The Association For Perioperative Practice (AFPP 2005) Describes The Perioperative Environment: Perioperative Practice Dissertation Proposal, MU, Australia

University Melbourne University
Subject Perioperative Practice

Perioperative Practice

The word ‘perioperative’ is a fairly recently devised term. The Association for Perioperative Practice (AfPP 2005) describes the perioperative environment as the are utilized immediately before, during, and after the performance of a clinical intervention or clinically invasive procedure. The word ‘peri’ derives from the Latin ‘around’, so perioperative means around the operation or intervention. Therefore, perioperative care should start with good-quality information giving and sharing with the patient from the first time they interact with a healthcare professional. The patient’s first interaction and continuing care may be as part of the caseload of a surgical nurse consultant or advanced surgical care practitioner, who may care for the patient throughout their surgical journey and should be considered as perioperative.

The perioperative period is a term used to describe the three distinct phases of any surgical procedure, which includes the pre-operative phase-the hours before surgery-, the intraoperative phase-involves the surgery itself-, and the postoperative phase-the period immediately following surgery-.

Once a patient admits to hospital starts on a journey in less familiar surroundings which, dependent on age, ethnicity, and language, competence and understanding may have caused anxiety and fear which the healthcare professionals responsible for the care of the patient must make every effort to resolve as part of their service to the people who need their help and support. Sometimes, in this busy pressurized world, there may a tendency to forget that the patient does not experience the surgical environment every day as do the specialized healthcare professionals. Even the least complex procedure in the perioperative environment may be a major event for the patient.

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A perioperative period is a stressful event that triggers the specific emotional, cognitive, and physiological responses of a patient. Anxiety during this period is determined by various factors that need to be considered by an anesthetist and the team. Anxiety may occur in any person undergoing surgery either in a transient or a chronic form thus triggering specific emotional, physiological, psychological, and spiritual responses of the patient which may continue throughout the postoperative period thus causing difficulties in managing postoperative pain. Psychological preparation for invasive procedures has been based on the rationale that high levels of preprocedural fear are determinants of patients’ subsequent adaptation during their perioperative period. [3].More recently, the patient has been considered holistically and the term ‘perioperative’now much better describes the care of the patient from initial referral and diagnosis full recovery, or as full as that recovery might be for their physical condition.

It was then at this point that the perioperative care in anesthesia, surgery, and postanesthetic recovery took place as suggested by the AFP. When following the literature multiple studies have suggested that more information is needed to reduce anxiety.

Adequate management of anxiety may result in a smoother induction- medication given to produce unconsciousness- and even a better outcome of surgery. [12] Preoperative surgical and anesthetic information provision had protective effects on preoperative anxiety. Many studies suggest that different modalities of information provision and patient education minimize the level of preoperative anxiety. [13].So, it is very important for an anesthetist to properly assess the level and determinants of anxiety among the patients undergoing surgery to plan for interventions that are required to reduce the level of anxiety via avoiding the anxiety-provoking factors.

Anesthesia is one of the greatest discoveries of modern medicine. In fact, many of today’s operations, especially for the very young, very old, or very ill would not be possible without it.

‘Anaesthesia’ is derived from the Greek word meaning ‘without sensation’. The term applied to medications that can produce anesthesia, as well as to the whole process that patient undergoes when having surgical and other medical procedures. People often describe ‘anesthesia’ as being ‘put to sleep’. This is not strictly true: in ‘general anesthesia’ anesthetists in fact place their patient into the state of carefully controlled unconsciousness so that they will be unaware and not feel pain.

Anesthetists are specialist doctors who are responsible for providing anesthesia to patients for operations and procedures. In addition, anesthetists have a range of practice that extends beyond anesthesia for surgery to include pain management and intensive care. The anesthetist’s visit prior to surgery fulfills two objectives: to provide a platform for patients to clarify their doubts about anesthesia and customization by the anesthetist of premedication, both of which help to allay anxiety. Hospitals also should make arrangements for various activities related to coping skills, diversion therapies, dissemination of information related to the stressors, clarifying misconceptions related to surgery and anesthesia so as to facilitate the patient experience surgery and hospitalization that is free of fear and anxiety.

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