Running Head: PERIOPERATIVE NURSING 1

Safety and Quality in Perioperative Nursing Care

Jennifer Mynhier
Ferris State University

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Safety and Quality in Perioperative Nursing Care
There are many important aspects that go into safety and quality of care in the
perioperative setting. There have been many studies done to gather evidence on procedures of
best practice for the surgical process. Perioperative nursing includes the preoperative period, the
operation itself, and the postoperative period.
Content
Safety is a huge concern with surgical nursing. The most imperative safety issue is proper
use of surgical asepsis. According to Hopper and Moss (2010), there are 1.7 million hospital
acquired infections each year in the United States, and 22% of these infections are related to
surgical site infections (SSI). This article explains that SSIs and other hospital acquired
infections cause an increase in hospital stays, therefore increase in expense of any particular
patients care. There are different types of breaks in sterile technique that can occur, such as a
hole in the glove, or bringing any sterile item below waist level. When such issues happen, the
problem must be assessed to figure out what may have been contaminated and what to do to fix
the issue (Hopper & Moss 2010). It is typically common knowledge that sterile technique is
important, reading this article provides a new understanding of what exactly it means, and how
many different possibilities that can occur that have the potential to cause infection in the patient.
As stated by Morton (2012), another aspect of care to help with the safety and recovery in
relation to surgical procedures, is managing fluids appropriately. According to the article, when
being used for irrigation and distension media, the temperature of the solution, the positioning of
the patient, assessing for allergies to solution, also the amount and type of fluid used in the
patients IV are all important considerations to be monitored (Morton, 2012).
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There are many aspects to surgical nursing that are important to quality of care of each
individual patient. There is preoperative care which includes prepping the patient for the
procedure physically and mentally, and which also includes teaching opportunities, such as deep
breathing exercises or muscle movements that the patient may need to do after the procedure to
help with the recovery process. Postoperative care is also necessary and this would include
frequent vital sign checks and neurological checks to make sure the patient is recovering well
from the surgery.
One teaching opportunity mentioned involves nutritional considerations. According to
Monahan (2012), there is a growing epidemic of obesity in the US, and patients being
overweight can affect many aspects of patients quality of life, and this can include recovery
from surgery. The care team is at risk for physical injury while moving patients, if the patient has
elevated blood sugar due to obesity related diabetes, this can affect the healing of the wound
(Monahan, 2012). This article also explained that other issues that can be related to obesity
include oxidation and inflammation which can also cause interferences in the healing process as
well.
Theory
The Nursing Theory from the textbook that is most related to perioperative nursing is
from 1979 by Margaret A. Newman. Her central theme explains that Nursing interventions are
focused, using a total-person approach to the patient care to help individuals, families, and
groups attain and maintain wellness (Taylor, Lillis, LeMone, & Lynn, 2008, p. 75). This also
relates back to the General Systems Theory which focuses on the aspect of many parts making
up a whole. When caring for a patient in a perioperative setting, and also in general care, it is
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important to treat the whole patient, this can include physically and mentally, patient safety and
environment; it also includes the patient and their support system.
Conclusion
Regardless of what a patient is being treated for or why, they should always be treated in
a way that best addresses safety to the patient, safety to the worker, and quality of the care given.
I believe that the patient will not have the best outcomes if they are not cared for in all possible
ways within our nursing scope. Important aspects to consider when working as a perioperative
nurse include surgical asepsis, pre- and post-op teaching, and fluid management. It is also
essential to care for the patient as a whole being and not just a leg amputation, a valve
replacement, or a colonoscopy, for instance.


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References
Hopper, W., & Moss, R. (2010). Common breaks in sterile technique: clinical perspectives and
perioperative implications. AORN Journal, 91(3), 350-367. doi:http://0-
dx.doi.org.libcat.ferris.edu/10.1016/j.aorn.2009.09.027 Retrieved from CINAHL.
Monahan, J. (2012). Perioperative nurses and nutrition. AORN Journal, 96(4), 438-442.
doi:http://0-dx.doi.org.libcat.ferris.edu/10.1016/j.aorn.2012.07.014 Retrieved from
CINAHL.
Morton, P. (2012). Implementing AORN recommended practices for minimally invasive
surgery: Part I. AORN Journal, 96(3), 295-314. Retrieved from CINAHL.
Taylor, C., Lillis, C. LeMone, P, & Lynn, P. (2008). Fundamentals of nursing: The art and
science of nursing care (7
th
Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.