Module 3: D. Types of Interventions – The Perioperative Patient for Registered Nurses

Types of Interventions

Mechanical prophylaxis

Pharmacological prophylaxis

Consideration	VTE Prophylaxis
Should be fitted and sized appropriately	ECS/IPC
Should be applied and working before induction	IPC
Should be monitored for appropriate function	IPC
Contraindications: Peripheral vascular disease, diabetic neuropathy, skin breakdown	ECS/IPC

(ORNAC, 2021)

If using mechanical prophylaxis, the circulating nurse provides patient education regarding the intervention before bringing the patient into the OR.
To ensure that patients are involved in their care and attention to safety is a priority, the briefing phase of the surgical safety checklist includes a discussion of the VTE prophylaxis.
The circulating nurse communicates the type of VTE prophylaxis during all transfers of care.
The circulating and scrub nurses should be provided with continuing education about the risks of VTE prophylaxis.

Healthcare institutions should have a policy or guideline for VTE assessment and prophylaxis.
It is necessary for the nurse to document the type of device and control number, start time, and end time.
The circulating nurse documents the assessment of the skin after removal of the mechanical VTE prophylaxis, if removal is required.

(ORNAC, 2021)

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In Blackboard complete the Graded Activity: Maintaining Normothermia and Preventing VTE

The normal core body temperature is 36°C to 38°C.
The hypothalamus triggers the cooling and warming effects when thermoreceptors receive a message regarding a change in core body temperature.
Thermoregulation can be maintained by active warming devices and passive warming devices.
Performing a thorough preoperative nursing assessment will identify the patient’s risks or challenges that may contribute to perioperative hypothermia.
The factors that affect normothermia include age, weight, gender, and medical conditions. The elderly, children, females, and those with a high ASA (America Society of Anesthesiologists) classification are at risk.

A patient’s temperature should be taken one hour before the planned procedure and documented.
Temperature monitoring should be done throughout the procedure. Noninvasive core temperature monitoring devices include a nasopharyngeal temporary probe, esophageal/rectal temporary worker probe, and tympanic thermometer.
The health care institution should have guidelines or a policy on management of unplanned perioperative hypothermia.
VTE can be a fatal complication, but it is preventable and risk factors should always be assessed to determine if interventions are required.
The preoperative team will collaborate on the most appropriate VTE prophylaxis for the patient.
There are two types of prophylaxis: mechanical and pharmacological.