Enf.º Paulo Silva

Chairman of the Nursing Council 
Nursing Coordinator of the HPA - Alvor
Master in Public Protection

The importance of a preoperative nursing consultation during Covid

HPA Magazine 14

The period prior to a surgical procedure is by nature a time of anxiety for the patient. The patient who is going to undergo surgery has numerous doubts inherent to an invasive procedure that to him is unknow, as well worries on how he will adapt in the post-surgical period. 
Mishel's Theory of Uncertainty in Illness (1988) was developed to address uncertainty during the phases of diagnosis and treatment of an acute illness or a disease with a negative evolution. Nurses evoke this theory as elements capable of positively influencing the patient's ability to adapt to a new reality concerning his health. 
Peri-Operative Nursing is based on the promotion of quality care, for which there are quality standards associated with good practices in the perioperative stage, as described by the Portuguese Association of Operating Theatre Nurses. 

The Preoperative Nursing Consultation then arose as a perioperative approach (before, during and after surgery), where an assessment is made of all patients who are to undergo elective surgical procedures, under general or local anaesthesia or sedation. In addition to a clinical evaluation, the necessary preoperative exams are confirmed and results analysed.
In addition to being an opportunity to help clarify some issues associated with the actual surgical procedure, this consultation represents an opportunity to provide the patient with guidance before admission. Information on the medication the patient is on, if it is to be suspended or continued, guidance on the care to be taken in the postoperative period (necessary information/documents to be taken) and also on the nursing procedures which will be carried out in the immediate preoperative period, on admission to hospital. This consultation, despite being at the beginning of the perioperative period, is the time when the patient should start planning the final procedure, that is, the moment he is discharged from hospital.

The information obtained by the nurse will detect relevant concomitant disease, as well identifying risk factors, which in turn will facilitating the Anaesthesiologist's evaluation. In short, a relevant contribution is made to the Safety-First Procedure, one of the International Patient Safety Goals. 
During the COVID period, and following the good practices recommendations (from DGS, specialized colleges of professional associations and technical-scientific societies), epidemiological screening is also carried out in eligible situations, using the swab test which also includes a questionnaire. This is an excellent opportunity to inform patients on security measures to be adopted in a pandemic context, what are the symptoms and mode of transmission as well as what to do if symptoms should occur. 
In short, the Preoperative Nursing Consultation plays an important role and contributes enormously to ensure the safety of all concerned, whether they are professionals or family members, but essentially that of the patient.