Outpatient Surgery Magazine

No More Never Events - February 2014 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1 3 1 F E B R U A R Y 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E SAFETY We also conduct caregiver burden interviews to understand the bur- dens the elderly place on their loved ones' lives. (We follow up 6 months post-op to see if surgery made the burdens greater or lesser.) Pre-op staff should carefully review patients' medications and give clear instructions on exactly which medicines they can take and which ones to stop after surgery. This more exhaustive evaluation, which can be done on patients older than 75 years, should take nurses or nurse practitioners an extra 15 minutes to complete. Ideally, you'll input the results of the pre-op assessment into an elec- tronic health record, so caregivers can access the information throughout the patients' stay. That's important because after an opera- tion, patients who might appear cognitively impaired might be exhibit- ing behavior that matches baselines measured in pre-op. In the OR The elderly lose body heat rapidly because their skin is extremely thin, so properly warming these patients is essential in order to stave off hypothermia (see "The Unintended Consequences of Unintended Hypothermia" on page 46). It's a good idea to use forced-air warming for surgeries lasting any significant length of time. Local and regional anesthesia is typically used more often in elderly patients, although deep sedation is sometimes required, even for these inhalational-anesthesia-avoiding techniques. Employ "just right care," which involves paying particular attention to the wishes of individual patients. Quality of life is more important to many elderly patients than length of life. For example, most patients of advanced age would opt for less invasive cancer surgery with less of a chance of cure compared to a more invasive operation OSE_1402_part3_Layout 1 2/6/14 3:02 PM Page 129

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