This is the act of rendering care to children who have undergone surgical intervention and managed accordingly before discharge from the hospital. A paediatric nurse is required to provide thorough assessment of the child immediately after the surgery and continuous planned management until the child recovers.
Aims
· Provide effective management of pain
· Provide thermo-neutral environment
· Provide support for caregivers
· Provide adequate hydration
· Prevent hypoglycaemia
· Identify and manage bleeding from incisional sites
· Prevent infection and other post-operative complications
· Allay fear and anxiety
Types
· Immediate management
· Subsequent management
Requirements
a. Trolley
b. Incubator (Neonate)
c. Operation bed
d. Thermometer
e. Blood pressure apparatus
f. Pulse oximeter
g. Glucometer with strips
h. IV fluids
i. Suction apparatus with catheters
j. Pain scale tool
k. Drip stand with infusion pump
l. Prescribed medication (analgesics, antibiotics)
m. Sterile gloves
n. Examination gloves
o. Sterile gauze and cotton wool
p. Antimicrobial solution
q. Adhesive tape
r. IV cannula
s. 3-way stop cork
t. NG tubes
u. Blanket/extra sheets
v. Mackintosh with towel/bed mat
w. Vomit bowl
x. Oxygen source
Steps
1. Perform five moments of hand hygiene
2. Wheel trolley to theatre to receive child
3. Ensure verification of child by checking the name on the identification band
4. Nurse child in a warm operation bed/incubator
5. Carry out quick assessment of the airway, breathing and circulation
6. Assess for secretion and suction if necessary
7. Administer oxygen therapy if necessary 10. Ensure continuation of IV fluids
8. Observe for signs of shock and report to Surgeon if any
9. Assess for level of consciousness and activity
10. Check incision site for bleeding and reinforce dressing if necessary
11. Read through post-operation orders and management plan
12. Check for type of operation and anaesthesia used
13. Check vital signs (temperature, pulse, respiration, blood pressure and SPO2) and record every 15 minutes for the first 1hour, 30 minutes for the next 2 hours, hourly until child fully recovered
14. Administer immediate post-operative medications and record
15. Perform pain assessment and manage accordingly e.g. epidural via perfusor
16. Check vital signs (temperature, pulse, respiration, blood pressure, pain and SPO2) and record 4 hourly
17. Take note of medication administered in the theatre noting time and dosage
18. Administer due medications and record
19. Observe urinary catheters and wound drain for output
20. Monitor intake and output
21. Monitor for any adverse reaction from anaesthetic agents and intervene accordingly
22. Manage incisional site according to ward protocol
23. Reassure child, caregiver/family
24. Involve caregiver in the management of the child
25. Express appreciation to child, caregiver/family
26. Dispose off, decontaminate and clean used items
27. Document findings manually or electronically
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