Conducting a fantastic pre-op interview can seem a little challenging if you’re new to the O.R. Our interactions with conscious patients are very limited. We introduce ourselves before surgery, do a quick interview, and then it’s off to dreamland for our patient while all of the work goes on around them.
Yet, even though our time is limited, and let’s be honest – often rushed – the time that we do get to spend interviewing our patients is crucial. And while we’re constantly pushed to have quick turnovers and minimal delays, it is vitally important that our interview is thorough.
But if you’re new to all of this, interviewing your patient can seem a little overwhelming.
Sometimes it’s difficult to come up with the right questions to ask, and to remember all of the different topics you need to cover while you’re asking all those questions. And nobody wants to do the walk of shame back to pre-op to go ask their patient one or two more questions because they forgot to ask them the first time!
Instead, I want to help you get it right the first time.
Today we’re going to go over the crucial elements of the patient interview. That way, when it’s time for you to go interview your patient, you’ll be set up for success. And you’ll be able to conduct a fantastic – and complete – interview with confidence.
And, as an added bonus, I’ve created a handy-dandy cheat sheet for you!
It covers all of the critical elements of the pre-op interview – and interview questions are included! Just click the link at the bottom and you’ll be able to download your free cheat sheet for conducting a fantastic pre-op interview.
Now let’s look at the 12 elements that I believe are best to include in any pre-op interview.
This is a general guideline. Some specialties may require more specific questions, just follow your facility’s policies for specifics.
The 12 Elements For Conducting A Fantastic Pre-Op Interview
#1 – Verify your patient’s name and date of birth
It may seem a little obvious, but always do this first. You want to make sure you have the right patient before you start asking any more questions.
Also, you should always use two patient identifiers when confirming your patient. Some facilities use name and date of birth. Others may require that you use the medical record number. Use whatever two identifiers your facility requires.
#2 – Confirm the patient’s allergies
Even though you can see their allergies in the computer or on their chart, always ask your patient. You want to hear the patient tell you what their allergic to. And you might be surprised to hear a different allergy than what the chart says. So always confirm.
This is also a good time to ask about sensitivities to latex and betadine. A patient might not have an allergy to them, so they might forget about it. I like to ask my patients directly about these sensitivities, just to make sure. And it’s as simple as saying, “Do you have any sensitivities to latex or betadine,” after you ask them to confirm their allergies.
#3 – Verify the patient’s surgeon
You’re just making sure that the patient knows who is working on them. And they don’t always know or remember, but it’s good to ask. And if they can’t remember, tell them who their surgeon is. Once you tell them, they’ll usually say, “Oh yeah, that’s right!”
#4 – Verify the patient’s procedure
You want the patient to tell you – in their own words – what they are having done. I always say to my patients, “Tell me what you’re having done today.” After they give me their description, I’ll read them what their consent says and ask if that sounds right. This is also the time that you confirm laterality – right or left – if it is appropriate for your case.
#5 – Verify that the surgical site has been marked
While you’re confirming what procedure is being done, check to make sure that your patient has been marked. This isn’t always necessary, depending on the case. But if a mark is required (right vs left for example) make sure that your patient is marked before rolling back to the O.R.
#6 – Verify the patient’s NPO status
Do you know how many times a patient waits until they see the O.R. nurse to admit to the Twinkie that they ate when they got up in the morning? Most patients will tell their pre-op nurse or the anesthesiologist if they’ve eaten anything. But there’s always those few who won’t mention it, and they say they haven’t had anything to eat. And then the O.R. nurse shows up to take them for surgery, and they admit to having a snack, drinking coffee with cream, or eating that dang Twinkie.
So don’t be afraid to ask your patient! You might find out something new.
#7 – Ask about body piercings or jewelry
Usually pre-op handles this and has the patient remove their jewelry. However, there are parts of the body that get pierced these days that you can’t see until the clothes come off. So, asking directly about piercings is a good idea. Patient’s either forget, or try to avoid removing certain piercings – not realizing that they could interfere with their procedure.
You could say, “Are you wearing any jewelry, or do you have any piercings in any place that I can’t see right now?” Patients usually get the drift and will tell you if there’s a piercing somewhere.
#8 – Ask about any metal inside the body
This has to do with placement of the bovie pad during a procedure and avoiding burns on the patient. For safety’s sake, most facilities tell you not to place a bovie pad over a site that has metal (let’s not debate whether that’s necessary or not).
I always ask, “Do you have any metal inside your body; any plates, pins, or screws?” Your patient will tell you about everything inside them after that question, but it’s helpful to know which areas to avoid with your bovie pad.
#9 – Ask about dentures, partials, and hearing aids
These can get overlooked. So I’ll ask if they still have them in when I go interview them. Sometimes patients like to keep them in until the last possible second, and I understand that. Who wants to be lying in a bed for 2 hours unable to hear and without any teeth? That would be embarrassing. But if it’s been a long time since the pre-op nurse worked on them, the dentures or hearing aids might get forgotten.
#10 – Confirm that the consent is complete, signed, and dated
This is just your final check to make sure that your paperwork is complete. You can’t operate on a patient if their consent isn’t signed. (I realize emergency situations are different)
#11 – Confirm that the H&P is complete, signed, and dated
Once again, just check it again to make sure that it’s complete. If it’s out of date, you’ll need it updated before you can roll back.
#12 – Ask if your patient has any other questions or concerns
This final question just makes sure that your patient has the opportunity to address any other concerns that they have. It might be something as simple as needing to get up to go to the restroom. Or they might want to speak with the surgeon again. Whatever they need, it helps to address it with them so that they feel comfortable before going into surgery.
And that’s it!
Conducting a fantastic pre-op interview will come naturally with practice and repetition. I hope that by breaking it down into 12 different elements it has helped you to understand the pre-op interview a little better, and taken away any fear you may have about asking the right questions.
Now, grab your free cheat sheet! When you click on the image, you’ll be prompted to enter your name and email address. After you enter those you’ll get the link to snag your freebie!
Enjoy!
Melanie
Please remember, this is a guideline for a basic pre-op interview. Subspecialties might require more detailed questions. Every facility has specific rules regarding their interview process and requirements for surgery. Always follow the rules specific to your facility and your area of practice.