BEEBE SCHOOL OF NURSING - QSEN



Beebe Healthcare

Margaret H. Rollins School of Nursing

Nursing 102

Nursing Care Of Adults

2014

Surgical Follow Through

In Nursing 102 the student will have the opportunity to follow a patient during all three phases of perioperative care. The student will be assigned the patient preoperatively, observe preparation of the patient prior to surgery, observe in the intraoperative phase, follow the patient to the post-anesthesia care unit and finally to the post-operative unit. The student will provide care as on a regular clinical day for the patient on Post-Operative Day One. The surgical follow through is a mandatory clinical experience. If a student is absent for their scheduled OR week, clinical will be rescheduled.

Patient Assignment:

A surgical patient will be assigned the week of the student’s OR clinical experience. The student is expected to be present during all phases of the perioperative experience.

Purpose:

The purpose of this assignment is for the student to write a professional paper, utilize APA formatting, enhance understanding of hospital systems, and have the opportunity to reflect on a surgical experience from the patient’s perspective. A professional paper addressing the student’s perioperative follow-through experience is a required component of the N102 semester. The student will write about their observations and experiences as they follow a patient through their surgical experience and also care for that patient in the post-operative period. In the Surgical Follow Through paper the following QSEN competencies are identified: patient-centered care, teamwork and collaboration, evidence based practice, quality improvement, informatics, and safety.

Due Date:

This assignment is to be completed and handed in no later than 0800 on the Monday

2 1/2 weeks after completion of the clinical assignment. Five (5) points will be deducted from the total grade for each class or clinical school day that the paper is late. If a student is going to be absent on the due date, it is the student’s responsibility to make arrangements to ensure the paper is submitted on time.

Formatting:

The student should refer to the APA textbook and their Student Handbook for “Guidelines Regarding Use of Resources” and the “Writing Competency Policy”. The student must document correctly within the text according to APA format any information taken from a source. A reference list of all resources used to complete the assignment must be included at the end of the paper in APA format. The Surgical Follow Through paper requires a minimum of two references that are current within the last five years. Copies of internet sources used must be included with the paper and the information referenced highlighted. An abstract and headings are not to be included. The student will write in the first person.

Criteria for Evaluation:

The paper will be graded on a scale of 0-100 points and will count as 10% of the theory grade. The graded paper will be returned within 4 weeks of submission.

Surgical Follow Through Guidelines

The following areas are to be addressed in the formal surgical follow through paper. Refer to the patient by initials only.

Preoperative Phase:

• Describe your first interaction with your assigned patient.

• What was the patient’s response to having a student nurse with them?

• If the response was positive, what do you think aided this? If negative, what could have been done differently?

• Discuss your patient’s thoughts and feelings in response to having surgery. Include verbal and non-verbal observations.

• Discuss the use of the electronic health record during the patient’s preoperative phase.

• Explain what pre-operative teaching was done prior to the patient being taken to the operating room. What was the patient’s response to this teaching?

• Describe the role of the preoperative nurse.

• Describe your overall view of the patient’s preoperative phase.

Intraoperative Phase:

• How was the patient greeted upon entering the operating room?

• What special preparations were done prior to surgery beginning and why?

• Discuss the Time-Out process and its purpose. Must cite reference in the text.

• Discuss the interactions of the OR team.

• Discuss the role of the intraoperative nurse.

• Discuss how you feel the patient was treated during surgery.

PACU Phase:

• Discuss unique aspects of the PACU environment.

• Discuss the role of the PACU nurse.

• Discuss SBAR technique and its purpose. Must cite reference in the text.

• Describe the nurse-to-nurse report when the patient was transferred into PACU. Was it comprehensive? How did it align or differ from SBAR technique?

• Was the information shared during report appropriate? If not why?

Post-operative Care:

• Describe the nurse-to-nurse report when the patient was transferred onto the postoperative floor. Was it comprehensive? How did it align or differ from SBAR technique?

• Was the information shared during report appropriate? If not why?

• Discuss how the electronic system used for medication administration impacts patient safety. How does it address the 10 rights of medication administration?

• Discuss the role of the postoperative nurse.

Conclusion:

• Reflect on the perioperative experience and discuss how providers in the healthcare setting contributed to your patient’s surgical experience

• How did your involvement in the patient’s care impact his/her experience?

• Identify the hospital tool for documenting unexpected occurrences?

• Why is tracking unexpected occurrences in the hospital important?

Evaluation of Surgical Follow Through:

• Choose one of the provided research articles. Identify whether the care provided your patient met this evidence based practice. Discuss why or why not.

• What were your feelings regarding the patient’s surgical experience?

• Discuss how this experience enhanced your learning.

• Was the experience what you expected? If not, how was it different?

Format:

• Grammatical and/or spelling errors are evaluated utilizing the grading rubric

• APA format within text and on reference list is graded for accuracy

• Minimum of two appropriate references are used– not greater than 5 years old, and a copy of each Internet source used, with the information referenced highlighted accompanies the paper

Grading Rubric

This paper is to be 5-7 pages in length. Students must address each area completely by answering all of the questions posed. Students are also required to self evaluate themselves utilizing the grading rubric provided. This self evaluation is to be included with paper submission. Any paper submitted one full week prior to the due date will be awarded 2 bonus points to the Surgical Follow Through grade.

For the section “Evaluation of Surgical Follow Through” choose ONE of the articles made available through Edvance 360.

Articles

Spruce, l. (2014). Back to basics: Preventing surgical site infections. AORN Journal, 99(5), 600-

611. doi:

Johansson, R.,  Malmvall, B.,  Andersson- Gä re, B., Larsson, B., Erlandsson, I., Sund-Levander,

M., Rensfelt, G., Mölstad, S., & Christensson, L. (2012). Guidelines for preventing

urinary retention and bladder damage during hospital care. Journal of Clinical Nursing,

22, 347-355. doi:10.1111/j.1365-2702.2012.04229.x

Knudson, L. (2012). New sterile technique recommended practices contain new evidence,

illustrations. AORN Journal, 96(6), C5-C6.

Parry, M., Grant, B., & Sestovic, M. (2013). Successful reduction in catheter-associated urinary

tract infections: Focus on nurse-directed catheter removal. American Journal of Infection

Control, 41, 1178-1181.

Larkin, B., Mitchell, K., & Petrie, K. (2012). Translating evidence to practice for mechanical

venous thromboembolism prophylaxis. AORN Journal, 96(5), 513-527.

Mong, A., & Pugh, L. (2013). Using evidence-based practice in the OR: One nurse’s experience.

OR Nurse 2013, 7(6), 12-16.

Margaret H. Rollins School of Nursing

Nursing 102 – Nursing Care of Adults

Surgical Follow Through Grading Rubric

|Criteria: Content |Exceeds |Meets |Below | |

| |Expectations |Expectations |Expectations | |

|2. Preoperative Phase |Comprehensively addresses |Addresses preoperative |Inadequately addresses | |

| |preoperative criteria (20) |criteria with basic |preoperative criteria | |

| | |information (18) |(16) | |

|3. Intraoperative Phase |Comprehensive information |Addresses intraoperative |Inadequately addresses | |

| |provided for intraoperative |phase with basic information |intraoperative phase criteria| |

| |phase (20) |(18) |(16) | |

|4. PACU Phase |Comprehensive information |Addresses PACU phase with |Inadequately addresses PACU | |

| |provided for PACU phase |basic information (18) |phase criteria (16) | |

| |criteria (20) | | | |

|5. Postoperative Phase |Comprehensive information |Addresses postoperative phase|Inadequately addresses | |

| |provided for postoperative |with basic information |postoperative phase criteria | |

| |criteria (20) |(18) |(16) | |

|6. Conclusion |Comprehensive information |Addresses conclusion with |Inadequately addresses | |

| |provided for conclusion |basic information |conclusion criteria (11) | |

| |criteria (15) |(13) | | |

|7. Evaluation of Follow Through |Comprehensive information |Addresses evaluation with |Inadequately addresses | |

| |provided for evaluation |basic information |evaluation criteria (11) | |

| |criteria (15) |(13) | | |

|5. Writing Style |Skilled presentation of ideas. |Able to present ideas. Work |Limited ability to convey | |

| |Engages reader. |appropriate for this level of|ideas. Below expectations of | |

| |(5) |student (4) |work at this level (3) | |

|6. Self Evaluation | |Self evaluation completed (2)|Self evaluation not completed| |

| | | |(0) | |

|Criteria: Format | | | | |

|1. Grammar |Grammar correct with no more |Grammar correct with no more |10 or more grammatical errors| |

| |than 3 errors (2) |than 5 errors |(0) | |

| | |(0.5) | | |

|2. Spelling |Spelling correct with no more |Spelling correct with no more|10 or more spelling errors | |

| |than 3 errors (2) |than 3 errors (0.5) |(0) | |

|3. APA format in text |APA format in text correct at |APA format in text correct at|APA format in text correct at| |

| |85% or more (2) |75%-84% (1) |less than 75% (0.5) | |

|4. APA format on Reference page |Reference page correct at 85% |Reference page correct at |Reference page correct at | |

| |or more (2) |75%-84% (1) |less than 75% (0.5) | |

|4. Resources current within last 5 | |All resources current |One or more resources not | |

|years | |(1) |current (0) | |

|5. Internet copies provided and |Internet copies provided and |Internet copies provided not |Internet copies not provided | |

|highlighted |highlighted (1) |highlighted (0.5) |(0) | |

|2 bonus points for early submission | |

|TOTAL POINTS EARNED | |

|Earned points/129 = % | |

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