Enhanced Recovery After Surgery (Eras) Are A Relatively

As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative

S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.

A nurse-driven protocol is the recommended tool to be used by the nurse to remove catheters without orders following set CDC guidelines and prevent CAUTI

On 01/27/2016, I observed about 22 patients in Postanesthesia Care Unit. Some of the patients were observed after surgeries while others were observed after endoscopy. During my shift, I observed patients awaiting recovery for removal of kidney stones, malignant melanoma (removal of moles), Endometrial Biopsy (EBX), superficial femoral artery (SFA), Hernia repair, Oophorectomy (ovary removal surgery), Cardiorrhaphy (Ventricular repair), Cystolithalopaxy (bladder stone removal), gall stone removal, Ectopic pregnancy surgery, and leg surgery.

First of all, gather all the information, such as facility policies and procedures. Research should be evidence-based. Why is it being implemented? How will we be affected? Perhaps other hospital's data could help in presenting the new procedure and how they implemented

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

Best practice guidelines are evidence-based recommendations that assist practitioners with assessment and management of appropriate healthcare (Taylor, 2012). One area that utilizes best practice to ensure excellent patient outcomes is ostomy care. The patient may have an ostomy for a number of reasons. They can be either temporary or permanent and are for patients who have bowel or bladder cancer, inflammatory bowel or diverticular disease, trauma, or perforation of the bowel. For ostomy care, it is important to focus on the areas of pre-operative, post-operative and discharge care (Taylor, 2012).

The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.

Due Date: Document will be due at the committee’s second meeting from now. If the committee

GDT has been found to be the pillar upon which the Enhanced Recovery after Surgery (ERAS) program is built upon. The downside of this technique is that it does not work well for bedside applications and most specialists do not allow the use of this method on a day-to-day basis. In the past few years, the use of GDT policies has been suggested as an important part of the ERAS package. The main concept of this plan is to have a myriad of solutions that will automatically lead to a better result in magnitude (Trinooson & Gold, 2013). Most of the studies, however have analyzed the effect and impact of implementation of the ERAS program. With regards to this shortcoming, it can be conclusively said that the outcome of using GDT mediation cannot be seen

This article looks at negative effects after surgery that can be avoided by ambulating patients early. The purpose of this study is to provide evidence to the outcomes of mobilizing patients versus not mobilizing them. The article states that

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

Pain can be categorised as either acute pain or chronic pain. Acute pain is short lasting and will commonly subside once healing has taken place (Mac Lellan 2006). It is often a sudden onset and usually lasts less than 6 months. The main example of acute pain would be the pain experienced post surgery. Chronic pain on the other hand is a prolonged and persistent pain that remains long after the normal healing process of 3- 6 months. A common example of such a pain would be chronic back pain (Mac Lellan 2006). For the purpose of this assignment, the management of acute pain post surgery will be discussed with reference to a particular scenario, which followed the care and pain management given to a patient post appendectomy.

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional