Question

Regarding care coordination, case management, and transition-related OT services (including OT discharge planning): In what ways would your preparation be the same and it what ways would it differ for Level II in a traditional practice environment (such as an SNF) versus an emerging practice environment (such as an Assisted Living Facility)? Be explicit in describing each of these types of settings in order to fully explore the similarities and differences related to care coordination, case management and transition-related OT services.

Answer 1

Nurses play an important role in maintaining the health and well-being of patients. There are different roles to be performed from the pre operative to post operative.

Preoperative Nurses:

-Create sterile environment

-Educate the client their treatment, illness, and anything regarding their health

-Keep equipment sterile

-Keep all emergency medicine ready

The three main groups are circulating nurses, scrub nurses, and registered nurse first assistants.   Below are the phases where we can see similarities and differences.

Circulating Nurse:

-These nurses are not scrubbed, and do not wear gloves or a gown.

-To monitor and document the procedures taken during the operation.

-They promote sterility of the OT room

-They only open the autoclaved packages

-They should only handle the sterile equipment

Scrub Nurse (Intra operative):

-They do scrub procedure, wear gloves, a mask and gown

-They aid surgeons by handing them equipment, sponges and other necessary instruments needed during the operation

-They monitor the patient condition during the operation and alert the surgeon and anesthetist

Nurse First Assistant (Intraoperative):

-They will be trained in specific education and training

-They directly work with surgeons

-They control bleeding use instruments and medical devices during the operation

-perform invasive procedures such as cutting tissue, and suture the patient when the operation has finished

Similarity:

-Should be very care full in every phase

-Maintain sterility

Differences:

-Each nurse has to play different roles

-Circulating nurse has to take care of sterile environment

-Scrub nurse helps in open and provide OT instruments

-OT nurse wil actively participate and assist doctor’s in cutting tissues and all

Post operative:

• Once patient is shifted to recovery room, Nurse has to check patient’s airway breathing.
• They attend to relieve pain and other complications
• They will provide provide patients and their caregivers with support and instructions and requirements needed for home care
• Vitals recorded every 15 minutes in first 24hrs after surgery which Inclusive of, heart rate, blood pressure, temperature, respiratory rate and oxygen saturation
• Maintain urine output, assessment of wound sites, replacing intravenous requirements and reporting any abnormalities
• Also maintain mobility restrictions, nutrition and education requirements prior to discharge from hospital. When these tasks are taken out it is proven to improve recovery.