Perioperative Nursing
The special field known as perioperative and perianesthesia nursing includes a wide variety of nursing
functions associated with the patient’s surgical experience during the perioperative period.
Perioperative and perianesthesia nursing addresses the nursing roles relevant to the three phases of the
surgical experience: preoperative, intraoperative, and postoperative
The preoperative phase
It begins when the decision to proceed with surgical intervention is made and ends with the transfer
of the patient onto the operating room table. The scope of nursing activities during this time can
include establishing a baseline evaluation of the patient before the day of surgery by carrying out a
preoperative interview
1) ensuring that necessary tests have been or will be performed (preadmission testing), arranging
appropriate consultative services, and providing preparatory education about recovery from
anesthesia and postoperative care.
2) On the day of surgery, patient teaching is reviewed, the patient’s identity and the surgical site are
verified, informed consent is confirmed, and an intravenous infusion is started.
3) If the patient is going home the same day, the availability of safe transport and the presence of an
accompanying responsible adult is verified.
Preadmission Testing
Initiates initial preoperative assessment
Initiates teaching appropriate to patient’s needs
Involves family in interview
Verifies completion of preoperative testing
Verifies understanding of surgeon-specific preoperative orders (eg, bowel preparation, preoperative
shower)
Assesses patient’s need for postoperative transportation and care
Admission to Surgical Center or Unit
Completes preoperative assessment
. Assesses for risks for postoperative complications
Reports unexpected findings or any deviations from normal
Verifies that operative consent has been signed
Coordinates patient teaching with other nursing staff
Reinforces previous teaching
Explains phases in perioperative period and expectations
Answers patient’s and family’s questions
Develops a plan of care
In the Holding Area
Assesses patient’s status; baseline pain and nutritional status
Reviews chart
Identifies patient
Verifies surgical site and marks site per institutional policy
Establishes intravenous line
Administers medications if prescribed
Takes measures to ensure patient’s comfort
Provides psychological support
Communicates patient’s emotional status to other appropriate members of the health care team
The intraoperative phase begins when the patient is transferred onto the operating room table and
ends when he or she is admitted to the postanesthesia care unit (PACU).
Maintenance of Safety
Maintains aseptic, controlled environment
. Effectively manages human resources, equipment, and supplies for individualized patient care
Transfers patient to operating room bed or table
Positions the patient : Functional alignment Exposure of surgical site
Applies grounding device to patient
Ensures that the sponge, needle, and instrument counts are correct
Completes intraoperative documentation
Physiologic Monitoring
Calculates effects on patient of excessive fluid loss or gain
Distinguishes normal from abnormal cardiopulmonary data
Reports changes in patient’s vital signs
Institutes measures to promote normothermia
Provides emotional support to patient
The postoperative phase begins with the admission of the pa- tient to the PACU and ends with a
follow-up evaluation in the clinical setting or at home
Postoperative Assessment Recovery Area
Determines patient’s immediate response to surgical intervention
Monitors patient’s physiologic status
Assesses patient’s pain level and administers appropriate pain relief
Maintains patient’s safety (airway, circulation, prevention of injury)
Administers medications, fluid, and blood component therapy, if prescribed
Provides oral fluids if prescribed for ambulatory surgery patient
Assesses patient’s readiness for transfer to in-hospital unit or for discharge home based on
institutional policy
Continues close monitoring of patient’s physical and psychological response to surgical intervention
Assesses patient’s pain level and administers appropriate pain relief measures
Provides teaching to patient during immediate recovery period
Assists patient in recovery and preparation for discharge home
Determines patient’s psychological status
. Assists with discharge planning
