Preoperative (Preop) Education

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Preoperative Care (Picmonic)
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Outline

Overview

  1. Goal of education
    1. Increases patient safety
    2. Prepares patient and family
      1. What to expect before, during, after surgery
    3. Decreases anxiety and fear
      1. Before and after surgery
    4. Decreases length of stay
    5. Decreases postoperative complications
    6. Increases healing time
  2. Importance of education
    1. Increases patient autonomy
    2. Decreases knowledge deficit
  3. Education begins with provider

Nursing Points

General

  1. Patient education specifics
    1. Explain preoperative events
      1. Procedure specifics
        1. Duration
        2. Expected outcome
      2. NPO before surgery
        1. Designated time
          1. Prevent aspiration
      3. Medications
        1. Per provider
          1. What to discontinue
            1. Anticoagulants
          2. When to discontinue
          3. What to continue
      4. Prep for surgery
        1. Bowel
        2. Skin preparation
          1. Bathing
      5. Diagnostic tests
      6. IV Insertion
      7. Anesthesia type
        1. To be explained by anesthesia provider
    2. Explain intraoperative events
      1. Role of circulating nurse
        1. Remain with patient during induction
        2. Patient privacy and dignity
      2. Monitoring equipment application
      3. Administration of anesthesia
        1. Schedule of events
          1. Communication with family during procedure
    3. Explain postoperative events
      1. Expected length of stay
      2. Presence of
        1. Lines
        2. Drains
        3. Catheters
      3. Pain management
        1. Pain medications
        2. Deep breathing
      4. Discharge
        1. Home
        2. Step down
        3. Instructions
          1. Wound care

Nursing Concepts

  1. Comfort
  2. Coping
  3. Patient education
  4. Safety

Patient Education

  1. Teach patient to ask questions
  2. Encourage patient to repeat learning
  3. Encourage patient to involve family with education

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Transcript

Hey guys let’s talk today a little bit about the preoperative education of a surgical patient.

So education of our surgical patients is super important.  I’ve had to say the most important part of patient education is increasing our patients safety, but in addition to that, education is going to prepare the patient and the family for what will come which most definitely reduces the fear and anxiety that surgery can bring.  When our patients are properly educated this can really decrease the time they’re in the hospital, it can decrease any postop issues and can most definitely promote quicker healing.  Patient education occurs during the entire surgical process from admission to discharge by all perioperative team members however, the majority of the education occurs before the surgery with the preoperative RN.

So just to bring home the importance of patient education a little bit further, it really increases patient autonomy, it makes patients feel like they are in control of their own health and well-being.  It helps to answer any and all questions that patients have, knowledge is power for patients, this should be included within the informed consent process.  And guys patient education should begin with the provider!  Make sure you check out the specific lesson on informed consent for more details!

So for me personally being a perioperative nurse for quite some time when I think of preoperative patient education I like to break it down in my mind into the different components that the patient is going to go through. Like I mentioned a few slides ago, the preoperative nurse will do the majority of the education but they’re going to help the patient understand what is going to occur in not only the pre-op area but also in the intraoperative area (during surgery) and after the surgery or the post-operative events.

So the preoperative nurse is going to first teach the patient about things that are critical before surgery.  Patients and families like to be educated on their procedure specifics, like how long the procedure is expected to take and what they can expect afterwards.  It is okay to tell patients you will check with the provider for the best answer to these questions!  A super important part of preoperative education is the NPO status of patients.  This is critical to the surgical patient as aspiration is a risk with patients going under anesthesia.  Please know that preoperative education should start before the day of surgery especially things like when to stop eating or drinking.  Also, the preoperative nurse will discuss (with direction from the provider) the patients current medications and if and when to stop them.  Just like NPO guidelines the patient should have this education prior to the day of surgery.

Continuing with some more specifics of preoperative education the patients are often given instructions as far as preps that are necessary before their procedure.  These can include things like possibly a bowel prep if they are having a colon resection or even bathing with a specific type of soap for an orthopedic procedure.  Obviously this is something that the patient will do before surgery so as the preoperative nurse you will want to confirm with your patient that these things have been completed.  You will also teach the patient about their IV what that will entail, any testing that they may require before the procedure like a pregnancy test or x-ray, and also the type of anesthesia that they are going to have.  Education regarding anesthesia is typically discussed by someone from the anesthesia department. 

So the preoperative nurse will begin to explain to the patient what will occur during surgery or when they are brought into the operating room.  The circulating RN will continue the education and explain to the patient that they will protect their privacy and safety during the procedure.  I’ve found that explaining what will happen in the OR, applying monitors, the timeline of anesthesia before the patient is brought into the OR helps to ease anxiety.  And finally we want to educate our patients as far as how we will communicate with their family during the procedure.

Explaining to the patient what will occur after surgery preoperatively is super important because after anesthesia patients do not tend have the best memory or comprehension!  So teach your patient what they can expect in the postop area like if they might wake up with any drains or catheters, the plan for pain control, and the steps that will be taken to get the patient discharged and on their way home.

So as always with patient education you’re just going to want to really encourage your patients to ask questions especially if they are unsure or confused about anything related to their surgery.  It is also a good idea to encourage the patient to repeat what they learned in a subtle way to promote their understanding.  Finally we want patients, if they are ok with it, to involve their family or support person with education for support after the procedure.

Ok guys the nursing concepts that can be applied to preoperative patient education are most definitely comfort, coping, and safety.  Remember surgery can be scary for patients so education will help them cope with the situation as well as comfort them.  Education of the surgical patient is first and foremost for their safety. 

Okay guys some key points for preoperative education, the goal is always to increase patient safety by preparing the patient, decrease anxiety and complications to help increase healing time.  Patient education is very important because it increases patient autonomy and decreases any knowledge deficits.  So to make preoperative education a little less daunting so we break the preoperative education down into the different sections, preop, intraop, and postop events.  You explain the procedure specifics, NPO status medications, any preps that they may require, diagnostic tests before the procedure, insertion of their IV and the anesthesia type.  As far as during the procedure explain the role of team members specifically the circulating RN, the application of monitoring devices that will be applied when they go into surgery, the events of the anesthesia administration, and how and when their families will be updated.  Finally guys explain the events that will occur after surgery, their expected length of stay, if they will wake up with any drains or catheters, help them understand their pain management plan, and the events that will lead up to their discharge and thereafter. 

Okay guys I hope you enjoyed this lesson on the preoperative education of a surgical patient!  Make sure you check out all the resources attached to this lesson, as well as the rest of the lessons in this course. Now, go out and be your best self today. And, as always, happy nursing!

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Concepts Covered:

  • Labor Complications
  • Microbiology
  • Respiratory Disorders
  • Infectious Disease Disorders
  • Acute & Chronic Renal Disorders
  • Anxiety Disorders
  • Cardiac Disorders
  • Pregnancy Risks
  • Basics of NCLEX
  • Renal Disorders
  • Emergency Care of the Cardiac Patient
  • Disorders of Pancreas
  • Noninfectious Respiratory Disorder
  • Sexually Transmitted Infections
  • Respiratory Emergencies
  • Studying
  • Central Nervous System Disorders – Brain
  • Musculoskeletal Disorders
  • Cardiovascular Disorders
  • Shock
  • Immunological Disorders
  • EENT Disorders
  • Perioperative Nursing Roles
  • Test Taking Strategies
  • Intraoperative Nursing
  • Medication Administration
  • Postoperative Nursing
  • Preoperative Nursing
  • Terminology
  • EENT Disorders
  • Emergency Care of the Trauma Patient
  • Adult
  • Understanding Society
  • Communication
  • Substance Abuse Disorders
  • Lower GI Disorders
  • Postpartum Complications
  • Oncologic Disorders
  • Neurologic and Cognitive Disorders
  • Basic
  • Reproductive System
  • Emotions and Motivation
  • Prenatal Concepts
  • Prioritization
  • Neurological
  • Psychological Emergencies
  • Concepts of Mental Health
  • Concepts of Pharmacology
  • Note Taking
  • Respiratory System
  • Infectious Respiratory Disorder
  • Labor and Delivery
  • Statistics
  • Personality Disorders
  • Pediatric
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  • Learning Pharmacology
  • Concepts of Population Health
  • Circulatory System
  • Urinary Disorders
  • Cognitive Disorders
  • Newborn Complications
  • Documentation and Communication
  • Legal and Ethical Issues
  • Integumentary Disorders
  • Tissues and Glands
  • Community Health Overview
  • Vascular Disorders
  • Developmental Considerations
  • Developmental Theories
  • Depressive Disorders
  • Factors Influencing Community Health
  • Oncology Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Musculoskeletal Disorders

Study Plan Lessons

Adult Vital Signs (VS)
Nursing Care Plan (NCP) for Infection
Nursing Care Plan (NCP) for Impaired Gas Exchange
Vitals (VS) and Assessment
Nursing Care Plan (NCP) for Pertussis / Whooping Cough
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Anxiety
ABGs Nursing Normal Lab Values
Adult Vital Signs (VS)
Congestive Heart Failure Concept Map
Congestive Heart Failure (CHF) Labs
Critical Thinking
Fluid Volume Overload
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Isotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Respiratory Failure
Time Management
Pleural Effusion for Certified Emergency Nursing (CEN)
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care and Pathophysiology for Cardiogenic Shock
Nitroglycerin (Nitrostat) Nursing Considerations
Disease Specific Medications
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Defects of Decreased Pulmonary Blood Flow
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Cataracts
Day in the Life of an Operating Room Nurse
Day in the Life of a Peds (Pediatric) Nurse
Formulating Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Intraoperative Nursing Priorities
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
NRSNG Live | So You Want to be a Surgical Nurse?
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Respiratory Failure
Nutrition Assessments
Perioperative Nursing Roles
Perioperative Nursing Course Introduction
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Procedural Terminology
Sterile Field
Surgical Incisions & Drain Sites
Surgical Prep
Strabismus
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Ventilator Settings
Intraoperative (Intraop) Complications
Informed Consent
General Anesthesia
Crash Cart
CRNA
Advanced Cardiovascular Life Support (ACLS)
Dark Skin: IV Insertion
Flight Nurse
Finding Your First Nursing Job as a New Grad
Goal Setting
Head to Toe Nursing Assessment (Physical Exam)
ICU Nurse Report to Floor Nurses
ICU Nurse Report to OR (Operating)Team
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Hypovolemic Shock Case Study (OB sim) (60 min)
Intake and Output (I&O)
Introduction to Health Assessment
Interviewing for Nursing School
IV Drip Administration & Safety Checks
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Levels of Consciousness (LOC)
Lung Sounds
Life Support Review Course Introduction
Male Reproductive Anatomy (Anatomy and Physiology)
Maslow’s Hierarchy of Needs in Nursing
Menstrual Cycle
Moderate Sedation
Neuro Assessment
Neuro Terminology
Nursing Care and Pathophysiology for Asthma
Nursing Care Delivery Models
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Infection
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Migraines
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Suicidal Behavior Disorder
Nursing Care Plan for Macular Degeneration
Nursing Case Study for Pediatric Asthma
OLD CARTS Mnemonic (OLD CARTS)
NURSING.com Assessment & Skills Checks
Phases of Nurse-Client Relationship
Pharmacology Course Introduction
R – Real-Life
Questions To Ask Before Applying To A Nursing Program
Respiratory Structure & Function
Surgical Incisions & Drain Sites
Surgical Counts for Certified Perioperative Nurse (CNOR)
Test Taking Course Introduction
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Tuberculosis (TB) Case Study (60 min)
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Prealbumin (PAB) Lab Values
Pictures
Personality Disorders
Pediatric Advanced Life Support (PALS)
Patients with Communication Difficulties
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Decreased Cardiac Output
NRSNG Live | How to Pass Any Nursing School Test
NRSNG Live | My Super Secret Note Taking Method
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
NRSNG Live | The Successful State of Mind
NRSNG Live | What Your Nursing Professors Want to Tell You But Can’t
Insulin Drips
How to Write a Nursing Care Plan
High-Risk Behaviors
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart (Cardiac) Failure Therapeutic Management
Fundal Height Assessment for Nurses
Emergency Drugs Nursing Mnemonic (LEAN)
Drawing Blood from the IV
Drawing Pictures
Disease Specific Medications
Disasters & Bioterrorism
Day in the Life of a NICU Nurse
Day in the Life of an ICU (Intensive Care Unit) Nurse
Congestive Heart Failure (CHF) Labs
Communication of Patient Outcomes (Continuum of Care) for Certified Perioperative Nurse (CNOR)
Common Pathogens for UTI Nursing Mnemonic (KEEPS)
Cognitive Impairment Disorders
Cataracts
Cardiopulmonary Arrest
Cardiac Terminology
Cardiac Cycle
Cardiac Anatomy
Cardiac (Heart) Physiology
Body System Assessments
Blood Flow Through The Heart
Blood Pressure (BP) Control
Attention Deficit Hyperactivity Disorder (ADHD)
Advocating For Your Patient
Advanced Cardiovascular Life Support (ACLS)
3rd Degree AV Heart Block (Complete Heart Block)
2nd Degree AV Heart Block Type 2 (Mobitz II)
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
Documentation Basics
Trusting your Gut
Overview of the Nursing Process
Nursing Process – Diagnose
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Infection
Nursing Care Plan (NCP) for Glaucoma
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Syncope (Fainting)
Goal Setting
Hygiene
How to Write A Nursing Progress Note
How to Write a Nursing Care Plan
Health Promotion Assessments
Intraoperative Nursing Priorities
Hypertension (HTN) Concept Map
Maslow’s Hierarchy of Needs in Nursing
MSN (Masters) vs. DNP (Doctorate)
Nurse-Patient Relationship
Nursing Process – Plan
Nursing Process – Evaluate
Our Goals for Teaching
Nursing School Application Essay
Pain and Nonpharmacological Comfort Measures
Perioperative Nursing Roles
Phases of Nurse-Client Relationship
Preoperative (Preop) Nursing Priorities
Preoperative (Preop)Assessment
Program Planning
Purpose of Nursing Care Plans
Self Concept
Identifying Interventions per Nursing Diagnoses for Certified Perioperative Nurse (CNOR)
Health Promotion & Disease Prevention
Health Promotion Model
Erikson’s Theory of Psychosocial Development
Continuity of Care
Community Health Education
Communicating with Other Nurses
Depression Concept Map
Disease Specific Medications
Advocating For Your Patient
Access to Care
Breast Cancer Concept Map
Intro to Community Health
Depression Concept Map
Congestive Heart Failure Concept Map
Concept Map Course Introduction
Head to Toe Nursing Assessment (Physical Exam)
Maslow’s Hierarchy of Needs in Nursing
Nursing Care Plan (NCP) & Interventions for Increased Intracranial Pressure (ICP)
Program Planning
Sepsis Concept Map
Stroke Concept Map
Hypertension (HTN) Concept Map
Drawing Pictures
Body System Assessments
Bowel Obstruction Concept Map
Blood Pressure (BP) Control
Asthma Concept Map
Aneurysm & Dissection
Amputation Concept Map
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Tuberculosis for Certified Emergency Nursing (CEN)
Tuberculosis (TB) Case Study (60 min)
TB Drugs Nursing Mnemonic (RIPE)
Respiratory Infections Module Intro
Nursing Care Plan (NCP) for Tuberculosis
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care and Pathophysiology for Tuberculosis (TB)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Isolation Precaution Types (PPE)
Communicable Diseases
Anti-Infective – Antitubercular
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Casting & Splinting
Care of Vulnerable Populations
Complications of Immobility
Head to Toe Nursing Assessment (Physical Exam)
Mechanical Aids
Mobility & Assistive Devices
Musculoskeletal Terminology
Introduction to Health Assessment
Fractures
Preload and Afterload
Sympatholytics (Alpha & Beta Blockers)
Heart Failure Case Study (45 min)
Congestive Heart Failure Concept Map