POSTOPERATIVE BENEFITS OF REGIONAL ANESTHESIA IN JOINT REPLACEMENTS
Laurie Joyce
Curry College
Introduction The focus of my academic paper is to discuss how regional anesthesia benefits patients in the postoperative phase of recovery after undergoing a joint replacement. A comparison of what general anesthesia and regional anesthesia entails will be discussed including the benefits, the risks, and the complications. This paper will also show the importance of incorporating preoperative education into a patient’s plan of care. The outcome is that patients will have a better surgical experience. Background Joint replacement surgery
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Because of the decreased amount of medication that is required there is less incidence of nausea and vomiting or confusion. They require less opioid medications because regional anesthesia is achieved by instilling numbing medication around the spinal nerves in the lumbar spine area. The benefit of this is that regional anesthesia wears off slowly giving twelve to twenty-four hours of pain relief. Patients are able to ambulate earlier because of less sedation, decreasing their chances of developing deep vein thrombosis and have a better ability to participate in rehabilitation because of minimal to no …show more content…
Patients have fears and misconceptions about what to expect. Patients need clear simple answers regarding what is actually going to happen. Starting weeks before surgery, written and verbal teaching helps patients tremendously in preparation of a surgery that can causes significant pain and other unpleasant side effects. Active participation in your care is an important aspect of patient teaching. This allows patients to have all the information needed in order to make an informed decision about their care. In study Wilson, Watt-Watson, Hodnett, & Trammer (2016) it was found that the use of written and verbal educational material was beneficial to patients undergoing a joint replacement but the teaching couldn’t stop there. This was just the starting point. Through research trials it concluded that the preoperative educational tool was helpful but it was just the starting point. The patient teaching and patient evaluation needed to be incorporated into the entire process from preoperative interview, through the surgical procedure and into the postoperative recovery phase with continual reevaluation and reinforcement by all professionals involved in the patient
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The teach-back method is an evidence-based practice used in patient education. Clinicians use teach-back to educate patients about health information and enable them to “subsequently evaluate whether learning has occurred” (Tamura-Lis, 2013, p. 267). Teach-back checks for patient understanding of medical diagnosis, treatments, and instructions regarding disease complications (Tamura-Lis, 2013, p. 269). Patients become knowledgeable about their disease process and consequently, teach-back promotes clarification and prevents communication errors. It is important to hospital-based nursing because it optimizes patient learning and comprehension (Tamura-Lis, 2013, p. 270). Ultimately, teach-back helps improve quality care, safety, and patient satisfaction (Tamura-Lis, 2013, p. 271).
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It will seek to demonstrate the appropriateness in supporting the patient and their family, whilst reflecting upon personal experience, and how literature may influence the healing effectiveness. The factors that enhance and inhibit the learning environment will be explored and suggested techniques to improve clinical learning will also be discussed. Finally the nurse-patient learning relationship will be explored along with the application of teaching and learning strategies will be examined.
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Brody, Michael, and Donald Martin. “The Role of Anesthesiologists.” Physicians Protecting Patients. N.p. N.d. Web. October 21, 2015. An anesthesiologist is a physician who has received at least 8 years of schooling and has completed a residency program dealing with anesthesiology. Now, a licensed physician, an anesthesiologist deals with the administration of anesthesia during many medical procedures, including surgical or obstetric procedures, and pain management for acute and chronic illnesses, or cancer related pain. Anesthesiologists are also in charge of “anesthesia care teams” that include the anesthesiologist, an anesthesia assistant, certified registered nurse anesthetist, and an anesthesia technician. As the leader of the care team, the anesthesiologist is responsible for assessing the patient before, during, and after medical procedures, as well as developing and monitoring performance and quality of practices and standards in regards to administering anesthesia. The entirety of
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
The goal of my learning plan is to promote health maintenance and restoration for hip or knee replacement surgery patients by providing patient education sessions and information pamphlets on post-operative pain and swelling management between the periods of week 8 to week 10. During the implementation process of my learning plan I used the Community Health Nurses association’s standard as a guide to help me advance with the production and presentation. I focused my learning plan on the standard of health maintenance, restoration, and palliation under the category of promoting health. This standard can be defined as “providing clinical nursing, palliative care, health teaching and/or counseling to individuals and families as they experience illness and life crisis…” (Peter, Sweatman, & Carlin, 2012, p. 66) I am doing a teaching session and pamphlet for my learning plan which is included in the area of health teaching. Peter et al also described the possible outcomes of this process which is to encourage participation of patient and family members to engage in the development of their care plan by maximizing their capacity to take responsibility for and manage their own care. (Peter et al, 2012, p. 66) I hope the implementation of my learning plan can educate the patients so they can understand more about their health and gain knowledge on types of interventions they can use at home to enhance their recovery. For example, if the patient feels pain and swelling at home, they will be able to have the knowledge that they can use ice to help reduce the pain and swelling. I followed the CNO’s ethics practice standard. This standard stated about respecting client’s choice and ensuring privacy and confidentiality during the caring process...
Perioperative nursing is a specialized area of practice that works with patients before (preoperative), during (intraoperative) and after (postoperative) surgery (Potter et al., 2013). It is pra...
As a medical surgical nurse you work with your patients before, during, and after surgery. Before surgery you want to explain the procedure to them and help prepare...
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
I am now more comfortable playing roles such as the initiator and recorder. Furthermore, I now know the scope of practice of professionals like occupational therapist, physical therapists and social workers. Attending the Help Save Stan simulation also had a positive impact on my learning. In the ‘Simena’ simulation, I saw a resident who was experiencing difficulty in communicating with a patient, due to his belief that the patient was drunk and dependent on pain medication. From this scenario, I was able to identify the need for professionals to listen to patients without making assumptions because patients are the expert of their own symptoms and have all the key data (Warren, 2015). Again, in the ‘Say what’ simulation, I was able to identify how communication affects patient safety. In this scenario, I received a change of shift report with some vital details missing. Since safe clinical handover is a requirement for safe patient care, the use of structured communication tools, such as SBAR (situation, background, assessment and recommendation) will provide a framework for providing key information (Guadine & Lamb,