Perioperative Nurses Act as Advocates and Provide Safe, High Quality Care - Medical Science Assignment Help

Assignment Task:

Task:

“Perioperative nurses act as advocates and provide safe, high-quality care to people when they are most vulnerable”.  

• Discuss legal,?ethical?and cultural?issues?relating to care?delivery.? 
• As patient advocates, perioperative nurses must ensure both the quality and continuity of care delivered to their surgical patients. In the perioperative setting, nurses continually assess the care of perioperative patients, attempting to ensure that patient’s physical, emotional, and ethical needs are met.
• One of the responsibilities of the perioperative nurse is to ascertain that the consent form has been completed and signed by the patient. The consent form must be signed by someone who is competent and has the legal capacity to give consent. If a patient is unable to give consent, it must be gained by a statutory health attorney. The patient must have an understanding on the procedure and can articulate it to the perioperative nurse on request (Gilbert, 2017). The non-delegable responsibility for providing necessary information and advice to the patient remains the responsibility of the treating medical officer.
• Failure to obtain the patient’s consent for a procedure may result in civil charges for assault and battery, and failure to disclose all relevant material risks regarding the procedure, can result in civil charge of negligence (Gilbert, 2017).
• Patients in the perioperative environment have an increased need for protection from adverse events and advocacy because the patient undergoing general anaesthesia or conscious sedation experiences temporary sensory and perceptual alterations or loss. Patient advocacy in the perioperative environment entails maintaining the patient’s physical and emotional comfort, privacy, rights and dignity.
• Patient advocacy in the perioperative environment can also mean ensuring that patient’s are well-informed regarding their surgery, by understanding what interventions are involved and why
• Consider how?professional standards, guidelines and?policy support nursing?practice.? 
• Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). Ethics have an integral part in nursing practice. Nurses in Australia are guided by the Code of Ethics whose purpose if to develop fundamental ethical values and standards to which the nursing profession is committed to (REF).
• The Code of Ethics for Nurses in Australia strives to protect the patient’s rights and outlines values such as kindness, respect, confidentiality and access to health care (Nursing and Midwifery board of Australia [NMBA], 2016). These ethics set standards for nurses and allows them to make ethical decisions (NMBA, 2016).
• The Code of Conduct for Nurses sets out the legal requirements, professional behaviour and conduct expectations for all nurses in Australia (NMBA, 2016). The framework acts as reference point which allows the nurse to reflect about their conduct, and guidelines in ethical decision making processes.
• Nursing and Midwifery Board of Australia (NMBA)
• Registered standards for practice
• Code of Conduct
• Scope of Practise
• ACORN states ‘perioperative nurses are aware that undertaking activities not within their scope of practice may compromise the safety of persons in their care’ (ACORN, 2020, 1, p.68).
• Discuss human factors and non-technical skills.? 
• Communication failures can lead to sentinel events in the perioperative environment. In particular, communication errors contribute to many adverse events, transfer delays, and length of stay. Performing high quality clinical handovers is integral to patient safety, especially when patients are in a vulnerable period, transitioning to different areas of care and to different providers. Within the PARU environment, the risk for handover error is significantly increased, this is due to environmental distractions, multitasking, strict theatre schedules and high patient turnover (Coleman et all, 2015).
• Communication is one of the most fundamental elements of nursing practice. Communication is defined as the exchange of information and thoughts amoung people using verbal and non-verbal means.
• SSI,
• To enhance positive communication between health professionals, a systematic approach has been implemented, such as ISBAR, an acronym for Introduction, Situation, Background, Assessment and Recommendation (Clinical Excellence Commission, 2017). By implementing ISBAR, it provides positive communication between, nurses, surgeons and anaesthetist, in a clear and concise manner, thus improves patient safety and satisfaction.
• It is the responsibility of the perioperative team to complete a surgical safety checklist, developed by The World Health Organisation (WHO). The checklist or surgical time out must be completed prior to the commencement of the procedure. This involves the entire operating team to stop and pause to check the safety list and confirm the patient’s identity, correct side of operation, the operation to be performed and allergies.
• Analyse specialist perioperative nursing roles and advanced?practice.? 
• Examine factors relating to promoting a safe?environment.?? 
• Surgical count, asepsis, hand hygiene, environmental management
• As patient advocates, perioperative nurses must assess and monitor factors that can cause harm, such as patient’s intraoperative position, equipment malfunction, environmental hazards and protect patient’s dignity and interests while they are anaesthetised.
• Perioperative nurses must intervene to protect the patient and implement strategies to reduce or eliminate adverse events intraoperatively.
• Patient positioning is a fundamental element in maintaining a safe environment for a patient and preparing them for surgery, and is the responsibility of the perioperative team (ACORN, 1, p206). The patient’s position on the operating table depends on the surgical procedure to be performed, as well as their physical condition and the maintenance of patent or protected airway. Hyperextending joints, compressing arteries or pressuring on nerves and bony prominences usually result in discomfort, pressure injury and damage, especially when the position is sustained for a long period of time (Farrell, 2017).
• Warming
• It is the responsibility of the perioperative nurse along side the surgical team to assess, monitor and manage adverse events and complications.
• The circulating and scout nurse must perform a surgical count of all surgical instruments, gauze, swabs and sponges before the commencement of surgery, on closure of a body cavity and finally as the skin is closed, is essential that no item is inadvertently retained as a foreign body.
• Demonstrate a person-centred approach to?care.?
• Compassion is regarded as the foundation of patient-centered care. When providing patient-centered care, it must be tailored to meet the needs of the patient, by considering their physical and psychological needs (Baillie, 2017). Pelzang (2010) describes patient-centred care as seeing the patient as an individual and tailoring care specifically to each individual needs. For a nurse to provide compassion, it involves recognizing and responding to each individual with empathy, whilst preserving the dignity of the patient (Henderson & Jones, 2017).
• References
• Baillie, L. (2017). An exploration of the 6Cs as a set of values for nursing practice. British Journal Of Nursing, 26(10), 558-563. doi: 10.12968/bjon.2017.26.10.558
• Henderson, A., & Jones, J. (2017). Developing and maintaining compassionate care in nursing. Nursing Standard, 32(4), 60-68. doi:10.7748/ns.2017.e10895
• Pelzang, R. (2010). Time to learn: understanding patient-centred care. British Journal Of Nursing, 19(14), 912-917.

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