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  • General


    • INTRODUCTION


      Welcome to AN3163 Fluids and Electrolyte Balance and Perioperative!

      This subject aims to provide a general introduction to the basic topics in Fluid and electrolyte and Perioperative.

      Fluid and electrolyte are a key concept to understand for maintaining homeostasis, and for successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. Understanding the basics of these complex concepts is vital to your success in caring for complex patients.

      The perioperative period begins when the patients is informed of the need of surgery, includes the surgical procedure and recovery, continues with discharge, and ends when the patient achieves his or her optimal level of postsurgical function. The perioperative nursing provides essential knowledge of pre-, intra-, and post-operative practices through the continuum of care for surgical patients. The nurse helps to plan, implement, and evaluate treatment of the surgical patient and may work closely with the patient, family members, and other health care professionals.

      In this course guide, I will share the course learning outcomes, the overview of the plan of the course and the assessments. I will also share the expectations of being a student in this course. It is our intent to make this learning experience both convenient and fun while achieving the intended outcomes.

◄Topic 6 : Post-Operative Management and Nursing Care Using The Nursing Process [Part 2]Topic 8 : Care of Client With Fluids And Electrolytes Imbalance►

Topic 7 : Perioperative Procedures

  • Topic 7 : Perioperative Procedures

    INTRODUCTION

    The process of scrubbing, gowning, and gloving is one that all members of the surgical team must complete before each operation.

    In the surgical scrub, the hands and forearms are decontaminated. A sterile surgical gown and pair of gloves are subsequently donned, creating an aseptic environment.

    ‘Scrubbing in’ dramatically reduces the risk of infection and significantly improves patient outcomes. As such, it is a skill that should be taken seriously and always performed to the highest standard.

    Sterile procedures are required before and during specific patient care activities to maintain an area free from microorganisms and to prevent infection. Performing a surgical hand scrub, applying sterile gloves, and preparing a sterile field are ways to prevent and minimize infection during surgeries or invasive procedure.

    LEARNING OUTCOME

    At the end of the lecture, the students will be able to:

    • Demonstrate the ability to reflect upon nursing practice for awareness and improvement.
    • Identify the importance of each procedures that would lead to SSI Surgical Site infection.
    • The purpose of carrying out surgical hand washing donning sterile gown and glove.

    • LEARNING RESOURCES

      THE IMPORTANCE OF DONNING STERILE GOWN AND GLOVES

      The surgical team should wear a sterile gown and gloves to reduce the risk of SSIs. Aseptic practices, including scrubbing, gloving, barrier clothing, drapes, and instrument sterilization, are pivotal to protecting the integrity of the sterile field.

      A surgical gown is a personal protective garment intended to be worn by health care personnel during surgical procedures to protect both the patient and health care personnel from the transfer of microorganisms, body fluids, and particulate matter.


      THE IMPORTANCE OF EACH PROCEDURES THAT WOULD LEAD TO SURGICAL SITE INFECTION (SSI)

      One of the major concerns of the perioperative team is surgical site infections (SSIs). An infection that develops due to the transfer of microorganisms to the patient's wound during surgery is called SSI. It threatens the lives of millions of people each year due to antibiotic-resistant infections. It is the most common type of nosocomial infection in patients who have undergone surgical procedures. Approximately seven percent of the patients in developed nations and more than 25% of the patients in developing countries are affected by healthcare-associated infections (HCAIs).

      SSIs result in delayed wound healing, increased hospital stays, increased use of antibiotics, unnecessary pain, and in extreme cases, even death of the patient. Hence, their prevention is a crucial aim of health services. According to estimates, 26-54% of such infections can be avoided. Proper aseptic techniques, including hand hygiene, can prevent these infections. The surgical team should wear a sterile gown and gloves to reduce the risk of SSIs.

      Aseptic practices, including scrubbing, gloving, barrier clothing, drapes, and instrument sterilization, are pivotal to protecting the integrity of the sterile field. However, because of the fast-paced nature of the operating room (OR), the short time available for training, and the scarcity of experienced medical personnel, these abilities are challenging for medical students to learn. Hand preparation for surgery includes initial hand washing, procedural steps of rubbing, drying off hands, wearing an operating gown, and wearing sterile surgical gloves.

      In 2008, an initiative of 'Clean Care is Safer Care' was launched by the World Health Organization (WHO) to improve hand hygiene (HH) compliance among healthcare workers (HCWs).

      Gloves, gowns, and masks have a role in preventing infections but are often misused, increasing service costs unnecessarily. This surgical audit aims to assess glove-donning practices in the elective surgical operation theatre There is a scarcity of such clinical audits on standard donning sterile surgical gloves practices. To our best knowledge, this is the first in-field prospective audit on this topic from, using the WHO standard guidelines and involving education and assessment of the participants.

      Clinical audit was performed and indicating that more audits are required to improve patient safety. On the other hand, significant progress was made through the training sessions. Clinical audits that are conducted periodically are of the utmost significance in bringing about a good change in clinical practice.

      More audits should be done on a regular basis to improve adherence to standard guidelines. This can lead to a significant improvement in the reduction of health hazards, which still in turn, can help a country's economy by reducing prolonged hospital stays and minimizing the iatrogenic disease burden. Such clinical audits provide the framework to improve patient care collaboratively and systematically and educate healthcare professionals to become better caregivers and overcome their shortcomings. This also highlights the importance of intervention for amelioration/improvement.

    • LEARNING RESOURCES - VIDEOS

    • KNOWLEDGE CHECK ACTIVITIES

    • Topic 7 Discussion Forum

      Students, please answer the questions posted in this forum. 

    • CONCLUSION

      Staff who do not perform the procedures properly should have a live teaching perhaps a video and reaudit. To reduce mortality and morbidity cause by HAIS and SSI ,the issue need to be address quickly perhaps mentoring and checklist of new staff and trainees to operation Theatre.

    • REFERENCES

      Sara, L., Justine, H. & Hayley, G. (2020). The Royal Marsden Manual of Clinical Nursing Procedures (10th ed). United States: John Wiley and Sons Ltd

      Sutherland-Fraser. S., Menna, D., Brigid, M. G. & Benjamin, L. (2020). Perioperative Nursing : An Introduction (3rd ed). Australia: Elsevier

      LeMone, P. & Burke, K.M. (2019). LeMone and Burke's Medical-Surgical Nursing : Clinical Reasoning in Patient Care. (7th ed.). USA: Pearson

      Baranoski, S. (2020). Wound Care Essentials :Practice Principles (5th ed). USA: Wolters Kluwer Health

      Hinkle, J. L. & Cheever, K. H. (2018). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (14th ed.).Philadelphia: Wolters Kluwer Health.

◄Topic 6 : Post-Operative Management and Nursing Care Using The Nursing Process [Part 2]Topic 8 : Care of Client With Fluids And Electrolytes Imbalance►