TOPIC: NURSING INTERVENTION IN THE PREVENTION OF POST-

OPERATIVE COMPLICATIONS.

TABLE OF CONTENT

CHAPTER ONE

INTRODUCTION………………………………………………………………………..1

1.0 Background of the study………………………………………………………………1

1.2 Problem Statement…………………………………………………………………….2

1.3 Aim of Study……………………………………………………………………………3

1.4 Research Questions……………………………………………………………………..3

1.5 Research Hypothesis……………………………………………………………………3

1.6 Research Objective……………………………………………………………………..4

1.6.1 Main Objective……………………………………………………………………….4

1.6.2 Specific Objective……………………………………………………………………4

1.7 Scope of Research …………………………………………………………………….4

1.8 Significance of Study………………………………………………………………….4

1.9 Definition of Key Terms ……………………………………………………………...4

CHAPTER TWO

LITERATURE REVIEW………………………………………………………………...6

CHAPTER THREE

MATERIALS AND RESEARCH METHODOLOGY

3.1 Study Design…………………………………………………………………………..8

3.2 Study Duration………………………………………………………………………..8

3.3 Study Area…………………………………………………………………………….8

3.4 Study Population………………………………………………………………………8

3.5 Sampling and Sample Size………………………………………………………………….8

3.5.1 Sampling Method…………………………………………………………………………..8

3.6 Selection Criteria…………………………………………………………………………….8

3.7 Data Collection………………………………………………………………………………8

3.8 Data Analysis………………………………………………………………………………..9

3.9 Ethical Consideration……………………………………………………….……………….9

 CHAPTER ONE
Introduction
1.0 Background of the study
Surgery is a branch of medicine that treats injuries, diseases and deformities by physical
removal, repair or readjustment of organs and tissues, usually through cutting into the body.

About 310 million patients undergo surgery worldwide each year with more procedures
taking place in high-income countries (Weiser TG et al., 2012). Findings from epidemiological
Studies reveals that 4.8 billion people are unable to access safe surgical treatment and that at
least 143 million additional procedures are required each year primarily in low-and-middle
income countries. Estimates from high-income countries suggest that post-operative
complications occur in up to 20% of patients (Meara. JG et al., 2015)

We note that surgery is a branch of medicine that deals with cutting through tissues for the
purpose of treatment. Post-operative complications are a common outcome of surgery
nowadays and this is related to various factors including Nursing practices and other related
aspects.
- Post-operative complications. These are problems that can happen after you
have had a surgery but were not intended. (Dr Mary Lowth 30th July 2017)
- Complication: An unanticipated problem which arises as a result of a procedure,
treatment or illness. (Melissa Conrad stoppler 2021)
- Intervention: In medicine, it is a treatment, procedure or other action taken to
prevent or treat a disease or improve health in other ways.
- Prevention: Prevention refers to actions aimed at avoiding the manifestation of a
disease, which may include factors to improve health through changing the impact
of social and economic determinants on health; the provision of information on
behavioral and medical health risks alongside consultation. (NIC dictionary of
cancer terms)
Postoperative complications will be heavily managed if quickly identified and proper
measures are been taken. A rare individual has no complications after surgery. Most patients
experience a minor complication or two, problems that resolve quickly and easily in the days

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following. Avoiding these complications can lead lo faster recovery after surgery. (Jennifer et
al.,2020)
Having surgery might provide you with a sense of relief or a sense of apprehension about
what comes next. While most people recover from surgery just fine, some people develop post-
surgery complications that can range from minor itching at the incision site to serious blood clot
in the lungs. Being well educated on the warning signs, the complications will be easily
preventable. (The Lancet Commission on Surgery)
Low Grade Fever of about 37.5 degree is not abnormal after having surgery but if you
develop a high fever above 38.5 degree (which is 101.3F) you should call your surgeon or the
nurse in charge.
Fever can indicate several post-surgical complications. Including an infected wound.

1.2. Problem Statement

We note that surgery is a branch of medicine that deals with cutting through tissues for the
purpose of treatment. Post-operative complications are a common outcome of surgery nowadays
and this is related to various factors including Nursing practices and other related aspects.
In Cameroon, postoperative complications are heavily managed if quickly identified and
proper measures are been taken. A rare individual has no complications after surgery. Most
patients experience a minor complication or two, problems that resolve quickly and easily in the
days following. Avoiding these complications can lead lo faster recovery after surgery.(Jennifer
et al.,2020)
Some postoperative complications are related to the exact surgery you had. But many may
occur after any kind of surgery. It can be because of
- Poor hygiene
- Lack of knowledge
- Negligence
- Pre-existing infections (Dr Mary Lowth et Dr Bonsall., 2017)

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 Post-operative complications are one of the leading causes of health-related deaths, which
could be prevented primarily through identification of risk factors, which include;
- Age
- Underlying disease condition e.g., Diabetes, cardiac disease.
- Anesthesia
- Duration of hospitalization
- Blood transfusion
- History of sepsis
- Corticosteroid use
- Smoking
- Weight (Andrew j schoenfel et al 2011)
These are for general surgeries only, so there is more on surgical specialties and unless these
risk factors are well known and taken into consideration for proper action in the prevention of
post-operative complications, the occurrence/rate will stay high.

1.3 Aim of study

To identify possible risk factors predisposing patients to post-operative complications and to
find out possible ways by which post-operative complications can be prevented

1.4 Research Questions

1. What is the knowledge among the population of the Limbe community

2. What is the practice rate in the prevention of these complications

1.5 Research Hypothesis

1. Post-operative patients have inadequate knowledge regarding post-operative

complications
2. Post-operative patients have inadequate practices in the prevention of post-operative
complications

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1.6 Research Objectives

1.6.1 Main Objective

The main objective of this research will be to assess the knowledge and practice of the
prevention and management of post-operative complications among the Limbe population

1.6.2 Specific Objectives

i. To assess the knowledge of post-operative complications among the post-operative

patients in the limbe population

ii. To ascertain the practice of preventive methods against these post-operative

complications

1.7 Scope of Research

This scope of this research study involved post-operative patients in the Limbe community

1.8 Significance of Study

The findings obtained from this study will be used by policy makers and stakeholders to identify
the awareness and practice of post-operative complications measures so as to provide
information about operative and post-operative complications among the limbe population

1.9 Definition of Key Terms

Knowledge: it refers to the verbalization of learned information and familiarity with fact or truth
regarding menstrual hygiene.

Practices: These are ways or majors use regarding menstrual hygiene

Health: A state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity.

Post-operative complications. These are problems that can happen after you have had a surgery
but were not intended. (Dr Mary Lowth 30th July 2017)
Complication: An unanticipated problem which arises as a result of a procedure, treatment or
illness. (Melissa Conrad stoppler 2021)

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Intervention: In medicine, it is a treatment, procedure or other action taken to prevent or treat a
disease or improve health in other ways.
Prevention: Prevention refers to actions aimed at avoiding the manifestation of a disease, which
may include factors to improve health through changing the impact of social and economic
determinants on health; the provision of information on behavioral and medical health risks
alongside consultation. (NIC dictionary of cancer terms)

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 CHAPTER TWO
LITERATURE REVIEW

When a clinician completes implant therapy with a patient, regardless of the phase involved, it
is paramount that follow-up care be continued. As described in this chapter, postsurgical
complications may arise even in the best of initial operative situations. Prosthetic complications
are also of concern, which necessitates a comprehensive follow-up program. The implant
clinician who is aware of potential postoperative complications in all phases of implant therapy
will be ready to treat any situation in a rapid and competent manner. An understanding of the
necessity of maintaining close communication with the patient throughout the entire treatment
process is crucial. Knowing the potential for these complications beforehand and communicating
them to the patient, along with a using a strong follow-up protocol, gives the patient further
confidence in the clinician should any circumstance arise. This is beneficial to reduce stress for
the implant clinician and the patient, which minimizes the chances of medico-legal issues.
(Randolph R. Resnik et al 2018)

Post-surgical or post-operative complications are relatively common in this population and

include a myriad issues both intra-operatively and post-operatively, given the complex nature of
surgery in this area and technical issues related to reconstruction. Certainly the incidence of
intra-operative outcomes such as severe bleeding, myocardial infarction, and death has decreased
over time; however, postoperative complications including salivary fistula, bleeding, infection,
poor speech and swallowing function, airway obstruction requiring tracheostomy, loss of taste,
and loss of tongue mobility continue to plague patients and their treating physicians. The
counseling of patients undergoing therapy for advanced tongue base malignancy is often as
multimodal as the therapy, and frank discussions about expected surgical outcomes and surgical
complications, as well as complications related to radiation and chemotherapy, should be held
with the patient at several points along the course of treatment. (Krzysztof J. Misiukiewicz, …
Brett A. Miles et al 2018)

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 Postoperative complications are common in patients with Crohn’s Disease or Ulcerative
Colitis undergoing surgery The main, and most challenging complications are Surgical
Infections, Intra-abdominal abscess, Anastomotic leak (acute and chronic), and Anastomotic
stricture. Aggressive preoperative management should be administered with adequate nutritional
support, minimization of the use of corticosteroids and other immunosuppressive medications,
and percutaneous drainage of abscesses, if present. While acute massive anastomotic bleeding
may be managed surgically, endoscopic approach can play a major role in controlling bleeding.
The documentation of the history of acute complications in Crohn’s Disease or Ulcerative Colitis
surgery is important for the subsequent management of chronic complications, which can be the
consequences of the prior complications. Those late complications, such as Anastomotic stricture
and sinus, are amenable to endoscopic therapy. (Yi Li, Weiming Zhu, in et al 2018)

Postoperative complications sometimes generate multiple consultations with physicians who

have overlapping abilities. An example might be a patient with a postoperative fever that
prompts consultations from Pulmonology, nephrology, Dermatology, general medicine, and
infectious diseases. In theory, gathering a critical mass of medical experts together should
increase the likelihood of accurate diagnosis, timely treatment, and foolproof follow-up. In
reality, however, coordination and communication are never perfect. Personal rivalries, diffusion
of responsibility, and many other psychological factors may impede interactions among
consultants. Opportunities for miscommunication may be further accentuated if the patient has
an exotic diagnosis that is a special draw on the consultant's attention (e.g., pheochromocytoma).
Arguing in front of the patient, in view of other professionals, or in the medical record can be
demoralizing. The priority is to communicate effectively with the surgical team responsible for
the patient and encourage that team to make the final decision. (Donald A. Redelmeier, in
Goldman’s Cecil Medicine [Twenty Fourth Edition] )

Therefore, this study was aimed to assess the knowledge and practice of post-operative
complications management among the post-operative patients in the Limbe population. The
information obtained from this study will be used by policy maker and stakeholders to identify
the awareness and practice of post-operative complications measures so as to provide
information about post-operative complications among the post-operative patients in the limbe
population

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 CHAPTER THREE

MATERIALS AND RESEARCH METHODOLOGY

3.1 STUDY DESIGN

In this study, the approach employed will be a Hospital Base cross- sectional design in the
Regional Hospital Limbe and District Hospital Bota.
3.2 STUDY DURATION
This research will be carried out in three months, within the months of January and March.
3.3 STUDY AREA
This research will be carried out at the Regional Hospital, Limbe and the District Hospital
Bota.
3.4 STUDY POPULATION
In this study, the population will include 5 to 10 post-operative patients in the Limbe
Population.
3.5 SAMPLING AND SAMPLE SIZE
Post-operative patients experiencing post-operative complications will be included in the
study.
3.5.1 SAMPLING METHOD
A random sampling technique will be used in this research and implies that all participants
will have equal chances to be chosen.
3.6 SELECTION CRITERIA
This will includes a list of characteristics essential for membership in the target population
therefore; it determines the target population and the sample are selected from the accessible
population within the target population.
3.7 DATA COLLECTION
This study will use a self-administered questionnaire with close-ended questions which
contains three parts
Section a; Demographic data
Section b; Assess the knowledge of post-operative management among post-operative
patients

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Section c; Assess the practice of post-operative management among post-operative patients
3.8 DATA ANALYSIS
After collection of data, the quantitative data will be represented on tables. The respondent’s
percentage and responds mean score will be represented on a pie chart which will be used
later to interpret the qualitative data.
3.9 ETHICAL CONSIDERATION
On behalf of this research work
 An approval of research topic from school was gotten
 An approval from the Ministry of Higher Education
 An approval from the Director of the Regional Hospital Limbe and the Director of the
District Hospital Bota

This permitted us to carry on with our research project.

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 CHRONOGRAM OF ACTIVITY

JANUARY FEBRUARY

RESEARCH DATA
PROPOSAL DATA COLLECTION RESEARCH PROJECT
ANALYSIS

MARCH

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BUDGET

Numbers Instruments Description and Per unit price Total cost

Justification
1 Sources of Use of internet 5000XAF of 5000XAF
information for books and devices internet service
the research
2 Transport and Transport, Feeding, Transport=6000xa 18500XAF
airtime credit and Communication f
airtime Feeding=10000xaf
Airtime=2500xaf
3 Printing document Research project of Printing 100xaf 5600XAF
and spiral binding about 50 pages, 3 per page and spiral
different copies and binding 200xaf per
each to be spiral copy.
bended
4 / / / 29100XAF

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