Introduction

Perioperative nursing is the care that nurses provide to patients before, during and after surgery.

It involves collaborating with the surgical team, ensuring patient safety, providing education and support, and promoting optimal outcomes.

Perioperative nursing encompasses three phases: preoperative, intraoperative and postoperative.

The Association of periOperative Registered Nurses (AORN) sets the standards and guidelines for perioperative nursing practice.

These include evidence-based recommendations for infection prevention, patient safety, environmental management, professional development, and quality improvement.

Types of surgery Surgical procedures can be classified by body system, purpose, degree of urgency, and degree of risk.

Some examples of surgical purposes are ablative (removal of a diseased body part), diagnostic (confirmation or ruling out of a diagnosis), palliative (relief of discomfort or symptoms without curing), reconstructive (restoration of function), cosmetic (improvement of appearance), transplant (replacement of a failing organ or tissue), and procurement (donation of an organ or tissue from a brain-dead person)

The degree of urgency refers to how soon the surgery needs to be performed.

Emergency surgery is done as soon as possible to save life or limb, such as in cases of internal hemorrhage, organ rupture or trauma.

Urgent surgery is done within 24 to 48 hours to alleviate symptoms, repair a body part or restore function, such as in cases of removal of a cancerous breast or internal fixation of a fracture.

Elective surgery is recommended but not time-sensitive, such as in cases of torn ligament, rhinoplasty or removal of rectal polyps.

The degree of risk refers to the potential for complications or adverse outcomes from the surgery.

Major surgery is associated with a high degree of risk, involves vital organs, requires a large incision, involves significant blood loss or anesthesia, and has significant postoperative risks.

Examples are coronary artery bypass grafting (CABG), organ transplant, nephrectomy or colon resection.

Minor surgery is performed on an outpatient basis, involves little risk and fewer complications.

Examples are cataract extraction, tonsillectomy or skin biopsy.

Never events are serious and costly errors that result in severe consequences for the patient.

They are called never events because they should never happen in the surgical setting.

Medicare no longer reimburses costs for never events.

Some examples are surgery on the wrong body part or patient, deep vein thrombosis (DVT) or pulmonary embolism (PE) after hip replacement, foreign body left in patient or surgical site infection.