Component Task: Peri-Operative Care of a Paediatric Patient: Pre-Operative Care of a Child

This is a process where the nurse provides physical, physiological and psychosocial care to a child according to the developmental age prior to surgery. The period begins when the child is booked for surgery until the child enters the theatre.

Aims

·         Provide physical care

·         Provide psychosocial care

·         Ensure completion of physiological process

·         Prevent complications during surgery

·         Provide information about the surgery to the child and caregiver

·         Facilitate the signing of the consent form

·         Ensure a successful surgery

Requirements

·         Tray for vital signs

·         Thermometer

·         Blood pressure apparatus

·         Glucometer with strips

·         IV cannula (G22, 24, 26)

·         Giving set

·         Infusion pump and drip stand

·         Identification tag

·         Verification list

·         Consent form

·         Prescribed medication for surgery (antibiotics, analgesics)

·         IV fluids

·         Theatre gown

·         Bed linen

·         Trolley/wheelchair

·         Pain scale tool

Steps

1.        Establish rapport (Refer to steps)

2.      Perform five moments of hand hygiene

3.      Explain procedure to child, caregiver/family (Refer to steps)

4.      Allow child/caregiver to ask questions and give appropriate responses

5.      Encourage family to voice out concerns or fears

6.      Obtain informed consent

7.       Introduce child/caregiver to others who have undergone same surgery

8.      Obtain baseline vital signs (temperature, pulse, respiration, blood pressure, pain assessment, SPO2) and weight

9.      Monitor random blood sugar

10.    Commence bowel preparation 24-48hours before the surgery, if the surgery is gastrointestinal related

11.      Obtain an IV access and hydrate child with IV fluids

12.    Ensure child is fasted as indicated by the anaesthetist (6-8hours)

13.    Place identification bracelet on hand

14.    Mark/label site for surgery

15.    Explain pain scale tool to child/caregiver for post-operative management

16.    Ensure items for surgery are all available

17.    Perform personal hygiene and change child into theatre gown

18.    Remove any ornaments on the child which will interfere with surgery (beads, earrings, nail polish etc.)

19.    Put child in a wheelchair or on a trolley with a clean linen

20.  Wheel child to theatre

21.    Hand over child’s folder and items for surgery to theatre nurses

22.  Continue to provide emotional support to caregiver

23.  Dispose off, decontaminate and clean used items

24.  Document procedure manually or electronically