The Patient’s Surgical Experience
The multidisciplinary team are with the patient through their “surgical experience” in what we describe as three phases:
- Preoperative
- Intraoperative
- Postoperative
The ORNAC Standards define each of these phases as they apply to perioperative nursing practice and are known as the “Perioperative Phases of Patient Care” (ORNAC, 2021).
Preoperative Phase
The Preoperative phase encompasses the care of the patient prior to surgery. The patient should be prepared physically, mentally, and psychologically for the procedure they are about to undergo. Perioperative nursing practice in this phase focuses on patient safety through thorough preoperative assessment (physical/labs), consent for the procedure (mental), and correct patient, procedure, and where appropriate, side/site identification (psychological).
The patient should be prepared physically, mentally, and psychologically for the procedure they are about to undergo.
Intraoperative Phase
The Intraoperative phase begins when the patient is on the OR bed, or procedure table, until their admission to the postanesthetic area. The safety of the patient is critical in this phase and requires perioperative nurses to be vigilant in all aspects of care such as transference, positioning, induction (if a general anesthetic), maintenance of the aseptic environment, instrument/sponge counts, and extubation. The Surgical Safety Checklist also begins in this phase, and you will learn about that in other modules. Perioperative nursing practices demonstrate ongoing advocacy on the patient’s behalf, especially when the patient is no longer able to speak for themselves.
Postoperative Phase
Once the surgical intervention is complete the postoperative phase begins. The patient is prepared to be transferred back to their stretcher/bed and taken to the post anesthetic /recovery area. Patient safety remains the perioperative nurse’s priority with transference, positioning, communication to the receiving unit nurse on the patient’s condition and the intervention performed.
