Perioperative Nursing and Safety

Laurisha Faurisma Chamberlain College of Nursing NR 103: Transition to the Nursing Profession Spring 2020

Perioperative Nursing and Safety

Safety in the hospital encompasses protecting patients from any risks or dangers that could harm them as well as preventing such risks. Without safety in the hospital, there is no order and structure on how to properly execute procedures, leading to preventable mistakes. In surgery, where someone’s life is on the table, safety is paramount above everything. As noted, “patient safety concerns being a public health issue, it caused for an immediate response” (Banschbach, 2016, p. 161).

The importance of patient safety in perioperative nursing cannot be overstated. Perioperative nurses play a crucial role in ensuring the safety of patients before, during, and after surgery. This involves rigorous adherence to safety protocols, continuous monitoring, and effective communication among the surgical team. According to the Joint Commission, a comprehensive approach to patient safety includes making hospitals become learning organizations, acknowledging the critical role of hospital leaders, and fostering a culture of safety (Banschbach, 2016).

The Role of Perioperative Nurses

Perioperative nurses are tasked with numerous responsibilities that directly impact patient safety. Their duties include:

1. Preoperative Assessment and Preparation: Ensuring that the patient is physically and psychologically prepared for surgery. This includes verifying patient identity, obtaining informed consent, and reviewing medical history and current medications.
2. Intraoperative Care: Assisting the surgical team by maintaining a sterile environment, monitoring the patient’s vital signs, and ensuring all surgical instruments are accounted for.
3. Postoperative Care: Monitoring the patient for any signs of complications, managing pain, and educating the patient and their family about post-surgical care and recovery.

Safety Protocols in Perioperative Nursing

The implementation of safety protocols is critical in perioperative nursing. These protocols include:

• Surgical Checklists: The use of checklists before, during, and after surgery to ensure all steps are followed correctly. The World Health Organization (WHO) surgical safety checklist is a widely adopted tool that has been proven to reduce surgical complications and mortality.
• Time-Out Procedures: A mandatory pause before surgery to confirm patient identity, the surgical procedure to be performed, and the site of surgery. This practice helps prevent wrong-site, wrong-procedure, and wrong-patient surgeries.
• Infection Control: Strict adherence to sterilization and aseptic techniques to prevent surgical site infections. This includes proper hand hygiene, sterilizing instruments, and using appropriate personal protective equipment (PPE).

Case Study: Safety in Practice

A personal experience that I have relating to safety in healthcare is from my time working as a nursing assistant in a rehabilitative nursing home. One day, while doing my rounds, I encountered a situation where a patient was at risk of falling due to improperly set bed rails. Recognizing the danger, I immediately alerted the nursing staff and secured the patient, thereby preventing a potential injury. This experience underscored the importance of vigilance and prompt action in maintaining patient safety.

Leadership and Safety Culture

Effective leadership is essential in promoting a culture of safety within healthcare organizations. Hospital leaders must prioritize patient safety by:

• Encouraging Reporting and Transparency: Creating an environment where staff feel comfortable reporting errors and near misses without fear of retribution. This transparency allows for the identification and mitigation of potential safety hazards.
• Investing in Education and Training: Providing continuous education and training for healthcare professionals to keep them updated on the latest safety protocols and best practices.
• Implementing Safety Systems: Developing and maintaining robust safety systems, such as electronic health records (EHRs) and automated medication dispensing systems, to reduce human error and improve patient outcomes.

Technological Advances in Perioperative Safety

Technological advancements have significantly enhanced perioperative safety. Innovations such as:

• Robotic Surgery: Robotic-assisted surgeries offer greater precision and control, leading to fewer complications and faster recovery times for patients.
• Advanced Monitoring Systems: Continuous monitoring systems that provide real-time data on a patient’s vital signs during surgery, allowing for immediate intervention if necessary.
• Telemedicine: Enables perioperative consultations and follow-ups, ensuring patients receive timely care and reducing the risk of postoperative complications.

Patient Involvement in Safety

Patient involvement is a crucial aspect of ensuring safety in perioperative care. Educating patients about their surgical procedures, potential risks, and postoperative care empowers them to take an active role in their health. Encouraging patients to ask questions, voice concerns, and participate in decision-making processes helps to identify and address potential safety issues.

Conclusion

Perioperative nursing and safety are integral to achieving positive patient outcomes in surgical settings. By adhering to established safety protocols, fostering a culture of safety, leveraging technological advancements, and involving patients in their care, perioperative nurses can significantly reduce risks and enhance the overall quality of care. The importance of leadership in promoting safety cannot be overstated, as it is essential for creating an environment where patient safety is a shared responsibility and a top priority.

Through continuous education, effective communication, and a commitment to excellence, perioperative nurses play a vital role in safeguarding patient health and ensuring successful surgical experiences. As the healthcare landscape continues to evolve, the focus on patient safety must remain steadfast, with ongoing efforts to innovate and improve practices that protect and benefit all patients.

References

Banschbach, V. S. (2016). Improving patient safety in the perioperative setting. AORN Journal, 103(2), 161-167. https://doi.org/10.1016/j.aorn.2016.01.017

Merriam-Webster. (n.d.). Safety. In Merriam-Webster.com dictionary. Retrieved October 12, 2023, from https://www.merriam-webster.com/dictionary/safety

O’Donovan, Ward, M., De Brún, A., & McAuliffe, E. (2019). Safety culture in health care teams: A narrative review of the literature. Journal of Nursing Management, 27(5), 871–883. https://doi.org/10.1111/jonm.12740

Stevens, & Lee, R. (2018). The Potential to Reduce Falls and Avert Costs by Clinically Managing Fall Risk. American Journal of Preventive Medicine, 55(3), 290–297. https://doi.org/10.1016/j.amepre.2018.04.035

Tingle. (2022). Past cases provide basis to improve patient safety education and training. British Journal of Nursing (Mark Allen Publishing), 31(15), 824–825. https://doi.org/10.12968/bjon.2022.31.15.824

World Health Organization. (2023). Patient safety. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/patient-safety#:~:text=Common%20adverse%20events%20that%20may,blood%20transfusion%20and%20venous%20thromboembolism.