CHAPTER ONE

Introduction

Pre-operative assessment is a process where nurses check patients before they have surgery. This assessment is very important because it helps nurses understand the patient’s health and readiness for the operation. Nurses look at the patient’s medical history, current health conditions, and any allergies they may have. They also check vital signs like heart rate and blood pressure. Through this, nurses can identify any potential risks and ensure that the patient is safe for surgery Hinkle & Cheever (2018).

Nurses use several techniques to assess patients before surgery, they perform a physical examination, which involves looking for any signs of illness or problems. They also ask the patient questions about their symptoms and feelings to gather more information. Observing the patient’s behaviour is another important technique. Nurses use tools like checklists and charts to organize their findings and ensure they do not miss anything important Rooke & Baird (2020). These techniques help nurses collect accurate information quickly, which is essential for patient safety.

Nurses face several challenges in the surgical assessment of patients. A common challenge is that patients may feel anxious or in pain, making it hard for them to provide clear information. Language barriers can also complicate communication between nurses and patients. Some patients may have complex health issues that are difficult to assess. These challenges can affect the quality of the assessment and the overall care that patients receive Peate & Pritchard (2019).

1.1.Background of the study

The clinical practice of assessment techniques for surgical patients by nurses is essential for optimizing surgical outcomes across various for patients worldwide. Globally nurses employ comprehensive assessment methods, including detailed health histories, physical evaluations, and risk stratification, which are critical in identifying patient-specific needs and tailoring preoperative care Hernandez et al., (2023). These thorough evaluations not only reduce preoperative anxiety but also enhance patient readiness for surgery, leading to improved postoperative recovery. Robust preoperative assessments correlate with decreased rates of surgical site infections and shorter hospital stays, as patients are better prepared and informed about their procedures Hernandez et al., (2022). The use of standardized assessment protocols promotes improved communication within multidisciplinary teams, ensuring that all healthcare providers are aligned in their approach to patient care, which ultimately enhances patient safety and satisfaction Johnson & Lee (2023). Notably, in areas with advanced nursing practices, the positive impact of these assessment techniques is evident in lower complication rates and higher patient satisfaction scores post-surgery Brown et al., (2023). The integration of effective assessment techniques by nurses is therefore necessary in promoting favourable surgical outcomes. 

In Africa, surgical patient assessment involves a range of practices that significantly influence surgical outcomes. In many healthcare settings within the continent, nurses utilize systematic approaches to assess patients preoperatively, including comprehensive health histories and physical examinations to identify potential risks. In countries like Nigeria and Kenya, nurses often employ the ASA (American Society of Anaesthesiologists) classification system to stratify patient risk based on comorbidities and overall health status Munyiginya et al, (2021). This practice aids in tailoring aesthetic plans and surgical approaches, thus improving patient safety. Many nurses within the continent conduct thorough evaluations of vital signs and laboratory results to monitor patient’s stability before surgery. In South Africa (SA), the integration of nursing assessments into multidisciplinary surgical teams has been shown to enhance communication and expedite decision-making processes, leading to better-prepared surgical patients Abebe et al., (2023). Postoperatively, nurses play a critical role in monitoring recovery through regular assessments of surgical sites and patient responses, which are essential for early detection of complications such as infections or haemorrhage Woodhead (2023). The implementation of these assessment practices, when applied consistently, has demonstrated a positive impact on reducing surgical site infections and improving overall recovery times. Thus, while challenges remain, the effective application of nursing assessment techniques considerably contributes to better surgical outcomes.

In Cameroon, the role of nurses in the assessment of surgical patients is crucial to enhancing healthcare delivery and ensuring optimal patient outcomes. Nurses are integral in performing comprehensive evaluations, which include assessing patient’s medical histories, conducting physical examinations, and monitoring vital signs. This proactive approach aids in the early identification of potential complications, thereby contributing to safer surgical procedures. The Cameroon Health Sector Strategy (CHSS) emphasizes the importance of nursing roles, stipulating guidelines for nursing assessments that align with national healthcare objectives Ministère de la Santé Publique (2016). These provisions encourage nurses to engage in continuous professional development, enabling them to stay updated on best practices in surgical care. Nurses are responsible for administering medications and managing postoperative pain, which requires adherence to established protocols to ensure patient safety. Their role extends to providing patient education, helping individuals understand their conditions and treatment options, thus promoting an environment of informed consent and collaboration. The nursing profession in Cameroon is guided by regulatory frameworks that advocate for the importance of advocacy and effective communication between patients and the surgical team, ensuring that patient’s rights and needs are prioritized within the healthcare system Cameroon Nursing Association (CNA) (2019).

1.2. Problem of the Statement

Nurses play an important role in assessing patients before surgery. They have the role to gather information about the patient’s health, medical history, and any risks that could affect the surgery. This assessment is crucial for ensuring that patients receive safe and effective care. By understanding a patient’s unique circumstances, nurses can identify potential issues and advocate for the patient’s needs, helping to promote a smoother surgical experience Peate & Pritchard (2020).

However, despite their vital role, many nurses face limitations that prevent them from fully utilizing their skills in this area. One of such limitations is that many nurses follow strict institutional Standard Operating Procedures (SOPs) that restrict how they can assess patients. These procedures often lead nurses to focus primarily on collecting medical history and basic information, while the deeper aspects of patient assessment are left to doctors. this long-standing culture of role shifts within most clinical environments leaves nurses ignorant of their professional roles which is necessary irrespective of the presence of a medical practitioner. added to this is evidence to support these claims as the principal investigator noted on several internships hoe nurses only focus on charting patients and never almost go beyond their implied roles of charting patients before surgery. it is against this back drop that the principal investigator seeks to analyse the nature of this situation in the Tubah District Hospital by assessing the techniques used in the general assessment of patients necessitating surgery by nurses at the Tubah District Hospital

1.3 Research Questions

1.3.1 Main Research questions

What are the techniques used in the pre-operative assessment of patients necessitating surgery by nurses at the Tubah District Hospital?

1.4 Specific research questions

1. What are the techniques used in the pre operative assessment of patients by nurses at the Tubah District Hospital?
2. What is the adherence with techniques used in pre-operative preparation of patients by nurses at the Tubah District Hospital?
3. What are the challenges faced in the pre-operative assessment of patients by nurses at the Tubah District Hospital?

1.4.1 Main Research Objective

To assess the techniques used in the pre-operative assessment of patients necessitating surgery by nurses at the Tubah District Hospital

1.4.2 Specific Research Objectives

1. To examine the techniques used in the preoperative assessment of patients by nurses at the Tubah District Hospital.
2. To determine the adherence with techniques used in pre-operative preparation of patients by nurses at the Tubah District Hospital.
3. To identify the challenges faced in the pre-operative assessment of patients by nurses at the Tubah District Hospital.