Discharge (DC) Teaching After Surgery
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Outline
Overview
- Discharge teaching after surgery
- Promotes safety
- Decrease complications
- Increases healing
- Surgeon specific instructions
- Planning should begin early
- Involve family
- Add support
- Increase understanding
- Promotes safety
- Provide to patient
- Written discharge materials
Nursing Points
Assessment
- Assess
- Patient specific learning needs
- Vary
- Age
- Disabilities
- Level of education
- Vary
- Readiness
- Anesthesia
- Ability to focus
- Pain
- Patient understanding
- Patient specific learning needs
- Provide a learning environment
- Free from distractions
Nursing Concepts
- Patient-centered care
- Safety
- Infection control
Patient Education
- Anesthesia
- Common side effects
- Dizziness
- Drowsiness
- For 24 hours NO
- Driving
- Drinking alcohol
- Common side effects
- Surgery specific
- Dressing
- Change/remove
- Drain care
- Shower
- Ice at site
- Restrictions
- Exercise
- Return to work
- Dressing
- Diet
- How to progress
- Specific diet
- Bowel habits
- Increase fiber/fluids
- Stool softener
- Medications
- New medications
- Prescriptions
- Document last dose
- If no pain meds
- NSAIDs
- Acetominophen
- Home medications
- When to resume
- New medications
- What to report
- Fever greater than 101 degrees Farenheit
- Worsening pain
- Not relieved with meds
- Unexpected bleeding
- Warm, red surgical site
- Incision pus
- Inability to void
- Persisent nausea and vomiting
- What to expect
- Pain amount and duration
- Specific needs
- Equipment
- Home care
- Support availability
- Family
- Caretaker
- Questions
- Who to call
- Follow-up
- Appointment with surgeon
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Transcript
Hey guys! Let’s talk today about discharge teaching after a patient has surgery!
Discharge teaching is super important as it promotes patient safety by decreasing complications and hence promoting their healing! Teaching is often going to be specific to the orders of the provider which will be procedure specific but we also have to take into account other teaching points like issues concerning anesthesia and medications. Guys discharge teaching and planning should actually begin way before the patient arrives in the post anesthesia care unit! Be sure to check out our lesson on preoperative assessment and education for more information! And guys we also want to involve the family or caretaker in this process (if the patient permits) as they often provide support and understanding to the patient!
So with discharge teaching after surgery it’s going to be very important to assess the patient’s learning needs! Obviously this can vary depending on the patient’s age, cognitive and education level. And also guys are they ready to learn? Remember your patient just received anesthesia which means they may be a little out of it and are they able to focus remember people that are in pain have a difficult time with this! Also, after you have taught your patient you need to make sure that they actually comprehend what you said!
Ok let’s look at some of the important things that we need to teach our surgical patients at discharge! We want to make sure we teach our patient common side effects of anesthesia like drowsiness and dizziness and guys it’s super important that we stress no driving and no alcohol for 24 hours after anesthesia and the patient really should have a caretaker for a day after. Make sure you check out the additional lesson on general anesthesia and moderate sedation for more information! Teaching specific to the surgery is also important like when to change and remove dressings, when to shower or bath, and any restrictions like exercise.
Medications is another important discharge topic as patients typically are prescribed new medications to take at home. Explaining these and also providing the patient the time of the last dose is critical. Also guys if the patient isn’t prescribed any pain medications we talk to them about the use of acetominophen and NSAIDS as long as they aren’t contraindicated! And we also stress the importance of not taking acetominophen if other medications include it! It is extremely rare to have a patient who isn’t on some type of medication preoperatively so reviewing when to resume home medications is important too! Diet is also a big deal as remember your patient just had surgery so review the diet instructions provided by the surgeon and make sure your patient understands!
Ok so as we all know surgical site infections are a huge concern after surgery! So with this said we need to teach our patients any signs of this including fever greater than 101° F, warm, red incision or any pus, also worsening pain that can’t be relieved with medications, and nausea and vomiting that is persistent…and we say persistent because occasionally patients will experience nausea and vomiting after discharge because of anesthesia. We also teach our patients that certain things like pain can be expected for a certain amount of time because remember they did just have surgery! Be sure to check out intraoperative and postoperative complications for more information!
Ok so we need to make sure our patient understands who to call if they have any questions or concerns and also provide them the contact information. We also want to teach the importance of patient support by family or a caretaker and involve them as much as possible because patients often need assistance after surgery. Finally guys we need to teach the patient when to follow-up with the surgeon including providing the appointment or when they should schedule one!
Ok guys here are some nursing concepts besides the obvious patient education! As PACU nurses we provide patient-centered care meaning we always take into consideration their specific needs and desired outcomes when teaching at discharge which keeps the patient safe with the prevention of infection as one of the goals.
Ok guys lets look at some key points! Discharge teaching after surgery is patient-centered and it promotes safety to decrease complications and promote healing, it is good to involve the family if possible! We need to assess the patient for readiness, learning needs, and understanding after instructions are given. We teach surgery specific instructions like dressing changes, drain care, when to shower, and restrictions. Also the patient should report fever, pus, redness and warmth at the incision, and persistent nausea and vomiting. The patient should be taught that anesthesia can cause dizziness and drowsiness after surgery and the patient should not drive or drink alcohol for 24 hours after anesthesia. Finally the patient should be taught about new medications including pain meds, when to resume home meds and when to follow-up with the provider.
Okay guys I hope you enjoyed this lesson on discharge teaching after surgery! 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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Final Exam
Concepts Covered:
- Terminology
- Urinary System
- Respiratory Disorders
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Oncology Disorders
- Integumentary Disorders
- Preoperative Nursing
- Musculoskeletal Trauma
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- Disorders of the Posterior Pituitary Gland
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- Central Nervous System Disorders – Brain
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- Intraoperative Nursing
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