B017213 - CLINICAL SURGERY NURSING

Italian

Italian

italian

Organisation and management of pre and post-operative nursing;
The surgical division;
Postoperative pain: management and treatment;
Clinical risk management in perioperative path;
Clinical pathways in surgical patients undergoing:
- breast surgery;
- gastrointestinal surgery;
- thoracic surgery;
- endocrine surgery;
- orthopedic surgery.

The course intends to acquire basic skills for the management of clinical care issues in surgery, paying attention to both the social and cultural changes of the population, both to the specific stages of the nursing management.
Also, it provides the theoretical knowledge for the design of safe nursing care and based on scientific evidence through the application of the nursing process.

-Brunner-Suddarth Infermieristica medico-chirurgica vol. 1 e 2; Casa Editrice Ambrosiana
-L.J. Carpenito-Moyet Piani di Assistenza Infermieristica e documentazione; Casa Editrice Ambrosiana
-L.J. Carpenito-Moyet Diagnosi Infermieristiche-applicazione alla pratica clinica; Casa Editrice Ambrosiana
-M.E. Doenges, M.F., Moorhouse, A.C. Murr Piani di assistenza infermieristica - linee guida per un'assistenza personalizzata; Edizioni Minerva Medica
- D’Innocenzo M. Procedure diagnostico terapeutiche e assistenziali Casa Editrice McGraw-Hill
- Cambieri, Girardi, D’alfonso, Luongo, Il reparto Operatorio: Progettazione, organizzazione, controllo; Il Pensiero Scientifico Editore
- Rosanna Alloni, et all,. Infermieristica Clinica in Chirurgia; CasaEditrice Hoepli

Brunner-Suddarth Nursing medical-surgical vol. 1 and 2; Casa Editrice Ambrosiana, 2010
L.J. Carpenito-Moyet Nursing Care Plans and Documentation; Casa Editrice Ambrosiana, 2011
Carpenito Diagnosis Infermieristiche- application to clinical practice; Casa Editrice Ambrosiana, 2001
D'Innocenzo M. diagnostic procedures and therapeutic care publishing house McGraw-Hill
Cambieri, Girardi, D'alfonso, Luongo, The Surgical Department: Planning, organization, control; Il Pensiero Scientifico Editore
Rosanna Alloni, et all,. Clinical Nursing in Surgery; Casa Editrice Hoepli
Lise M. Surgery for Health Professions; Piccin-Nuova Libraria, 2006

G.Rosa-F.Bilotta, Topics in Anesthesia and Intensive Care for the health professions (only the part concerning the anesthesia), and Piccin material provided by the lecturers of the course (slides, handouts)

- Brunner-Suddarth Infermieristica medico-chirurgica vol. 1 e 2; Casa Editrice Ambrosiana , 2010
- L.J. Carpenito-Moyet Piani di Assistenza infermieristica e documentazione; Casa Editrice Ambrosiana, 2011
- L.J. Carpenito-Moyet Diagnosi Infermieristiche-applicazione alla pratica clinica; Casa Editrice Ambrosiana, 2001
- D’Innocenzo M. Procedure diagnostico terapeutiche e assistenziali Casa Editrice McGraw-Hill
- Cambieri, Girardi, D’alfonso, Luongo, Il reparto Operatorio: Progettazione, organizzazione, controllo; Il Pensiero Scientifico Editore
- Rosanna Alloni, et all,. Infermieristica Clinica in Chirurgia; CasaEditrice Hoepli
- M.E. Doenges, M.F., Moorhouse, A.C. Murr Piani di assistenza infermieristica - linee guida per un'assistenza personalizzata; Edizioni Minerva Medica

The objectives of the current course are 1. the identification of phenomena / problems of nursing nature related to the principal pictures of surgical interest, through the utilisation of the nursing methodology and of the critical thought, as well as 2. the development of the diagnostic deductive hypothetical reasoning, of the health care planning, with monitoring and assessment of the whole process, in relation to the theoretical model and / or the accredited reference classification. The form supplies the contents for the adoption and the management of health care strategies / choices able to the caring of the person with health problems as a result of surgical treatment.

The teaching aims, through the use of nursing and critical thinking methodology, identification of nursing phenomena / problems related to the main square of surgical interest, as well as the development of diagnostic hypothetical deductive reasoning, the care planning , with monitoring and evaluation of the entire process, in relation to the theoretical model and / or credited to the reference classification.
The module provides the content for the adoption and management of care strategies / decisions that are likely to take charge of the person with surgical treatment of health problems.

At the end of the course students will have acquired knowledge relating to the preparation of a candidate patient to surgery. Will assist the anesthesiologist during the intra and postoperative immediate period. Will manage the postoperative period as regards the control of vital signs and the assessment and the need to treat pain

Prerequisites approved by CdL

B4 - The vocational training activities

Frontal lessons, seminaries, exercises. Discussion clinical cases.

Lectures, seminars,
exercises.

lectures, simulations, visual teaching aids and / or audio-visual

Possible integrated seminaries.

Written and or oral examination regarding clinical cases.

Verification written and / or oral of clinical cases.

Check ongoing written and / or oral

Organization of nursing pre intra- and post-operative.
Definition of planned and emergency hospitalization.
Preoperative nursing care:
- Ensuring that nursing preoperative
- Key nursing diagnoses and collaborative problems in the path perioperative
- Education and preoperative preparation
Organization of the sector operative:
- Environment and planning of routes
- Standard equipment of the operating room
- Team of the operating room and skills
- Risk management in the sector operative
Postoperative nursing care and pain management
assistance process in surgical area applied to the person subjected to:
- Breast Surgery
- Intestinal Surgery
- Gastric and oesophageal surgery
- Thoracic surgery
- Endocrine surgery
care pathway applied to the person undergoing orthopedic surgery:
- arthroplasty
- Osteosynthesis
- Amputation of a limb

Functional model (tasks model). Patient-centered modular care, Case Manager, Primary Nursing. Definition of hospitalization planned with screening/signs and symptoms. Emergency hospitalization. Classification of surgery.
Pre operative nursing care:
Pre operative nursing assessment: nutritional state, respiratory state, cardiovascular state, risk of infection, psychosocial factors spiritual and cultural beliefs.
Main nursing diagnoses and collaborative problems in the pre and post operative
Pre operative education: deep breathing, mobility, pain treatment, coping strategies
Bowel preparation, Skin preparation, Pre operative fasting.
Pre-anesthetic administration of drugs, antibiotic prophylaxis and antithrombotic. Person transfer to the operating sector.
Operating sector organization: background and path planning; Standard equipment of operating room; Operating room team
Skills of the nurse assigned to operating room and anesthetist attending and skills of the nurse assigned to surgical instrumentation
Environmental controls in order to maintain asepsis
Prevention of positioning injury during the surgery. Risk factors for chemical, physical, microclimatic, default devices, ionizing radiation, injury, burnout .
Personal protective equipment
Operative nursing care:
Operative nursing assessment
Clinical risk management in surgery: pre-operative, operative and post-operative check list
Targets of safety.
Anesthesia methods and nursing skills: local anesthesia, sedation, total anesthesia, epidural anesthesia, spinal anesthesia.
Management of pre-operative, operative and post-operative complications: nausea, vomit, hypoxia, anaphylaxis, hyperthermia.
Post-operative nursing care:
After operation ward acceptance
Nursing assessment. Nursing skills for treatment and prevention of main post-operative complications: Deep vein thrombosis, wound infection, haematoma, dehiscence , evisceration, hypothermia, haemorrhage, hypovolemic shock, urinary retention, paralytic ileus, bronchial-lungs complications, malnutrition.
Surgical wound directions. Drainage thypes and directions
Pain: valuation scales and treatment
Nursing care plan to breast surgery subjected person:
Pre-hospitalization; Hospitalization;
Pre-operative, operative and post-operative care plan
Removal surgery and breast reconstructive surgery methods
Treatment of main post-operative complications like lymphedema. Treatment of surgery ipsilateral arm. Therapeutic education and follow up.
Nursing care plan to digestive surgery subjected person:
Major malignant, benign and inflammatory colon and rectum diseases
Pre-hospitalization.
Pre-operative, operative and post-operative care plan
Nursing diagnosis
Nursing treatment of main complications. Therapeutic education and follow up.
Nursing care plan to gastric and esophageal surgery subjected person:
Major malignant, benign and inflammatory stomach and esophagus diseases
Pre-operative, operative and post-operative care plan
Surgery and main complications
Early and late dumping syndrome.
Main surgery and nursing care for obesity
Malnutrition.
Care plan to chest surgery subjected person:
Lung abscess. Lung cancer
Pre-operative, operative and post-operative care plan
Chest drainage directions.
Care plan to orthopedic surgery subjected person:
Pre-operative, operative and post-operative care plan to person subjected to:
Hip prothesis knee prothesis Arthroplasty and Osteosynthesis
Amputation Trans-skeletal traction Cast and external fixators
Care plan to enterostomy subjected person:
Enterostomy types
Surgical directions
Complications. Ostomy and devices care
Post-operative administration and diet plan
Nursing diagnosis
Closure of stoma and intestinal recanalization
Pain:
“Hospital without pain” was created in 2001
Main targets of ”Hospital without pain”
Pain valuation scales and treatment
Hospital discharge:
Planning withing 72 hours of discharge
Types of discharge. Definition of protected discharge. Definition of difficult discharge. Risks of an unplanned discharge.

the anesthetic risk assessment: visit anesthesia, ASA classification, preoperative tests.
The candidate's patient surgery: preoperative fasting and premedication.
The components of general anesthesia. General anesthesia phases: induction, deepening, maintenance, patient awakening and recovery.
inhalation and intravenous anesthesia: main drugs used. I note on muscle relaxation. Tracheal intubation: material preparation. Perioperative monitoring (notes). Instruments and anesthesia devices. Major complications of anesthesia general.
locoregional anesthesia: main techniques, medications, contraindications and complications. The patient positioning during execution of subarachnoid and epidural anesthesia.
Postoperative pain: physiopathology, evaluation systems and pain relief methods