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Hysterectomy Removal of Uterus

Care Of Patient Vaginal And Abdominal Hysterectomy

Purpose

Hysterectomy is the removal of uterus (womb), when the disease affecting the uterus can be cured only surgically and cannot be treated by giving medicines.

Scope

Patient who undergo vaginal and abdominal hysterectomy.

Definition-Vaginal and Abdominal Hysterectomy

Abdominal hysterectomy – Surgical removal of the uterus (a hysterectomy) is done through an incision made in the abdominal wall.  As opposed to a vaginal hysterectomy in which the incision is made within the vagina.

Applicable Areas

Gyneac & Obstetric Department.

Responsibility

Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife, Head Nurse and Housekeeping attendant.

Procedure

  • Receive the patient to Ward from billing department.
  • Collect all investigation reports and other OPD papers.
  • Check the doctor’s order whether the patient to be admitted or not.
  • Ask the patient about past and present family history.
  • Check the vital signs.
  • Enter the admission in the admission book.
  • Check the OPD paper for any further investigation.
  • Check the Blood Group, HB percentage, HIV, HbsAg, HCV reports.
  • Provide the hospital gown to the patient.
  • Check the date and time of surgery.
  • Do the local preparation the day prior to surgery i.e. shaving of umbilicus to thigh and private parts.
  • Tell the patient’s relatives to pay the O.T. booking deposit.
  • Blood units are reserved to manage excessive blood loss.
  • Ensure the consent from the patient and relatives with date, time, place and relative’s signature, husband’s signature is must.
  • Inform the anesthetist and physician (if needed) for the reference.
  • Inform the operation theatre staff about the surgery and the name of the doctor with date and time.
  • Injection T.T. 0.5 ml stat if advised by Gynecologist.
  • Valuables and Clothes to be handed over to relatives and signature to be taken in admission and discharge register.
  • Keep the patient NBM for previous night as per doctor’s advice.
  • On surgery day – soap and water / Proteolysis enema to be given at 6 a.m. as per consultant order.
  • IV Fluid to be started as per consultant order.
  • Inform patients and relatives about the hospital routines and visiting time.
  • If patient is diabetic or hypertensive confirm whether it is controlled or not before surgery and shift the patient to operation theatre after getting fitness from the physician.
  • Take high –risk consent, if needed.

Documentation

  • Admission and Discharge Register.
  • Billing Record Data.
  • Nurse’s Observation Sheet.