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EBOOK: CLINICAL COACH For Effective Perioperative Nursing Care

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Presurgical Assessment
Many patients will have the majority of their preoperative assessment
done in advance of the day of surgery through the surgeon’s office. The
surgeon will determine the need for surgery, and request the appropriate
presurgical evaluation, which may include sending the patient to
• His or her primary care physician for clearance
• Preanesthetic clinic for evaluation
• The laboratory for appropriate tests
Through a patient interview and physical examination, it is possible to
identify factors that may increase a patient’s perioperative risk. As you
interview your patient, you may discover things
that require you, the surgeon, or the anesthesia
provider to modify the intended plan of care.
For example, if you discover that your patient
does not speak English, you will be required to
obtain a translator. You may discover that your
patient wears a hearing aid, or uses mobility
assistance devices such as a cane.
Surgical Scheduling
Presurgical screening will help the surgeon determine whether the
patient should be scheduled at a freestanding ambulatory facility, as a
23-hour admission, as a same-day admission, or as an inpatient. Patients
scheduled at hospital facilities have a greater degree of perioperative risk,
either due to their preexisting medical conditions or their need for more
invasive surgery.

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