Curriculum 2011 – SXP711SE (in English)

LAUREA UNIVERSITY OF APPLIED SCIENCES

Perioperatiivisen hoitotyön erikoistumisopinnot, SXP711SE

Specialisation studies

Introduction

Perioperative nursing refers to the pre-, intra- and postoperative care of patients who undergo surgery or other
procedures. Preoperative care takes place before surgery, intraoperative care takes place during surgery, and
postoperative care takes place after surgery. Perioperative nursing refers to the care of surgery/procedural patients
as carried out by surgical and anaesthetic nurses.

 The services must be efficient, economical, safe and flexible in order to meet the requirements of the changing size
and age of the population who use health care services, the current statutory requirements, and various
international or national programmes. Perioperative services are characterised by acute, round-the-clock need for
care, resource-intensiveness, and susceptibility to complications. In order to manage the public costs of
perioperative services, the aim is to improve the efficiency and productivity of care, for example by means of
centralised services and shorter treatment times. Perioperative practices are carried out by teams in specialist/
multidisciplinary clinical units. Perioperative nursing is invasive, which means that it involves penetrating or entering
the patient’s body. In these activities, the focus is on safety and asepsis, the management of rapid changes, and
knowledge of medical technologies. Perioperative nursing requires specialist competence. The qualification gained
on completion of this education is equivalent to the international and Finnish criteria NQF6 and EQF6.

 In the Specialisation Studies in Perioperative Nursing, the main focus is on clinical nursing competence. The aim of
the studies is to acquire the necessary skills to provide effective, patient-oriented and safe care of patients. The
studies are designed for working professionals who wish to supplement, advance or acquire the specialist skills
needed in a perioperative nursing environment. The studies encompass 30 credits and can be completed alongside
work.

 The curriculum has been designed using the latest research data about the vocational qualification requirements of
surgical and anaesthetic nurses, the most recent evidence for recommendations, and the clinical experience of local
workplace representatives.

The perioperative nursing environment

Perioperative nursing environments include surgical and anaesthetic departments, recovery rooms, day surgery
units and various procedure clinics. Certain units and departments provide care in a number of disciplines, such as
surgery, gynaecology, ophthalmology and neurology, whereas other departments focus on a single discipline. These
departments often carry out the most demanding procedures in the field. Day surgeries and minor procedure clinics
often have responsibility for the patient's entire perioperative nursing process. Professionals working in a
perioperative nursing environment must be prepared for rapidly changing and critical situations.

 The safety of the perioperative environment depends on the invasiveness of the procedure, the technical aspect of
the operating environment, and various medical factors. Surgical treatment involves a greater risk of infection due to
the invasive nature of the procedures. In a perioperative nursing environment, care-associated infections are
prevented by aseptic techniques and the systematic monitoring of infections. Surgical and anaesthetic departments
and recovery rooms primarily use intravenous medication, which increases the risks associated with medical
treatment and the possibility of complications. The technical operating environment requires sound knowledge of
equipment and its use, and attention to electrical safety. The use of x-ray equipment requires radiation safety
training, and gas safety is also a part of a perioperative nurse’s responsibilities. In perioperative nursing, frequent
patient transfers, positioning patients for surgery, and static - often difficult - working positions during surgery are a
challenge for ergonomics.

 Perioperative care typically involves multidisciplinary team work. The nurses, the operating surgeon and the
anaesthesiologist together form a close team working to provide safe and sound patient care. Other professional
teams working in the wards and units also participate in patient care and the associated arrangements, and as such
they also contribute to the safety of the environment.
 The competence areas of perioperative nursing are based on the general competences of nursing along with the
added requirements brought by the nature of the perioperative working environment. A nursing degree does not
necessarily provide the prerequisites to work in a perioperative nursing environment. Proper orientation,
occupational instruction and additional clinical training in perioperative nursing are required to ensure the right
competence.

Expertise in perioperative nursing

Expertise in perioperative nursing includes both multidisciplinary and subject-specific competence. A perioperative
nurse is an expert in surgical and anaesthetic nursing, providing personal and safe, high-quality care as part of a
multidisciplinary team. The nurse operates as an independent expert in the various roles - instrument nurse, head
nurse, anaesthetic nurse - providing the medical care assigned to the patient. The nursing expertise comprises the
following areas: assistance, instruction and guidance, monitoring duties, situational management, knowledge of care
practices, quality assurance, and communication and interaction.

Skills in perioperative nursing

Perioperative nursing competence is based on general nursing expertise. Perioperative nursing requires a
combination of nursing-specific and multidisciplinary knowledge with competent and ethical practices. Perioperative
nursing is guided by humanistic values and the concept of holistic care. Respect for the patient's individualism,
privacy, integrity and right of self-determination is crucial. The key principles of perioperative nursing are safety,
health-centricity, individual responsibility, family-centricity, and the continuity of care.

 Perioperative nursing is primarily team work. Cooperation, communication and decision-making skills, as well as
documentation, are important in multidisciplinary team work. The roles of surgical and anaesthetic nurses share
certain responsibilities, such as preparing the patient and the operating environment, anaesthetic and medical care,
patient guidance, documentation of treatment, and communication.

 Other key areas of surgical nursing are asepsis and safety, prevention of complications, and knowledge of surgical
nursing techniques and surgical positions. Surgical nurses must be able to identify risks and life-threatening
situations which affect the patient or the surgical team, and they must be capable of independent situational
assessment and action. In addition to medical care, pain management and rehydration, other key competence areas
are knowledge of anaesthetic technologies, monitoring, supporting and maintaining the patient's vital functions, and
patient guidance and recovery support. Perioperative nursing roles require sound multidisciplinary knowledge, which
these studies are designed to provide.

Growth process in perioperative expertise

The prerequisites of competence in perioperative nursing are general nursing skills and a comprehensive and
advanced knowledge of general and perioperative nursing practices, including critical understanding and evaluation
of theories, key concepts, methods and principles. The specialisation studies are designed to provide students with
these specialist skills. The studies provide knowledge of the various duties involved and the ability to apply
multidisciplinary and multiprofessional knowledge in perioperative nursing and as a part of ethical practice.

 Upon completion of the Specialisation Studies in Perioperative Nursing, students will have advanced competence
with sound knowledge of the subject matter and the ability to critically and creatively apply evidence-based data to
resolve complex and unexpected situations. They will be able to lead complex professional activities and to work as
experts in the field. In addition to the evaluation and development of their own competence, the students will be able
to assume responsibility for the development of individuals and groups. They will have the skills for continuous
learning. They will be able to communicate orally and in writing to both specialist and non-specialist audiences.

Description of the specialisation studies

Table 1. Specialisation Studies in Perioperative Nursing - programme structure


                          Specialisation Studies in Perioperative Nursing, 30 credits
                                     Perioperative nursing practice and
                                    development,
                                     10 credits
                                    Medical and multidisciplinary
                                    studies, 5 credits

                                     Evidence-based development of
                                    perioperative nursing practice in a
                                    work placement, 15 credits


Evaluation

The evaluation of the Specialisation Studies in Perioperative Nursing supports the students’ professional
development. Students are encouraged and motivated towards self-direction and to set their own learning goals.


                                                                                                 1. year
OP                        STUDIES
P010                      SPECIALISATION STUDIES IN PERIOPERATIVE NURSING
P0068                     Perioperative nursing practice and development                                         10
P0069                     Medical and multidisciplinary studies                                                   5
P0070                     Evidence-based development of perioperative nursing                                    15
                          practice in a work placement
                                                                                                                  0
P010 SPECIALISATION STUDIES IN PERIOPERATIVE NURSING, 30 cr


P0068 Perioperative nursing practice and development, 10 cr

The student is able to:
•   critically assess their own professional development, identify their strengths and areas for development, and set
    realistic learning goals which support personal development
•   Act responsibly in a team
•   Act in accordance of the values and principles of perioperative nursing
•   Have sound knowledge of legislation related to perioperative nursing
•   Acquire and apply data related to the field, understand the broader concepts, and critically evaluate data
•   Competently apply the concepts of perioperative nursing in their work
•   Prepare patients for surgery, taking into account requirements related to safety and privacy
•   Take into account the laws and regulations related to equipment safety, electrical/gas/radiation safety, the
    related precautions, and to ensure the safe treatment of patients
•   Provide patient-oriented, holistic, competent and safe care during surgery
•   Monitor and interpret the patient’s condition and be able to make quick decisions in rapidly changing and critical
    situations
•   Generate documents and reports as required by laws and regulations
•   Guide and instruct patients, colleagues and students in a productive way
•   Evaluate and develop perioperative nursing practices and have knowledge of quality control tools


Contents of the study unit:
•  Expertise and development: IT skills, information retrieval skills, strategies and tools of online learning, the
   expertise model, team work skills, development methods
•  Clinical perioperative nursing practice: Aseptic techniques, safety and risk management, ergonomics,
   documentation, guidance and instruction, healthcare technologies, surgical nursing techniques, surgical
   positions, managing unexpected situations
•  Developing the quality of perioperative nursing practices: Values, ethical choices and control systems in
   perioperative nursing, quality development processes and tools



P0069 Medical and multidisciplinary studies, 5 cr

The student is able to:
•   Understand and apply the basics of infection control
•   Provide safe and effective medical care, rehydration and pain management
•   Monitor and interpret the patient’s condition before, during and after anaesthesia and perform in an appropriate
    and productive manner based on evidence
•   Handle tissues and assist in surgery using the acquired knowledge of surgery, anatomy and physiology


Contents of the study unit:
•  Microbiology and infection control
•  Anaesthesiology (physiology and pharmacology in anaesthetic practice, blood transfusion and component
   therapy, medical care, rehydration, anaesthesia and pain management)
•  Surgery (surgical anatomy and tissue handling, different surgical techniques, keyhole and open surgery)




P0070 Evidence-based development of perioperative nursing practice in a work placement, 15 cr

The student is able to:
•   Know the principles and methods of research and development
•   Act responsibly in cooperation with partners and colleagues
•   Operate proactively, conduct the development task in a productive way and take responsibility for its completion
•   Present the development process and results in a clear manner both verbally and in writing
•   Apply and critically evaluate their knowledge of perioperative nursing in their activities
•   Make decisions that demonstrate sound clinical knowledge of perioperative nursing practices
•   Make decisions in complex and unprecedented situations and justify and critically evaluate their professional
    decision-making
•   Act as responsible team members


Contents of the study unit:
•  Work placement or internship at an anaesthetic and surgical department or day surgery
•  Development work in a training environment