Desarrollo e implantación de un protocolo perioperatorio de enfermería en cirugía plástica mamaria ambulatoria

Abstract

Perioperative nursing cares place the patients in the best possible conditions for their recovery at home. This fact together with the blocking of the thoracic paravertebral and pectoral nerves as well as with a depurated surgical technique, have enabled the implantation of the breast plastic surgery program in the outpatient system. We elaborate a perioperative nursing care protocol developing the following documents: preoperative nursing interview, presurgical check list, preoperative, intraoperative and postoperative cares, nursing cares and recommendations sheet, protocolized medical treatment sheet, telephonic follow up sheet to evaluate the observance of the treatment, pain, fever, main drain and breast tension. Later an anonymous survey was made to evaluate patients' satisfaction degree. From April 2012 to December 2013, 35 operations with different pathologies were performed in outpatient surgery under thoracic paravertebral anesthesia: 5 patients needed hospitalization, 2 because of pain, 2 because of bleeding and 1 because of vomiting and bleeding. All patients observed the treatment. In the first 24 hours after surgery 28 patients (93,3 %) had ≤3 points of pain in a numeric scale from 0 to 10 and after 48 hours all patients had ≤3 points of pain. Twenty seven patients (90%) reported that the satisfaction degree with the process was very good. To dispose of a perioperative nursing care protocol in outpatient breast plastic surgery with thoracic paravertebral anaesthesia assures the standarization of nursing practice increasing patient safety at home and improving their degree of satisfaction with all the process and with a very good evaluation.