REVIEW OF RELATED LITERATURE

Preoperative Nursing Management

By: Daisy Jane, RN, MN
Summary:
The article presented the important points to be considered during the preoperative phase.
A holistic preparation of the patient has been emphasized. The preoperative phase of the surgical
experience is the determinant as to the outcome of the surgery. The health care team to whom the
patient has entrusted himself/herself should be knowledgeable, skilful, and righteous enough to
put the patients welfare as their prime importance. The preoperative phase is composed of varied
assessment and preparation in order for the patient to be fit for surgery. This stage includes
assessment of the baseline parameters of the patient, conducting the preoperative interview and
preparing the patient for the type of anaesthetic that is to be administered on the day of surgery. It
is in the preoperative phase in which the nurse initiates the nursing care plan, wherein goals are
established by the nurse together with the patient and his significant others. The following should
be given emphasis in creating the care plan and teaching plan: assessment and correction of
physiological and psychological problems, provision of a complete learning and teaching
guidelines for the patient and their significant others regarding the surgery, instruction and
demonstration of exercises that will help the patient postoperatively, and discharge planning and
projected lifestyle changes due to surgery.
Physiologic assessment during the preoperative phase includes obtaining health history
and performing physical examination. This is done in order to establish a baseline data which
may be useful for future comparisons. Diagnostic examinations are also conducted during this
phase.

Psychological Assessment should also be taken into consideration most especially that
undergoing a surgery is a very stressful experience and intervention should be provided for prior
to surgery.
Critique:
Indeed the article presented the most ideal preoperative preparation of patients. It is really
encouraging to know that there are hospitals who are conducting such comprehensive
preparation. Which is really the right way, after all a well prepared patient ensures better patient
outcomes. It is sad on one hand since such practice has not been fully implemented in the
hospital where I am currently working for. Although, the hospital has been considered as tertiary
but there are various procedures that needs a lot of revising and updating at the same time. The
mere fact that leaflets are not even available for patient education is really saddening. This is the
reason why the investigators proposed the utilization of the leaflet as the means and tool for
patient education. This will certainly aid the nurses in the provision of education among patients.
Perhaps in this simple way, the leaflet would somehow assist the very limited number of rotating
staff in the unit; this by far would provide the salient information needed by cataract surgery
patients both pre and post operatively.