HOME CARE AFTER SURGERY

Home Care after Surgery



Home Care after Surgery

Kit aged 54 lives locally with his wife and teenage children.  Until 2 years ago Kit was a self-employed builder.  Mobility problems and restrictions imposed by his present condition, together with long periods of absence have forced him to leave his occupation.  Kit is diagnosed as having osteoarthritis of the hip. “Oesteoarthritis is a wear and tear arthritis that affects weight bearing and highly stressed joints such as the hip and knee”. (Palmer 1999).

 Prior to the onset of osteoarthritis Kit had enjoyed good health, was physically fit and active, he had minor eye surgery 7 years ago, and his appendix removed at 19.  Kit and his wife enjoy social dancing, mobility problems and pain have prevented this for the past 18 months, and their social life has consequently decreased.  Prior to surgery Kit said he felt himself to be a “Liability, unable to work and support his family financially, unable to enjoy himself socially, he felt worthless and incompetent with little positive future for himself”.  The psychosocial effect upon his quality of life made him feel constantly nervous and anxious.  Jackobson (2002) states “ There is an increasing risk with age of being affected by osteoarthritis, and therefore pain and decreased quality of life as a result”.

 Creamer (1997) suggests “Depression, anxiety and fatigue are significantly related to pain”.  Gradually his symptoms worsened, increasing pain, decreasing mobility and constant sleep disturbance.  He was prescribed Ibuprofen NSAIDS (Non Steroidal Anti-Inflammatory Drugs) and Tramadol, a centrally acting analgesic which helped relieve the pain but only partially, following X-Ray examination and several consultations Kit was advised to consider a total hip replacement.

Palmer (1999) states ”Total hip replacement is an elective procedure to remove deteriorating bone and cartilage in a joint and replace the joint with an artificial component known as a prosthesis”. Kit felt he needed time to consider if he should have surgery and not rush into it without exploring other options.  Naidoo (2000) states it is important that “People should make their own decisions about their own health”.

 

PRE ASSESSMENT SCREENING

After electing to undergo surgery Kit attended for pre-assessment screening.  A detailed medical history was taken, together with CBC (Complete Blood Count) ECG (Electrocardiogram) and a chest X-Ray.  His blood pressure and weight were  measured, he was screened for MRSA (Methiclin Resistant Staphloccus aureus) as Makoni (2002) states “MRSA is now endemic in many UK hospitals”.

Kit was informed he was fit for surgery and given a date for admission.

 

ADMISSION AND NURSING ASSESSMENT

Kit was admitted the day prior to his surgery.  He was oriented to the ward and introduced to his named nurse.  The principle of named nursing is that the allocated nurse should plan and evaluate all care for the named patients, ensuring the patient and his relatives have a main and consistent point of contact for information.  The concept was introduced in the Patient's Charter by the British Government in 1992.  “It is the responsibility of the named nurse ...