BEEBE HEALTHCARE
MARGARET H. ROLLINS SCHOOL OF NURSING
NURSING 102
NURSING CARE OF ADULTS
2014
SURGICAL FOLLOW THROUGH
In Nursing 102 the student will have the opportunity to follow a patient during all three phases of
perioperative care. The student will be assigned the patient preoperatively, observe preparation
of the patient prior to surgery, observe in the intraoperative phase, follow the patient to the postanesthesia care unit and finally to the post-operative unit. The student will provide care as on a
regular clinical day for the patient on Post-Operative Day One. The surgical follow through is a
mandatory clinical experience. If a student is absent for their scheduled OR week, clinical will
be rescheduled.
PATIENT ASSIGNMENT:
A surgical patient will be assigned the week of the student’s OR clinical experience. The student
is expected to be present during all phases of the perioperative experience.
PURPOSE:
The purpose of this assignment is for the student to write a professional paper, utilize APA
formatting, enhance understanding of hospital systems, and have the opportunity to reflect on a
surgical experience from the patient’s perspective. A professional paper addressing the student’s
perioperative follow-through experience is a required component of the N102 semester. The
student will write about their observations and experiences as they follow a patient through their
surgical experience and also care for that patient in the post-operative period. In the Surgical
Follow Through paper the following QSEN competencies are identified: patient-centered care,
teamwork and collaboration, evidence based practice, quality improvement, informatics, and
safety.
DUE DATE:
This assignment is to be completed and handed in no later than 0800 on the Monday
2 1/2 weeks after completion of the clinical assignment. Five (5) points will be deducted from
the total grade for each class or clinical school day that the paper is late. If a student is going to
be absent on the due date, it is the student’s responsibility to make arrangements to ensure the
paper is submitted on time.
FORMATTING:
The student should refer to the APA textbook and their Student Handbook for “Guidelines
Regarding Use of Resources” and the “Writing Competency Policy”. The student must
document correctly within the text according to APA format any information taken from a
source. A reference list of all resources used to complete the assignment must be included at the
end of the paper in APA format. The Surgical Follow Through paper requires a minimum of two
references that are current within the last five years. Copies of internet sources used must be
included with the paper and the information referenced highlighted. An abstract and headings are
not to be included. The student will write in the first person.
CRITERIA FOR EVALUATION:
The paper will be graded on a scale of 0-100 points and will count as 10% of the theory grade.
The graded paper will be returned within 4 weeks of submission.
SURGICAL FOLLOW THROUGH GUIDELINES
The following areas are to be addressed in the formal surgical follow through paper. Refer to
the patient by initials only.
Preoperative Phase:
 Describe your first interaction with your assigned patient.
 What was the patient’s response to having a student nurse with them?
 If the response was positive, what do you think aided this? If negative, what could have
been done differently?
 Discuss your patient’s thoughts and feelings in response to having surgery. Include
verbal and non-verbal observations.
 Discuss the use of the electronic health record during the patient’s preoperative phase.
 Explain what pre-operative teaching was done prior to the patient being taken to the
operating room. What was the patient’s response to this teaching?
 Describe the role of the preoperative nurse.
 Describe your overall view of the patient’s preoperative phase.
Intraoperative Phase:
 How was the patient greeted upon entering the operating room?
 What special preparations were done prior to surgery beginning and why?
 Discuss the Time-Out process and its purpose. Must cite reference in the text.
 Discuss the interactions of the OR team.
 Discuss the role of the intraoperative nurse.
 Discuss how you feel the patient was treated during surgery.
PACU Phase:
 Discuss unique aspects of the PACU environment.
 Discuss the role of the PACU nurse.
 Discuss SBAR technique and its purpose. Must cite reference in the text.
 Describe the nurse-to-nurse report when the patient was transferred into PACU. Was it
comprehensive? How did it align or differ from SBAR technique?
 Was the information shared during report appropriate? If not why?
Post-operative Care:
 Describe the nurse-to-nurse report when the patient was transferred onto the
postoperative floor. Was it comprehensive? How did it align or differ from SBAR
technique?
 Was the information shared during report appropriate? If not why?
 Discuss how the electronic system used for medication administration impacts patient
safety. How does it address the 10 rights of medication administration?
 Discuss the role of the postoperative nurse.
Conclusion:
 Reflect on the perioperative experience and discuss how providers in the healthcare
setting contributed to your patient’s surgical experience
 How did your involvement in the patient’s care impact his/her experience?
 Identify the hospital tool for documenting unexpected occurrences?
 Why is tracking unexpected occurrences in the hospital important?
Evaluation of Surgical Follow Through:
 Choose one of the provided research articles. Identify whether the care provided your
patient met this evidence based practice. Discuss why or why not.
 What were your feelings regarding the patient’s surgical experience?
 Discuss how this experience enhanced your learning.
 Was the experience what you expected? If not, how was it different?
Format:
 Grammatical and/or spelling errors are evaluated utilizing the grading rubric
 APA format within text and on reference list is graded for accuracy
 Minimum of two appropriate references are used– not greater than 5 years old, and a
copy of each Internet source used, with the information referenced highlighted
accompanies the paper
Grading Rubric
This paper is to be 5-7 pages in length. Students must address each area completely by
answering all of the questions posed. Students are also required to self evaluate themselves
utilizing the grading rubric provided. This self evaluation is to be included with paper
submission. Any paper submitted one full week prior to the due date will be awarded 2 bonus points
to the Surgical Follow Through grade.
For the section “Evaluation of Surgical Follow Through” choose ONE of the articles made
available through Edvance 360.
Articles
Spruce, l. (2014). Back to basics: Preventing surgical site infections. AORN Journal, 99(5), 600611. doi:
Johansson, R., Malmvall, B., Andersson- Gä re, B., Larsson, B., Erlandsson, I., Sund-Levander,
M., Rensfelt, G., Mölstad, S., & Christensson, L. (2012). Guidelines for preventing
urinary retention and bladder damage during hospital care. Journal of Clinical Nursing,
22, 347-355. doi:10.1111/j.1365-2702.2012.04229.x
Knudson, L. (2012). New sterile technique recommended practices contain new evidence,
illustrations. AORN Journal, 96(6), C5-C6.
Parry, M., Grant, B., & Sestovic, M. (2013). Successful reduction in catheter-associated urinary
tract infections: Focus on nurse-directed catheter removal. American Journal of Infection
Control, 41, 1178-1181.
Larkin, B., Mitchell, K., & Petrie, K. (2012). Translating evidence to practice for mechanical
venous thromboembolism prophylaxis. AORN Journal, 96(5), 513-527.
Mong, A., & Pugh, L. (2013). Using evidence-based practice in the OR: One nurse’s experience.
OR Nurse 2013, 7(6), 12-16.
Margaret H. Rollins School of Nursing
Nursing 102 – Nursing Care of Adults
Surgical Follow Through Grading Rubric
Criteria: Content
2.
Preoperative Phase
3.
Intraoperative Phase
4.
PACU Phase
5. Postoperative Phase
6. Conclusion
7.
Evaluation of Follow Through
5.
Writing Style
6.
Self Evaluation
Exceeds
Expectations
Comprehensively
addresses preoperative
criteria (20)
Comprehensive
information provided for
intraoperative phase
(20)
Comprehensive
information provided for
PACU phase criteria
(20)
Comprehensive
information provided for
postoperative criteria
(20)
Comprehensive
information provided for
conclusion criteria (15)
Comprehensive
information provided for
evaluation criteria (15)
Skilled presentation of
ideas. Engages reader.
(5)
Meets
Expectations
Addresses
preoperative criteria
with basic information
(18)
Addresses
intraoperative phase
with basic information
(18)
Addresses PACU
phase with basic
information (18)
Below
Expectations
Inadequately
addresses
preoperative criteria
(16)
Inadequately
addresses
intraoperative phase
criteria (16)
Inadequately
addresses PACU
phase criteria (16)
Addresses
postoperative phase
with basic information
(18)
Addresses conclusion
with basic information
(13)
Addresses evaluation
with basic information
(13)
Able to present ideas.
Work appropriate for
this level of student
(4)
Self evaluation
completed (2)
Inadequately
addresses
postoperative phase
criteria (16)
Inadequately
addresses conclusion
criteria (11)
Inadequately
addresses evaluation
criteria (11)
Limited ability to
convey ideas. Below
expectations of work
at this level (3)
Self evaluation not
completed (0)
Grammar correct with
no more than 5 errors
(0.5)
Spelling correct with
no more than 3 errors
(0.5)
APA format in text
correct at 75%-84%
(1)
Reference page
correct at 75%-84%
(1)
All resources current
(1)
10 or more
grammatical errors
(0)
10 or more spelling
errors
(0)
APA format in text
correct at less than
75% (0.5)
Reference page
correct at less than
75% (0.5)
One or more
resources not current
(0)
Internet copies not
provided (0)
Criteria: Format
1. Grammar
2.
Spelling
3.
APA format in text
4.
APA format on Reference page
4.
Resources current within last 5
years
5.
Internet copies provided and
highlighted
Grammar correct with
no more than 3 errors
(2)
Spelling correct with no
more than 3 errors (2)
APA format in text
correct at 85% or more
(2)
Reference page correct
at 85% or more (2)
Internet copies provided
and highlighted (1)
Internet copies
provided not
highlighted (0.5)
2 bonus points for early submission
TOTAL POINTS EARNED
Earned points/129 = %