Pre-op procedures involve assessing the patients before undergoing an operation. It is an essential component of the anesthetic care of patients which reduces surgery risk and costs. This article by Anne Dean (2012) focused on understanding the pre-op procedure undergone by patients before undergoing ambulatory surgery. The study was conducted in the Ambulatory Surgery Center such that it can offer a deep insight into pre-op design and how these environments can affect, hinder, or support nursing and patient interactions. Anne was interested in getting the in-depth systematic nature and detailed information about the patients as well as nursing experience prior to this type of surgery. The findings tend to mirror the quantitative nature of inpatient settings (Toy and Fournier et al., 2018). When conducting the preoperative interview conducted either through a telephone or on-site, the assessment perioperative team focuses on anxiety level, ASA status, food, and drug allergies.
Article Summary
This summary reviews the current clinical though relating to pre-op assessment procedures of the ambulatory surgery. According to Anne (2012), if ambulatory surgery is conducted properly, it involves low-risk and thus, adverse outcomes are likely to be infrequent. With this, the policies of most surgery centers require all patients to be interviewed before the ambulatory surgery is started. This process is aimed at collected a comprehensive history of the patient including the medications and identify most probable inherently dangerous conditions for the patient. Further, patients are assessed and counseled focusing on particular needs relating to a prior history of patient’s health, age, and the current health conditions. Some of these factors impact the proposed anesthetic and surgical event.
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Anne uses secondary data of the study conducted by the National Ambulatory Medical Care Survey (NHAMCS) in 2010. It showed that among the 48.3 million pre and post procedures conducted, 28.6 million involved ambulatory surgery. On a gender basis, 39% of the pre-op ambulatory procedures were performed to both male and female aged 45-64 years. More specific, 24% of the procedures were done on female and 18% for males both aged 15-44 years. The pre-op ambulatory procedure conducted on those below the age of 15 years was lower with 4% and 9% for males and females respectively. The study also focused on analyzing the data relating to the payment of the ambulatory procedure. 51% of the total population included in the study indicated that their ambulatory surgery costs are covered by private insurance, 8% Medicaid, and 31% Medicare. Further, the study showed that most of the pre-op procedure conducted include 4 million endoscopies of the large intestine, 2.9 million extractions of the lens, 2.2 endoscopies of the small intestine, and 2.6 million insertions of the prosthetic lens.
Discussion and Conclusion
As the importance of pre-op procedures continues to grow, NHAMCS statistical data shows the risk of ambulatory surgery increases with age. The largest age bracket that undergoes ambulatory surgery being 45-64 years. Although Anne’s article lacked sufficient quantitative evidence, this made a clinical sense considering that the ambulatory surgery test that has a high number of patient is endoscopy of the large intestine which is largely associated with old age. Thus, keeping in mind the age factor as the key quantitative variable in pre-op procedures, other non-quantitative variables such as health history play an essential role in ambulatory surgery (Rothrock, 2018). Further, using this article for analyzing surgical quantitative data is challenging due to the inconsistency of event reporting and classifying. The basic reason is that the health field is part of social science and thus, it is more qualitative data compared quantitative data ( Pereira, Figueiredo-Braga and Carvalho, 2016) . For instance, in this study conducted by Anne Dean, the only variables that can be described quantitatively are the age of the patients and the cost incurred in pre and post-op procedures.
References
Anne Dean, Founder, ADA Group | (August 15, 2012) . The Preoperative Patient Assessment in an Ambulatory Surgery Center . ASC Turnarounds: Ideas to Improve Performance. Retrieved from: https://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/the-preoperative-patient-assessment-in-an-ambulatory-surgery-center.html?tmpl=component&print=1&layout=default
Pereira, L., Figueiredo-Braga, M., & Carvalho, I. P. (2016). Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient education and counseling , 99 (5), 733-738.
Toy, P. C., Fournier, M. N., Throckmorton, T. W., & Mihalko, W. M. (2018). Low rates of adverse events following ambulatory outpatient total hip arthroplasty at a free-standing surgery center. The Journal of arthroplasty , 33 (1), 46-50.
Rothrock, J. C. (2018). Alexander's Care of the Patient in Surgery-E-Book . Elsevier Health Sciences.
