Archive February 2019 XX, No. 2

Primed for Success

5 ways to prepare your patients for great outcomes and satisfying experiences in the days before surgery.

Kendal Gapinski

Kendal Gapinski, Contributing Editor


PROPER PRE-OP PLANNING Improving your pre-operative processes will optimize your patient's experience.

Ever think of all you can do to optimize your patients' experience and improve their surgical outcomes — before they even step foot into your facility? Here are 5 easy ways to improve your pre-operative protocol.

1. Nutrition

A malnourished patient is likely to have bad outcomes. Thomas K. Varghese, Jr., MD, MS, head of the section of general thoracic surgery at the University of Utah, and a team of doctors created a simple checklist to screen for malnutrition.

The Strong for Surgery checklist asks patients 4 key questions to determine if the patient is malnourished. Refer the patient to work with a nutritionist or dietician in advance of surgery if the patient answers yes to any of these questions:

  • BMI less than 19;
  • unintentional weight loss over 8 pounds in the last 3 months;
  • poor appetite (eats less than half of meals or fewer than 2 meals per day); and
  • unable to take food orally.

As more facilities start to move to Enhanced Recovery After Surgery (ERAS) protocols, pre-op nutrition will become even more important for successful surgery, says Robyn Washington, MBA, BSN, RN, CNOR, a clinical nurse III at Houston Methodist at the Texas Medical Center. NPO after midnight has long been the standard, but ERAS encourages patients to drink clear liquids up to 2 hours before surgery and stop solid foods before midnight, says Ms. Washington. Houston Methodist encourages patients to drink apple juice — preferably a low-sugar brand — 2 hours before arriving at the facility.

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