Advanced Directives
This nursing cheatsheet will help you learn about advance directives, which are crucial for patient advocacy in healthcare. An advance directive includes documents like a Living Will and Medical Power of Attorney (MPOA). A Living Will is a legal document that outlines the patient’s wishes in situations where they cannot communicate, often including preferences on […]
Perioperative Assessment Documentation for Certified Perioperative Nurse (CNOR)
Perioperative Assessment Documentation Guidelines: The perioperative RN documents activities to record a description of the care provided to patients in the surgical setting Transfer of information from the perioperative environment throughout the care continuum Identification of pre-existing versus surgically-acquired injuries Wounds Pressure injuries SSIs Follows the nursing process framework for perioperative nursing care Assessment, […]
Perioperative Education Documentation for Certified Perioperative Nurse (CNOR)
Perioperative Education Documentation Guidelines: Preoperative patient education can reduce a patient’s anxiety, reduce perception of postoperative pain, shorten the length of hospital stay, and improve satisfaction with health care. Perioperative education: Can occur pre-operatively, intraoperatively (for procedures without general anesthesia), and post-operatively Adequate perioperative education can impact patient outcomes such as pain, anxiety, mobility, […]
Universal Protocol Performance for Certified Perioperative Nurse (CNOR)
Universal Protocol Performance Guidelines: The Joint Commission’s Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery Conduct a pre-procedure verification process Verify the correct procedure, for the correct patient, at the correct site Involve patient in verification process when possible Identify items that must be available for the procedure Mark the […]
Patient Rights Advocacy for Certified Perioperative Nurse (CNOR)
Patient Rights Advocacy Guidelines: Entitled to Calm, quiet professional experience Individualized care Ask questions Control their care Comforting measures Explanation before implementation (positioning esp) Considerations: Privacy in pre-op bay Noise from OR in pre-op or PACU Don’t put ortho right next to pre-op Assess anxiety and comfort levels Stoicism Warm blankets offer comfort […]
Patient and Family Teaching (Per Procedure) for Certified Perioperative Nurse (CNOR)
Patient and Family Teaching (Per Procedure) Guidelines: Education is required for informed consent Risks/benefits/recovery/future need “Need for further surgery” vague Alternatives Caregiver competence Must be completed while aox3 PACU is not reliable teaching Considerations: Surgical risks AND anesthesia risks Should have considerable teaching done in clinic before reporting for routine surgery Verify knowledge […]
Advanced Directive and DNR Status Confirmation for Certified Perioperative Nurse (CNOR)
Advanced Directive and DNR Status Confirmation Guidelines: Specific desires of the patient regarding care Can be completed by family if patient incompetent If family, allows for conversations intraop Often suspended or modified for surgery Get details! Considerations: Suspension of DNI, but what if they can’t wean post-operatively Ethical committee present in most hospitals […]
Pain Assessments for Certified Perioperative Nurse (CNOR)
Pain Assessments Guidelines: Narcotics to be minimized wherever possible Increase use of blocks where appropriate Consider alternative treatment options where appropriate Longer acting pain control Avoid peaks and valleys Ongoing participation in continuing education and pain control development Considerations: Patient fear of pain Opioids increase post op nausea Blocks can be performed intra-op […]
Confirmation of Correct Procedure (Operative Site, Side, Site Marking) for Certified Perioperative Nurse (CNOR)
Confirmation of Correct Procedure (Operative Site, Side, Site Marking) Guidelines: Licensed practitioner’s initials OK to be resident or other licensed practitioner working with attending Facility independent policies vary Must be present at time out! Marked before procedure, with conscious patient if possible If not possible, use facility policies Typically, 2 licensed providers Must be […]
Procedurally-Relevant Focused Assessments for Certified Perioperative Nurse (CNOR)
Procedurally-Relevant Focused Assessments Guidelines: RN should have working knowledge of surgical procedure to be performed Ensure patient has adequate knowledge of recovery and future care Identify risk factors that are increased for impending procedure Considerations: Positioning Joint pain-high lith? Jacknife? Lung status- trendelenburg Relevant surgical surgery Virgin abdomen vs adhesions Weeks gestation Patient’s […]