SAMPLE ANSWER

Peri Operative Nursing

Task 1- Safety issue

Perioperative refers to the practice of surgical procedure where patients experience surgical intervention. Perioperative nurses are tasked with the responsibility of taking care of the patient before, during and after the surgical intervention (Banschbach, 2016). During this time of surgery intervention and care, many safety issues many arise. According to Ford (2012), many safety issues such as emotional, physiological, and sociocultural safety issues may arise during the pre-operative, intra-operative, and post-operative phases of the surgical intervention because of the negligence of preoperative nurses.

Prior to the surgical procedure, perioperative nurses perform a patient assessment to evaluate the nursing care to be given in the operating room and after the patient returns to the nursing unit, or at home. This involves assessing the social, physical, and emotional needs of a patient. From the information obtained, the perioperative nurse can then predict the suitability of the surgical timing for the patient (Ford, 2012). However, studies have shown that during this assessment period, perioperative nurses are bound to making social mistakes that result in social safety issues. According to Steelman et al. (2013) perioperative nurses, at the interaction level with the patients, may fail to actively engage the patient’s family members who can furnish important information about the patient that can help in assessing the social and physical needs of the patient and consequently help in determining the care to be provided. In addition, Robinson (2016) states that sometimes the amount of and length of teaching recommended to a patient by the perioperative nurses is not sufficient enough to prepare the patient psychologically for the surgery type and procedure, leading to psychological safety issue during the intra-operative procedure where the patient can be more anxious and less cooperative.

According to the Nursing and Midwifery Board of Australia (2010), the information from pre-operative assessment helps in determining the surgery site and procedure for a patient. However, incorrect or insufficient information obtained from or about the patient can result in perioperative nurses recommending wrong site surgery for the patient, thereby resulting in physiological safety issue during the surgical intervention (Ford, 2012). Besides, insufficient or inaccurate information from the pre-operative assessment can result in verification errors, scheduling errors, medication error, and patient time-out errors (from the surgical room and out of hospital) (Steelman & Graling, 2013). Thus, wrong or insufficient pre-operative assessment can be a strong basis for physical, emotional, and social safety issues on the part of the perioperative nurses.

Further, according to the Nursing and Midwifery Board of Australia (2010), the information from the pre-operative assessment can be used in settling professional and legal issues concerning the surgical treatment of the patient as it depicts proof of the medical care provided. According to Steelman & Graling (2013), any documents completed by healthcare practitioners during the pre-operative assessment are legal documents and can be demanded by the court during legal proceedings concerning the health care of a patient. Thus, the pre-operative assessment should be undertaken with utmost care and keenness especially documentations such as pre-scribed medication, health care, and surgical areas.  Ford (2012) adds that pre-operative assessment is part of the professional duty of perioperative nurses to the patients. And as such, accurate assessment and evaluation is a vital part of nursing practice as it forms the basis for efficient and safe care provided to patients.

References

Banschbach, K. S. (2016). Perioperative nurse leaders and their role in patient safety. AORN Journal, 104(2), 161-164

Ford, A. D. (2012). Advocating for perioperative nursing and patient nursing. Perioperative nursing clinics, 7(4), 425-432

Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au

Robinson, L. N. (2016). Promoting patient safety with perioperative hand-off communication. Journal of PeriAnesthesia Nursing, 31(3), 245-253

Steelman, M., V. & Graling, P., R. (2013) Top 10 Patient Safety Issues: What More Can We Do? AORN Journal, 97(6), 679-701. Retrieved from: https://www.aorn.org/websitedata/cearticle/pdf_file/CEA13517-0001.pdf

Steelman, M., V., Graling, P., R., & Perkhounkova, Y. (2013). Priority patient safety issues identified by Perioperative nurses. AORN Journal, 97(4), 402-418

Task 2: Patient confidentiality and ethics in nursing

In their line of duty, perioperative nurses are bound to the duty of confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient is at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals. With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care. The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.

Additionally, in situations where the health condition of the patient deteriorates, health professionals find themselves in a dilemma state with regards to protecting the patient’s privacy whilst addressing the carers’ concerns about the patient’s condition (Price, 2015). For instance, patients that have undergone brain surgery are often mentally and physically unstable because of the nature of the surgery and as such are not in a position to interact with family as well as make important decisions concerning their health information, which could be confidential. At the same time, the patient’s family members might request to know about the health condition of the patient, being unaware and unfamiliar of the hospital procedure and policies and health care code of ethics regarding the application of confidentiality in their context (Ulrich et al., 2010). In this situation, disclosing the patient’s confidential health information to the family members can be a complex task. Thus, the nurse must obtain the patient’s permission about the information that can be shared, to who and under what circumstances to minimise possible misunderstanding with family member(s) as well as evade possible legal implications accompanying such (Olson & Stokes, 2016).

According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014). Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016). For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether. In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).

References

Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au

Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20

Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.

Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68

Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41

Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11).  doi:  10.1111/j.1365-2648.2010.05425.x

Task 3: Reflection

The perioperative period includes various processes and procedures that bring about multiple and challenging changes to a patient (Nursing and Midwifery Board of Australia, 2010). A major surgical intervention is accompanied with multiple stressful components such as worries about survival, length of admission to hospital, one’s physical condition after the surgery, separation from the family, and the financial implication, factors that significantly impact on a patient’s recovery (Gouin and Kiecolt-Glaser, 2012). For example, based on my reading, the patient revealed that during pre-operative phase, he experienced psychological stress and anxiety brought about by the thoughts of fear of death, physical deformity related with the surgical intervention, longer stays in the hospital, longer recovery period, and the cost of the whole surgical procedure and care. He affirmed that the fear, anxiety and stress slowed his recovery (Hudson & Ogden, 2016).

The physical environment of a patient such as lights and sounds can also affect a patient’s recovery (Nelson, et al., 2016). The patient also described the sounds from the equipment and people in the vicinity of the recovery unity as having affected his sleep and sensory, occasionally bringing back the thought of the surgery procedure. This deprived him of emotional peace. Besides, the patient described his confinement to the hospital bed in the recovery unit under the extensive monitoring machines as a painful and scary experience that distressed him (Hudson & Odgen, 2016). According to Gouin and Kiecolt-Glaser (2012), pain and distress during perioperative period can be influenced by emotions triggered by the physical environment factors result in physical changes in a patient, thus slowing his recovery period.

Surgery also results in inability on the patient. During the perioperative period, a patient is unable to engage in certain duties, responsibilities and activities. This leads them to have low self-esteem and feels insecure (Marks, 2015). The patient also described that during his recovery period, he experienced sudden changes in his social and family life as he could not return immediately to his normal life and perform the duties he valued most. This made him loose sense of self-esteem and raise insecurity concern on his part. Besides, having to live with a life-changing diagnosis for the rest of his life was traumatizing and frustrating altogether as it was associated with some form of isolation from friends and family. Nonetheless, he acknowledged the contribution of his carers (immediate family and clinicians) who gave him hope in life (Hudson & Ogden, 2016).

Having read the patient’s experience, I have come to appreciate the need for social and spiritual support for a patient undergoing major surgical intervention. The social support is crucial for enabling the patient understand the aftermath implications of the surgery and consequently prepare him on how to live with it. Spiritual support offers the needed help to a patient to have hope in life again during and after the surgery and treatment procedure (Hudson & Ogden, 2016). Conclusively, I have come to understand the need for perioperative nurses to understand the possible implications of the illness from the patient’s perspective to facilitate their recovery and offer the needed emotional support during their recovery period (Nelson et al., 2016).

References

Gouin, J., & Kiecolt-Glaser, K., J. (2012). The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Immunol Allergy Clin North America, 31(1), 81-93

Hudson, B., F. & Ogden, J. (2016). Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery- A Systematic Review and Meta-Analysis. Journal of PeriAnesthesia Nursing, 31(2), 118-133

Marks, R. (2015). Non-Operative Management of Knee Osteo-arthritis Disability. International Journal of Chronic Diseases & Therapy (IJCDT), 1(2), 9-16

Nelson, G., Altman, A., D., Nick, A., Meyer, A., L., Ramirez, P., T., Achtari, C., Antrobus, J., Huang, M., S., Wijk, L., Acheson, N., Ljungqvist, O., & Dowdy, C., S. (2016). Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery after Surgery (ERAS) Society Recommendations- Part 1. Gynecologic Oncology, 140(2), 313-322

Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au

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