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- by mumoffour May 24, '08Hi all , im new not sure really if im allowed on here im training as an ODP i need to follow a patient from pre op to well being. the placement im in at the mo are a bit funny about student leaving the department. i have asked for a few weeks to go to a pre op clinic but no one is listening to me. so i wondered if anyone could help here. what happens at the pre op clinic. is it
bloods not sure what for though?
urine again for what ?
patients medical history , allegries, medication
could anyone please tell me if im on the right lines thanks very much in advance violet:bowingpur
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- May 24, '08 by Silverdragon102Hi Violet
Not sure why you think you can't post here, all are welcome
They shouldn't stop you from following a patient, you have a criteria to learn and tick boxes to tick and generally students should be allowed to meet their needs. Do you have a tutor or preceptor you can talk to?
You are a on the right lines with what happens in a pre op clinic. It is generally to make sure the patient is fit for surgery. I also had a ECG done when I went for my pre op and sometimes CXR can be done. They may also swab for MRSA, I can not remember a urine test being done
- May 24, '08 by XB9SHiya Violet, welcome to allnurses.
There are lots of good stuff out there. Leeds have a good site for pre-assessment information
I run a pre-op assessment clinic so I will talk you through exactly what is done to our patients, hope it helps.
Basically the pre-assessment is to make sure the patient is fit for an anaesthetic.
Our patients get Height, weight then BMI estimated.
They then get a full assessment either by a Nurse practitioner or Doctor, this entails,
Presenting complaint, what they are having surgery
History of Presenting complaint, including how long, what symptoms / problems they experience and effects it has on thier day to day living
Past medical history, in particular any medical history that may affect anaesthetic, heart or lung disease, recent CVA that type of stuff. Also surgical history and if they have had any anaesthetic problems.
Medication history and allergies, what drugs they take and for how long
Family and social history especially anything that may affect discharge dates, do they need social service input post op so it can be started pre-op. Any family history of disease, I work with an endocrine surgeon so family history is vital. Smoking and drinking habits and I refer to smoking cessation if they give indication they want to quit. Also referals to dieticians if they have a high BMI
They then have an examination which focuses on cardiac and respiratory, to make sure they are fit for anaesthetic. We listen to lung and hear sounds and do a full cardiac and respiratory examination. We have cardio-pulmonary testing at my facility so they can be assessed with this as well.
They have full vitals, blood presure, pulse, temp, urine dip, spirometery. ECG if over 50 or have cardiac history and bloods according to the NICE guidence.
If ther are any concerns they are referred to the appropriate specialist for further investigations, this can include ECHO, radiology, cardiology review, further anaesthetic assessment.
They are given in depth information about thier surgery and anaesthetic risks and are given patient information leaflets to take away.
There is a great deal of literature available about best practice for pre-op assessment and this is what we follow, we use the NICE guidlines for investigations but also use clinical judgement if there are any concerns.
If you need anything else give me a shout.
- May 24, '08 by cariadthey also do a pregnancy test on every age appropriate female prior to surgery over here. also, consent forms are signed at the doctor's office prior to the admission, and patients are given copies of privacy practices and what their rights are.
- May 24, '08 by XB9SWe don't do a pregnancy test mainly because the pre-assessment may tke place up to 12 weeks prior to surgery. Any longer a new assessment will be needed but lots can happen in 12 weeks so a preg test wouldnt be valid. In the UK most pre-assessment units will follow the NICE guidence.
The thing with NICE is that it advocates minimal tests, so if you are a fit healthy person going for a procedure such as a hernia repair you may not have bloods taken at all.
- May 24, '08 by RGN1:wlcmggrp:
No reason why you can't post - I'm sure I'm not the only one who is happy to share with related fields!!
Our pre-assessments are a little closer to the surgery taking place (within 7 days) and are generally for patients undergoing joint replacements or other major surgeries.
We do the usual general assessment, clinical obs, weight, previous history etc.
We take a full blood count, urea & elctrolytes as a basic set. To that may be added group & save/cross match & coagulation screens as indicated.
We do a "dipstick" urine and if that shows anything abnormal then we'll take an MSU. If the surgery is urology or gynae then we do the MSU regardless.
We also discuss if the patient requires any social services on discharge & start the ball rolling if they do.
We take MRSA swabs if indicated - e.g. patient has had recent hospital admissions elsewhere, or has a history of MRSA or has come from a nursing home. There is talk of swabbing everyone but that hasn't started yet.
I think it's mean that they won't help you in this but i hope we have given you the general idea. as you can see there are variations on the theme but the basics are the same.
Sharrie has given you some great links too.
Hope to see you on here again!
- May 24, '08 by mumoffourThank you so much for the welcome and the answers i can see im going to be on this site all the time now i have found it. Violetxx
- May 26, '08 by FonenurseHello and welcome - great to see a new face! Apologies for the delay in responding - have been mega busy. We do telephone assessment to avoid patients having to come up to hospital, and only invite those with more complicated histories to visit the hospital.
- May 26, '08 by mumoffourThank you all so much for your support Violetxxbowingpur