Pre-Operative Teaching

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Pre-Operative Teaching

Pre-Operative Teaching

It is 10 pm and you make assessment rounds and find Bobby crying. You ask him what his pain level is. What pain scale are you using?

He says he misses his family and wonders when they are going to come to get him and take him home? He relates his dad told him to be brave but he couldn’t stay with him since

Bobby was going to be in the hospital for such a long time and his dad had to work. He has 2 other brothers older than him. You also notice that his tray is untouched.

In addition to Erikson’s theory of development, children have fear of loss. What is Bobby’s fear?
(do not forget the interdisciplinary team members)


Major visceral excision is the therapy of choice for variety of benign and malignant disorders of the visceral organs, and it is frequently cancer patients’ sole hope of survival. 
Expert surgeons can now execute exceedingly demanding and lengthy surgeries at specialized institutions with acceptable mortality rates thanks to recent developments in surgical methods and perioperative management. 
However, depending on the definitions employed, the types of surgeries performed, and the patients’ characteristics, total postoperative morbidity stays at 24–44 percent [1,2,3]. 
Patients’ postoperative outcomes are significantly harmed by postoperative complications, which lengthen ICU and overall hospital stays and increase death [3]. 
Postoperative difficulties impact not just the individual patient but also the healthcare system, given the enormous number of surgeries performed worldwide and the resulting cost increases [4]. 
As result, preventing postoperative complications is critical.


During the postoperative period, not all risk factors for the development of postoperative problems can be addressed. 
In the immediate postoperative scenario, for example, many patient-related parameters such as gender, age, and BMI, as well as procedure-related aspects such as tumor localization and surgical location, cannot be adjusted. 
In this context, being aware of preventable risk factors and fully exploiting the capacity to control them is very important. 
Deep vein thrombosis (DVT), pulmonary embolism (PE), pneumonia, burst abdomen, and in-hospital falls are all common and serious surgical consequences that can be mitigated to some extent by reducing risk factors such postoperative pain, coughing, and atelectasis [5,6,7]. 
The ability to undertake preventative activities in the postoperative phase is considered logical prerequisite for active prevention of the aforementioned problems. 
However, doctors’ lack of time for lengthy patient visits, as well as the concept of fast-track surgery, make providing adequate information to patients problematic. 
In these situations, nurse-led preoperative patient education session appears to be viable option. 
Preoperative patient education, which includes skill teaching and psychological support, has been studied for more than 20 years on patients’ recovery, postoperative pain, and psychological distress [8]. 
The evidence on preoperative patient education, on the other hand, is still mixed, and the benefit-to-cost ratio is still up for debate [9, 10]. 
Preoperative patient education in patients receiving significant visceral surgery, in particular, has little evidence. 
Cluster randomization allows hospital wards to be assigned to study groups rather than individual patients, perhaps ensuring adherence to group assignment and facilitating the implementation of randomized controlled trial addressing preoperative patient education.


The PEDUCAT trial’s goals were to (a) investigate the impact of preoperative patient education on postoperative complications such as pneumonia, DVT, pulmonary embolism, burst abdomen, in-hospital fall, and mortality, as well as postoperative pain, perioperative anxiety and depression, quality of life (QoL), and length of hospital stay (LOS) in patients undergoing major visceral surgery, and (b) assess the feasibility of cluster randomized trial in this setting. 
The PEDUCAT trial’s goals were primarily focused on the individual patient.
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