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Pre-operative assessment

  • Preoperative assessment aims to:
    • Reduce morbidity and mortality associated with surgery
    • Prevent unnecessary cancellations
    • Reduce hospital stay

Aim of preoperative planning

  • Inform patient of the proposed procedure
  • Obtain informed consent for the procedure
  • Assess pre-existing medical conditions
  • Plan pre and postoperative management of these conditions

Issues that should be discussed

  • Time of admission and starving instructions
  • Management of usual medication
  • Any specific pre-operative preparation that may be required
  • Transport to theatre
  • Any specific anaesthetic issues
  • Anticipated duration of surgery
  • Likely recovery period
  • Need for drains, catheters
  • Likely discharge date
  • Need for dressing change or specific postoperative care
  • Follow up requirements
  • Likely date of return to work or full activity

Important medical diseases that increase morbidity and mortality

  • Ischaemic heart disease
  • Congestive cardiac failure
  • Hypertension
  • Cardiac arrhythmias
  • Chronic respiratory disease
  • Diabetes mellitus
  • Endocrine dysfunction
  • Chronic renal failure
  • Nephrotic syndrome
  • Obstructive jaundice

Advantages of pre-admission clinic

  • Allows pre-operative optimisation of patients
  • Reduces duration of hospital stay
  • Reduces risk of unnecessary cancellations
  • Guidelines minimise unnecessary preoperative investigations

Bibliography

Bray A.  Preoperative nursing assessment if the surgical patient.  Nurs Clin North Am 2006;  41:  135-150.

 

 
 

Last updated: 05 January 2008

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