01.04 Preoperative (Preop) Education

Hey guys let's talk today a little bit about the preoperative education of a surgical patient.

So education of our surgical patients is super important.  I've had to say the most important part of patient education is increasing our patients safety, but in addition to that, education is going to prepare the patient and the family for what will come which most definitely reduces the fear and anxiety that surgery can bring.  When our patients are properly educated this can really decrease the time they're in the hospital, it can decrease any postop issues and can most definitely promote quicker healing.  Patient education occurs during the entire surgical process from admission to discharge by all perioperative team members however, the majority of the education occurs before the surgery with the preoperative RN.

So just to bring home the importance of patient education a little bit further, it really increases patient autonomy, it makes patients feel like they are in control of their own health and well-being.  It helps to answer any and all questions that patients have, knowledge is power for patients, this should be included within the informed consent process.  And guys patient education should begin with the provider!  Make sure you check out the specific lesson on informed consent for more details!

So for me personally being a perioperative nurse for quite some time when I think of preoperative patient education I like to break it down in my mind into the different components that the patient is going to go through. Like I mentioned a few slides ago, the preoperative nurse will do the majority of the education but they're going to help the patient understand what is going to occur in not only the pre-op area but also in the intraoperative area (during surgery) and after the surgery or the post-operative events.

So the preoperative nurse is going to first teach the patient about things that are critical before surgery.  Patients and families like to be educated on their procedure specifics, like how long the procedure is expected to take and what they can expect afterwards.  It is okay to tell patients you will check with the provider for the best answer to these questions!  A super important part of preoperative education is the NPO status of patients.  This is critical to the surgical patient as aspiration is a risk with patients going under anesthesia.  Please know that preoperative education should start before the day of surgery especially things like when to stop eating or drinking.  Also, the preoperative nurse will discuss (with direction from the provider) the patients current medications and if and when to stop them.  Just like NPO guidelines the patient should have this education prior to the day of surgery.

Continuing with some more specifics of preoperative education the patients are often given instructions as far as preps that are necessary before their procedure.  These can include things like possibly a bowel prep if they are having a colon resection or even bathing with a specific type of soap for an orthopedic procedure.  Obviously this is something that the patient will do before surgery so as the preoperative nurse you will want to confirm with your patient that these things have been completed.  You will also teach the patient about their IV what that will entail, any testing that they may require before the procedure like a pregnancy test or x-ray, and also the type of anesthesia that they are going to have.  Education regarding anesthesia is typically discussed by someone from the anesthesia department. 

So the preoperative nurse will begin to explain to the patient what will occur during surgery or when they are brought into the operating room.  The circulating RN will continue the education and explain to the patient that they will protect their privacy and safety during the procedure.  I’ve found that explaining what will happen in the OR, applying monitors, the timeline of anesthesia before the patient is brought into the OR helps to ease anxiety.  And finally we want to educate our patients as far as how we will communicate with their family during the procedure.

Explaining to the patient what will occur after surgery preoperatively is super important because after anesthesia patients do not tend have the best memory or comprehension!  So teach your patient what they can expect in the postop area like if they might wake up with any drains or catheters, the plan for pain control, and the steps that will be taken to get the patient discharged and on their way home.

So as always with patient education you're just going to want to really encourage your patients to ask questions especially if they are unsure or confused about anything related to their surgery.  It is also a good idea to encourage the patient to repeat what they learned in a subtle way to promote their understanding.  Finally we want patients, if they are ok with it, to involve their family or support person with education for support after the procedure.

Ok guys the nursing concepts that can be applied to preoperative patient education are most definitely comfort, coping, and safety.  Remember surgery can be scary for patients so education will help them cope with the situation as well as comfort them.  Education of the surgical patient is first and foremost for their safety. 

Okay guys some key points for preoperative education, the goal is always to increase patient safety by preparing the patient, decrease anxiety and complications to help increase healing time.  Patient education is very important because it increases patient autonomy and decreases any knowledge deficits.  So to make preoperative education a little less daunting so we break the preoperative education down into the different sections, preop, intraop, and postop events.  You explain the procedure specifics, NPO status medications, any preps that they may require, diagnostic tests before the procedure, insertion of their IV and the anesthesia type.  As far as during the procedure explain the role of team members specifically the circulating RN, the application of monitoring devices that will be applied when they go into surgery, the events of the anesthesia administration, and how and when their families will be updated.  Finally guys explain the events that will occur after surgery, their expected length of stay, if they will wake up with any drains or catheters, help them understand their pain management plan, and the events that will lead up to their discharge and thereafter. 

Okay guys I hope you enjoyed this lesson on the preoperative education of a surgical patient!  Make sure you check out all the resources attached to this lesson, as well as the rest of the lessons in this course. Now, go out and be your best self today. And, as always, happy nursing!