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Postoperative Care

  • Postoperative Care ;

Postoperative care is the management of a patient after surgery. This includes care given during the immediate postoperative period, both in the operating room and the post anesthesia care unit (PACU), as well as during the days following the surgery. In the immediate postoperative period, the patient should not be left unattended immediately after the surgery in her drowsy state. The scrub nurse should clean the patient’s operative area with the antiseptic solution and dressing of the incisions should be performed preferably with wash proof dressing. The patient is transferred to a specialized area for monitoring, such as the post anesthesia care unit and may continue after discharge until all activity restrictions have been lifted (Waldmann, Rhodes, Soni, & Handy, 2019). 

Upon admission of a patient to the PACU, the nurse’s priority assessment is respiratory adequacy. Physiologic status of the patient is always prioritized with regard to airway; breathing, and circulation, and respiratory adequacy is the first assessment priority of the patient on admission to the PACU from the operating room. Following assessment of respiratory function, cardiovascular, neurologic and renal function should be assessed as well as the surgical site…………………………………………………………

Phase I of PACU is an area designated for care of surgical patients  after surgery and for patients whose condition warrants close monitoring. Phase II of PACU is an area designated for care of surgical patients who have been transferred from a phase I PACU because their condition no longer requires the close monitoring provided in a phase I PACU. Phase III of PACU is a setting in which the patient is cared for in the immediate postoperative period and then prepared for discharge from the facility. Discharge from

PACU is based on patent airway; Patient awake (or baseline); VS baseline or stable; No respiratory depression; Oxygen saturation greater than 92%https://www.healthline.com/health/postoperative-care. Pain management; No excess bleeding or drainage; Report given. Modified Aldrete Scoring System is used to assess patient’s transition from Phase I to Phase II, discontinuation of anesthesia to return of protective reflexes and motor function, and a score of 9 or 10 indicates readiness for transfer or discharge to the next phase of recovery (Waldmann et a).

Hand off report

This requires effective communication between health care professionals. On arrival to the postoperative care unit, the anesthesia provider and circulating nurse give the receiving nurse a verbal hand-off report to communicate the patient’s condition and care need. The receiving nurse takes time to report back the information to verify what was said and to make certain both reporting person and the receiving nurse have the same understanding. The receiving takes the time to ask questions and the reporting professional must respond to the questions until a common understanding is established.

Postoperative Hand Off Report of the patient should have the type and extent of surgical procedure, type of anesthesia, and length of time the patient is under the anesthesia, how the patient tolerate it, allergies (especially latex/drugs), any health problems or diseases, O2 rate, status of vital signs, temperature, type and amount of IV fluids and drugs administered, estimated blood loss, any complications while in OR, any immobility’s, preoperative drugs and patient’s response, primary language the patient speaks, sensory impairments, communication difficulties, special requests, what was the anxiety level before surgery, respiratory function, medical history, substance history, location and type of surgery, dressings, catheters, tubes, drains, or packing, intake and output, lab values/complications.…..

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