NU321-OT :

Department

Faculty of Nursing

Academic Program

Bachelor in Science in Nursing

Type

Compulsory

Credits

04

Prerequisite

Overview

To prepare the students acquire appropriate knowledge, skills, and proper attitude in providing a continuum of safe patient care in the perioperative environment by utilizing the Nursing process in accordance to established safe standards. This includes a study of the patient’s Perioperative experience, Roles and Responsibilities of the surgical unit nurse, intra-operative nurse and the post anesthesia nurse; Principles and Practice of Sterile Technique; Operating Room Hazards; and Introduction to Surgical Technique. This will guide them in preparing the theater aseptically, maintaining sterility of instrument and supplies, and storage of equipment in a safe environment.

It is also design to train students to provide a comprehensive, safe and effective nursing care in carrying out nursing procedures and other nursing activities in Wound Management and Common Abdominal Surgeries.

Intended learning outcomes

Upon completion of this course, the students will be able to:

  1. Distinguish the three phases of surgical experience of client.
  2. Formulate nursing care plan for each of the three phases.
  3. Identify pathological processes requiring surgical intervention and classify the different surgeries
  4. Summarizes the preoperative preparation of client for surgery.
  5. Determine the different diagnostic test done prior to surgery.
  6. Discuss and demonstrate postoperative exercises
  7. Review the physical preparation a day before surgery and immediate preoperative nursing intervention.
  8. Differentiate the 3 surgical environment
  9. Differentiate the 2 surgical teams and state the responsibilities of each members of the surgical team.
  10. Discuss the principles of aseptic technique
  11. Review and Demonstrate procedures like surgical hand scrub, gowning, gloving, serving the gown and gloves.
  12. Classify and Identify the basic major instruments
  13. Review the different operative events
  14. Demonstrate the principles used in positioning patients and the use of positional aids.
  15. Identify common anesthetic agents and its effect
  16. Discuss the potential postoperative complications and its prevention.
  17. Discuss the 3 phases of post-operative care and formulate a plan of care
  18. Identify and classify the different types of wounds.
  19. Discuss the phases and mechanism of wound healing
  20. Discuss the management of wound complications.
  21. Demonstrate proper wound care.
  22. Define the common abdominal surgical procedures.
  23. Describe each abdominal procedures
  24. Identify the different instruments, equipment and supplies pertinent for each procedure for abdominal surgery.
  25. Demonstrate the proper skin preparation and draping techniques for abdominal surgery.

Teaching and learning methods

a. Lectures

b. Assignments and Research

c. Recitation and Reporting

d. Demonstration and return demonstration

e. Quizzes and Major examinations

Methods of assessments

· Midterm exam 30%.

· Practical Exam 12%

· Final exam 50%.

· Homework and reports 8%.

Course Outline

PERIOPERATIVE CONSIDERATIONS AND MANAGEMENT

  1. Introduction

11. Basic Concepts

a. Definition and suffixes

b. Four major types of pathological processes requiring surgical intervention

c. Surgical classification

d. Effects of surgery to client

e. Phases of surgical experience

111. Preoperative Nursing Care Management

A. Preparing the Patient for Surgery

1. Psychological Preparation

a. Assessment and Intervention

2. Physiological Preparation

2.1 Assessing the Surgical Risk Factors and its Potential Complications

a. Age

b. Nutritional Status

c. Respiratory Status

d. Cardiovascular Status

e. Hepatic and Renal function

f. Endocrine Function

g. Immunologic Function

h. Previous Medical History

i. Drug or Alcohol Use

j. Head, Ears, Eyes. Throat Status

k. Neurologic Status

l. Musculo skeletal Status (extremities and skin)

2.2 Assessing the Ambulatory Surgical Patient

2.3 Gerontologic Considerations

2.4 Preoperative Diagnostic Test

3. Legal Preparation

a. Informed Consent

4. Preoperative Patient Education

a. Deep breathing

b. Coughing exercise

c. Encouraging mobility and active body movement

5. Physical Preparation

a. Managing nutrition and fluids

b. Preparing the bowel for surgery

c. Preparing the skin

6. Immediate Preoperative Nursing Intervention

a. Early morning care (day of surgery)

b. Preoperative Medications

c. Administering the Pre-anaesthetic medications

d. Maintaining the preoperative record

e. Transporting the patient to the pre-surgical unit

f. Attending to the family needs

Intraoperative Nursing Care Management

A. Intraoperative Goal

1. Emotional well being

2. Surgical Asepsis

3. Safety

4. Control of the surgical environment

B. The Surgical Environment

1. Three Surgical Zones

2. Proper Attire

3. Health Hazards Associated with the Surgical Environment and Universal precaution

4. Principles of Aseptic technique

5. Surgical scrub, Gowning, and Gloving

C. The Surgical Team

1. The Nonsterile Team

2. The Sterile Team

D. The Surgical Experience

a. Anesthesia

b. Position of client for surgery

c. Draping

d. Instrumentation

Classification of instruments

· Cutting and dissecting

· Clamping and occluding

· Grasping and holding

· Dilating and enlarging

· Retracting (hand-held and self -retaining)

· Suctioning

Different Surgical set

· Minor instrument Set

· Major Instrument Set

Surgical Sutures and Surgical needles

· Absorbable and non- absorbable

· Traumatic and atraumatic

e. Common operative Events

E. Potential Intraoperative Complications

1. Nausea and Vomiting

2. Hypoxia and other Respiratory Complications

3. Hypothermia

4. Malignant Hyperthermia

F. Caring for the Patient During Surgery

1. Reducing Anxiety

2. Maintaining Safety

3. Preventing positioning & other Injuries

4. Maintaining patient’s dignity

5. Absence of complication

V. Postoperative Nursing Care Management

A. Post-Operative Goals

B. Three Phases of Postoperative Care

Phase 1. Immediate post-operative care

Nursing Care Management in the PACU

a. Assessing the Patient

b. Maintaining a Patent Airway

c. Maintaining Cardiovascular Stability

d. Relieving Pain & Anxiety

e. Determining readiness for Discharge from the PACU

Phase 2. Intermediate/ Convalescent post-operative care

Admitting Patient to the Surgical unit

a. Performs initial assessment

b. Review client’s chart

c. Review post-operative orders

Care in the Surgical unit

a. Vital signs

b. Maintaining client’s airway

c. Hydration

d. Relieving pain

e. Encouraging Activity & Promoting Self Care

f. Resuming Oral Intake

g. Promoting Bowel Function & Urinary Function

h. Wound Care

i. Care of drains

Prevention of Post-operative Complications

a. Pneumonia

b. Pulmonary Embolism

c. Hemorrhage

d. Hypovolemic Shock

e. Nausea and Vomiting

f. Abdominal Distention

g. Wound Infection

h. Urinary Retention

Phase 3. Discharge Planning, Teaching Referral

Promoting Home and Community-Based Care

WOUND MANAGEMENT

  1. Definition
  2. Types of Wound
  3. Classification of Wounds
  4. Wound Classification Associated to Surgical Site Infection Risk
  5. Phases of Wound Healing
  6. Mechanisms of Wound Healing
  7. Factors Affecting Wound healing
  8. Complications of Wound Healing
  9. Wound Assessment
  10. Wound Drainage
  11. Wound Dressing
  12. Types of dressing

ABDOMINAL SURGERIES

  1. Common Abdominal Incisions
  2. Layers of Tissue
  3. Common Abdominal Surgical Procedures

1. Gastroscopy

2. Gastrectomy

3. Small Bowel Resection

4. Appendectomy

5. Colostomy

6. Resection of Sigmoid and Rectum

7. Hemorroidectomy

8. Herniorrhaphy

9. Cholycystectomy

  1. Operative Technique

1. Procedure

2. Positioning

3. Surgical Skin Preparation

4. Draping

5. Instrumentation, equipment, and supplies

E. Intraoperative Nursing Management

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