CHAPTER ONE

1.1 :INTRODUCTION

Emergency surgery is a type of surgery that is carried out on a patient without prior planning, and therefore the time taken to prepare and teach the patient on how to manage post-surgery complications is short. And because it is short, there will be complications in taking care and also in healing.

1.2: Back Ground of the study

Emergency surgical care is defined as the care given to patients that have undergone surgery because of an urgent medical condition. This condition may be life threatening e.g. acute appendicitis, trauma etc. 

This kind of care given to patients after surgery is called the post-operative care and it very essential. Post-operative care refers to the time spent in the recovery unit until the patient is being transferred to the inpatient ward. [1] It is the responsibility of the nurse to provide a setting where patients receive the best possible support during the Emergency surgical procedure [2]. The primary purpose of the nurse is to ensure patients safety to identify, prevent and immediately treat early complications, especially surgical related complications before they develop into serious or life threatening problems.

These needs are fulfilled through creating and maintaining a sterile and safe environment, providing post-operative education, monitoring the patient’s physical and emotional wellbeing, and integrating and coordinating patient care throughout the surgical care continuum [1].

 Failure to give appropriate postoperative Emergency surgical nursing care will lead to high surgical morbidity and mortality rate. Inadequate postoperative emergency surgical nursing care can affect both the patient and the health care providers as it will lead to stress and increase rate of infection [3]. Peri-operative nurses take care of patients throughout the  surgical process, which covers admission, surgical intervention, and recovery in the post anesthesia care unit. However, certain stress factors limit nurses’ ability to provide best patient care. Several studies have shown that in the postoperative work environment, job stress, and burnouts are related to factors such as workload, time pressure, patient safety, inadequate communication among team members, feeling of unpreparedness for procedure, and demands for continuous learning [4]. Consequently, these factors lead to inefficiency of work, and decreasing productivity and quality of nursing care. These challenges faced by nurses will contribute highly to inadequate postoperative nursing care to patients that have undergone emergency surgery and hence more surgical complications [5]. The WHO guidelines for safe surgery (first edition) provide evidence for the essential components of safe surgical care which form the checklist [6] The CDC also states that improved workload and good organizational climate will reduce job related burnout and protecting patient from infection.[3]

According to W.H.O perioperative complications are a major global health care burden [6].  Postoperative deaths count for7.7% of all deaths globally. In 2020, Africa had hospital mortality rate of 2.1% with 18% developing postoperative complications and 9.5% of patients died following postoperative complications [6, 7] The W.H.O has estimated that about 3-16% permanent disabilities in the world due to surgical complications [7].

Surgical care which form the checklist The CDC also states that improved workload and good organizational climate will reduce job related burnout and protecting patient from infection.

According to W.H.O perioperative complications are a major global health care burden 1: Postoperative deaths count for7.7% of all deaths globally. In 2020, Africa had hospital mortality rate of 2.1% with 18% developing postoperative complications and 9.5% of patients died following postoperative complications.  The W.H.O has estimated that about 3-16% permanent disabilities in the world due to surgical complications [6].

 1.3: Problem of Statement

Adequate postoperative surgical nursing care is an essential procedure in health care and should be considered as a critical dimension of care transition for a surgical patient. The postoperative environment is “information intensive and relying heavily on how well information flows between phases, location, and providers. Failure of the nurse to have these qualities can cause communication breakdown, information loss, increased workload and competing tasks pose the greatest threats to patient safety. Overall, surgical complications rate has declined during the past 30years because of improved nursing care and surgical However, past studies still shows that surgical complications are common especially in low income countries like Cameroon [8]

These complications include: depression and risk of infection

Globally, 310million major surgeries are performed annually, with an estimate of 1-4% mortality rate, 15% serious postoperative morbidity and 5-15% readmissions within 30days of surgery. These percentages translate to an average global mortality rate of nearly 8million deaths per year with infection being the leading cause especially in sub-Saharan Africa. [10]. Previous studies indicate that in Africa up to 1/3 of patients undergoing surgery may be affected by a postoperative infection [11]. In 2021, the prevalence of SSI following abdominal surgery in Cameroon was 30.7% [12]. Thus a review on prevention of inadequate postoperative nursing care will go a long way to prevent surgical complications and facilitate patient satisfaction hence, reducing mortality and morbidity rate in Bamenda, Cameroon and the world at large [13]

1.4: Research Questions.

1. What are the types of emergency surgical care provided at Mbingo Annex Baptist Hospital?
2. What are the appropriate cares given to patients in the Mbingo Annex Baptist Hospital?
3. What are the challenges?

1.5: Research Objectives.

1. To assess types of emergency surgery in the Mbingo Annex Baptist Hospital.
2. To assess the care given to patients that has undergone emergency surgery in the Mbingo Annex Baptist Hospital.
3. To identify challenges faced in take care of patients who have undergone emergency surgery in the Mbingo Annex Baptist Hospital.