Introduction to Surgical Patient

Nursing being a vital part of treatment plays a considerate role in taking care of the surgical patients who are required to be treated in succession of several caring measures. These are mostly related to another potent consideration of perioperative measures in the field of nursing with a special consent of surgical patients (von Dossow and Zwissler, 2016). Peroperative measures primarily involves the method of evaluation followed by management and lastly carrying out pertinent outpatient processes. It is normally done before conducting any elective surgical procedures and is usually done by the non-surgical consultants like cardiologists, internists and pulnomologists, etc. This type of consulting mostly assists in the management of any prior medical issue of the client such as diabetes, etc., that may in turn impact upon the existing health related problem of the client. It also supports in the treatment of peri and post-operative complications that may arise in the form of any other infectious disease or cardiac and pulmonary related issues (Young and et.al., 2016). The below report has discoursed upon a similar consideration of surgical patient to be treated with the help of perioperative measures and is based upon a given case study of a virtual patient named Mr Oliver Orange and is 56 years old.

Critically appraise my own role in relation to the care of the surgical patient

I am hereby playing the role of a surgical care practioner who will be mainly responsible for taking care of those patients who are either operated or are in need of some surgical procedure. This in turn necessitates me to perform the perioperative practices that will in turn involve its 3-step process namely evaluation, management and outpatient procedures (Buckley and et.al., 2016). It is with a special consent of the conferred case scenario of Mr Oliver Orange who is 56 years old and has been recently admitted to the hospital followed by a workplace accident. I have met him in a perioperative setting that necessitated me to go through the three phases of scaphoid surgery for which he was diagnosed (Macht and et.al., 2016).

This is basically on considering the leading agenda of perioperative care that intends to provision improved condition to the patients before, during and after the operation. With a similar reference to it, the three-stage perioperative practice includes preoperative, intraoperative and postoperative services where each of these processes are with a distinct consent (Garrett, 2016). I am hereby required to go through the three mains steps of evaluation in terms of going through his past medical history, management for looking into a well considerate course of surgery to avoid any possible chances of obstacle and outpatient (Scott and et.al., 2017). This is basically to verify a sustained perioperative process for avoiding any probable complications after the surgery to ensure a successful surgical treatment of Mr Orange.

Critically examine contemporary issues and challenges in surgical care

Attempting to accompany a surgery with several set of responsibilities is itself referred to be a major challenge for a surgical care practioner who is required to look into all relative measures of the surgical procedure to avoid any atrocious fallouts with the wellbeing of client (Chan and et.al., 2017). It is where surgical nursing itself exists with both physical and emotional challenges for the nurse. This is with a similar reference to the given case of Mr Orange where the scaphoid surgery for the treatment of his fracture is referred to be physically demanding in nature and I am hereby required to be aware of the time period I need to spend in the operative room. On considering the emotional challenges I may face while treating Mr Orange, I am afraid about any distressing results that could occur in case the surgery goes wrong. It is thereby on the basis of the above two challenges, it can be said that patient safety is one of the most concerning issue where it is mostly due to general guidelines with no precise measures to handle a specific set of patients (Isenman, Michaels and Fisher, 2016). Also, communication plays a vital role in health care settings where gap in communication leads to no transmission of information across the surgical care pathway.

Synthesising theory and practice in relation to learning

This is on scrutinizing the above relative facts to further create a theory and practice of improvement in it, I have hereby learned to behave in a peaceful manner to avoid any sort of physical and mental challenges to perform the act of surgical care (Bruno and et.al., 2017). For which, I will also consider following an integral process of communication with a foremost consideration of listening and attending any queries made by the patient and his or her relatives. A proper communication procedure is apparent to reduce the chances of mishaps and will minimize the probabilities of risk.

To critically evaluate communication methods in the peri -operative setting

Communication plays an important role in a peri-operative setting that in turn makes a huge contribution in the undertaken surgery of the patient. A healthcare setting is comprised with enormous number of individuals such as patients, their family members and relatives along with the professional colleagues (Larochelle and et.al., 2016). It is therefore intended to be a significant prospect for the practioners to communicate in an effective manner as an essential medical skill. This is also referred to be a principal requirement for provisioning an intensive healing facility and a key to perform respectable medicinal practices. The current section has hereby referred to evaluate the communication methods that are likely to be used in the perioperative settings. This involves a foremost method of listening and attending the patients like Mr Orange and his family members or relative to address their concerns. On evaluating the practice of listening, it is always referred to initiate a respectful interaction of the practioner with that to the client and his or her relatives. This is for instance to refer to the case of Mr Orange, if I will prioritize listening to the issues of Mr Orange, I will be able to generate better ways and ideas to assist him at the rime of treatment (Palant and et.al., 2017). This will in turn fulfil both my professional responsibilities towards him by together fulfilling his personal desires.

Impact of effective communication with patients and members of the peri operative team

An effective communication is referred to be a key top get success in surgical care where it directly results in enhancing the provisioning of services to the patients like Mr Orange. Despite of several communication methods like verbal, non-verbal, questioning and written, communication in a health care setting, it is made effective with a primary use of the listening measure that leads the person to make an effective selection of the treatment to be given to the patient going through a traumatic disorder (Clayton and et.al., 2016). Apart from this, listening and paying attention also leads to an effective perioperative procedure that in turn assist the surgeons and surgical practioners to provide a likely treatment to the patient with less or almost no pessimistic consequences. This will also lead to an accurate diagnosis of the patient to further provisioning a correct treatment which is harmless for the patient and also leads to a greater level of satisfaction for both the patient and the team of experts provisioning the services.

To critically evaluate health and safety practices in the peri operative settings

This is to evaluate the health and safety practices in the perioperative settings by scrutinizing the efficacy of the applied practices. This mainly involves three leading measures in accordance to The Universal Protocol, WHO surgical safety checklist and Patient involvement. On evaluating these methods, it has been found that The Universal protocol is much effective in terms of verifying the pre-operative practices by the surgical practioner like me and include preprocedural process of verification followed by the marking of operative site and carrying out a time out before the process (Handzo, 2012). Another undertaken method defines an imperial use of Surgical Safety Checklist which is yet another beneficial tool for promoting the safety of a client. On evaluating this measure, it has been found that such verification process largely assists in reducing any possible chances of risks and errors by the surgeons in the operative room. Lastly, there existed another significant measure of involving patients that includes an official enlistment of patient for preventing any possible errors in the operative area. On evaluating this measure, it has been found that it is a slight challenging task that requires the surgeon to put his personal efforts by calming the patient at the time of preoperative assessment procedure.

Impact of infection control practice across the peri operative environment

This is to reflect upon the undertaken practices of infection control across the perioperative environment where during this course of time where I was supposed to take care of Mr Orange, I have strictly followed the below mentioned measures for controlling infection-

Hand hygiene

This indicated a foremost way for minimizing the risk of spreading infection where decontamination of hands is evident to defend both the service user and the provider (Beam, Keating and Razonable, 2016). I have thereby considered washing my hands every time I met Mr Orange and left her room for the elimination of microorganism that can be easily transferred to any healthy person by together harming any patient like Mr Orange to a great extent.

Aseptic technique

This was reflected to be yet another effective measure for the prevention of any infectious ailment to the patients like Mr Orange (Mueller and et.al., 2016). This duly necessitated me to sterilize and disinfect the medical devices used for the purpose of diagnosis. It together indicated a dual process has been done before and after detecting the clients to prevent the spread of any infection.

To critically evaluate communication methods when receiving, admitting and transferring patients

Communication being an important agenda usually involves oral and written methods at the time of receiving, admitting and transferring patients. Firstly, an interaction takes place among the referring and the receiving team to communicate about the condition of the patient, examination, plans for treatment, measures and timings for the transfer, etc., (Atkinson and et.al., 2017). It is with a special concern of confirm the acceptance of entrance to the unit receiving the patient. On evaluating the same, a slight discrepancy has been found over here where it is important to provide any updated set of information about any sort of development in patient’s condition to further proceed in an accordant manner.

reflect upon other effective forms of communication with patients

As a surgical practitioner, I have analysed that it is very essential to have effective communication with the patients so that their problems could be easily understood and necessary actions could be taken up. There are various forms of communication that could be used for interaction with patients. Some of them are discussed below:

Rapport

When there is effective communication between patients and doctors, it becomes easy to provide cafe to them. It could be enhanced by calling them with their names, having proper eye contact while talking to them etc, could build up healthy relations among them (Janis, 2016).

Explain

Patients could be asked with variety of questions that could motivate them to indulge themselves more into treatment procedures. They could be asked about their routines, habits and desires etc., which helps in getting more frank with the working team.

Show

It is always appreciable when someone collaboratively works with one another as team. Doctors and hospital service in-charge should participate in helping others rather than instructing them to accomplish following tasks.

Practice

it is an old saying that practise makes a man perfect. It is actually true in every aspect. When physicians are provided with trainings on how to deal with service users, it becomes easy for both of them to cooperate one another.

Evaluation of technical language and skills required when anaesthetising patients

Language and skills used for communicating with patients while inducing anaesthesia plays a major role in the entire treatment procedure. Trained professionals are generally preferring conscious communication only. It is in verbal form and generally involves logic behind everything (Piazza, Kalesan and Kappetein, 2013). Patient should be provided with all the necessary information regarding anaesthesia which may include its type, method to be used into the process and its effect in the body. It is also essential to ensure that there should not be side effects of it on the body.

Nowadays case of surgical errors has come into existence over the past few years. The reason behind this could be unresponsive behaviour of doctors and lack of patient's involvement in the treatment. Thus, it becomes very important that service user should be well aware about the medications that have been provided to them. Professionals should be well trained because if misconduct occurs then ultimately client have to bear the damages.

While giving anaesthesia, certain instructions could be given to the users such as lie still, raise your arm, release your body, etc. Patients should be asked to follow all the instructions carefully. In the subconscious state, sometimes people are not able to hear and follow the instructions carefully which may be dangerous to them (Nicholson, Lowe and Smith, 2014). In such cases, they could be asked to remain firm and it becomes the responsibility of the hospital authorities and involved doctors to ensure that the whole procedure gets completed in a systematic manner without facing any challenges. Patients should calmed by providing support and care that would be helpful in building confidence in them.

To reflect upon the patient's medical history and select the most appropriate anaesthetic technique

As per the given case, patient has a medical history of hypertension and angina. Mr. Orange is taking medications for it. Patients suffering from hypertension are generally asymptomatic. It is a common medical issue that is faced by many individuals across the world. It has been found that if blood pressure is greater than 160/100, then it presents case of hypertension (Cecconi, Corredor and Rhodes, 2013). While working as surgical Practitioner, to deal with the given situation I would be providing anaesthesia and certain questions would be asked to them so that patients exact mental condition could be analysed.

Before providing anaesthesia, patient should be asked about their medical history regarding illness which may include heart issues, kidney failure etc. It is important to find out the extent of hypertension as well because according to that only anaesthesia could be induced into body else the whole body would have side effects leading to issues like state of being in comma, mental issues and many more.

Patients like Mr. Orange require treatments on urgent basis. Some of the techniques that could be utilised are discussed below:

General Anaesthesia

it is basically utilized so that unconscious state could be created. For this, variety of medications are available that could be used such as pain killers, aesthetic vapours etc.

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Monitored Anaesthesia care

It is generally used by the surgeons in case when they are required to perform surgeries and close observation is required to carry out for identifying problems (Ghignone, Van Leeuwen and Ugolini, 2016). Patient's cooperation is much needed in such cases.

to critically evaluate how a duty of care is met in practice

In health care premises, it is very essential to identify potential factors that could affect implementation of services and support in the organization. Thus, basic function for the authorities is to identify extent to which risk can cause harm and its probabilities that it would occur again in the near future. If chance of occurrences for specific issue is more, then huge attention is required to be given to them considering its seriousness. According to the Arulkumaran, Corredor and Cecconi, (2014), breaching of duty of care could arise several issues. Relationship between a doctor and patient is needed to be healthy. When there is good communication between them, it becomes easy to handle health issues (Arulkumaran, Corredor and Cecconi, 2014).

When there is involvement of patients in the entire treatment procedure, then things become easy to identify and provide medications accordingly. Medical errors have come into existence over the few years which is required to be dealt off properly because medical errors could raise issues. Thus, doctors should be provided with trainings so that they could have enough knowledge about providing services to the clients. They should be also taught about how to use updated equipments because technology advancement has given rise to many new treatment opportunities and has increased life expectancy as well (Martin, Jacob and Kurz, 2013). It is the responsibility of authorities only that patients are provided with all the safety measures along with quality medications without being biased on any grounds.

reflect upon the practitioner's professional boundaries and link them to a duty of care

While working within health care organizations, there are certain limitations that comes across in working procedures. It is always appreciable to build healthy relations at workplace among employees and patients. But it is also necessary that it should be build in such a way that basic requirements of the service users are met. Nurses and doctors are not allowed to have personal relationships with the patients while serving their duty of care (Okabayashi, 2014). Socialization should be in such a way that set boundaries by the hospital authorities should not get crossed.

Professional boundaries should not get violated and if it is found then responsible person should be reported. Customers information and details are available to the healthcare organizations and it becomes very essential to maintain confidentiality because nobody has rights to breach someone's privacy. It is also needed to ensure that quality services are being provided to all the users without being biased and discriminated on any basis.

One should also ensure that people should not be engaged into making personal benefits by charging high fees and inappropriate financial transactions (Umpierrez, 2013). It is also needed to ensure that transparent working practices is ensured within the organization so that nobody could engage themselves into misconduct behaviours at workplace.

to critically evaluate how the scrub practitioner contributes to safer surgery

In healthcare organisation, the role of scrub practitioners could be defined as providing assistance to the surgeons in the surgical process so that patient's care in an appropriate manner could be ensured. It is thus required that staff involved into these practices gets high competencies.

Scrub Practitioners are basically engaged into providing care to the customers in the procedure of operations (Gerrits, 2013). For this, they are required to carry out checks on needle, instruments, equipments that would be used during surgery are of optimum quality. Needles are needed to be new every time and it should be ensured that pre-used injections should not be utilized again. As per the surgeon's specifications, specimens are needed to be handled with care properly. They are also engaged into safer disposals of all the sharps according to the hospital’s policies.

Scrub practitioners looks upon proper management of equipments and clinical wastes get disposed properly. Patients dignity and privacy should be maintained (Harris and et.al., 2015). They hold private details of the clients which is needed to be maintained confidential by the hospital authorities only. Practitioners could contribute into this segment.

to reflect upon the role of the circulating person and how their actions lessen the risks in the surgical swab counts

Circulating person also has associated responsibilities which is required to be performed by them. They are needed to check proper functioning of all the machineries and equipments in the healthcare organisations. They are needed to investigate that operation theatre are clean after surgeries. Scrub practitioners are assisted by circulating person in setting up operation theatre so that all the necessary requirements could be made available to them (Gili-Miner, 2014). On the Operation table, they are needed to place clean bed-sheet. Thus, they are engaged into maintaining nursing care and act as support system in the surgical team. They are not necessarily required to be present in the room during operation, thus they could move outside as well and collect information.

They are also engaged into observing possible errors that may occur during the surgery which may include use of injections that have been previously used, providing anaesthesia to the patients, etc. (Laflamme and et.al., 2015). In the given case, Mr. Orange is a patient which could be assisted by circulating nurse in his treatment to ensure he does not get aggressive and if the situation arise, necessary actions could be taken up to control him. They help patients from getting harmed by others as well as also look upon them that they do not cause damage to their health.

Conclusion

From the above report, it can be concluded that in health care organisations, it is very essential for all the professionals to be provided with proper trainings so that they could be able to handle situation and patients properly. Scrub practitioners and circulating persons have associated job responsibilities such as assisting surgeons in the operation theatre, observing them so that possible errors could be controlled, etc. Effective communication with patients helps in building good relations with the patients and is also beneficial in identification of problems from which they are suffering.

References

  • Arulkumaran, N., Corredor, C. and Cecconi, M., 2014. Cardiac complications associated with goal-directed therapy in high-risk surgical patients: a meta-analysis. British journal of anaesthesia.
  • Atkinson, R. A and et.al., 2017. Management and cost of surgical site infection in patients undergoing surgery for spinal metastasis. Journal of Hospital Infection.
  • Beam, E., Keating, M.R. and Razonable, R.R., 2016. A survey of infection prevention and control practices among hematopoietic stem cell transplant centers. infection control & hospital epidemiology.
  • Bruno, E and et.al., 2017. An Evaluation of Preparedness, Delivery and Impact of Surgical and Anesthesia Care in Madagascar: A Framework for a National Surgical Plan. World journal of surgery.
  • Buckley, L. F and et.al., 2016. Invited Commentary: Initial Experience with Direct Oral Anticoagulants in the Perioperative Setting. Current Emergency and Hospital Medicine Reports.
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