Lesson 1Anxiety assessment and nonpharmacologic interventions: communication techniques, teaching, relaxation, breathing exercises, use of anxiolyticsCovers structured anxiety screening, therapeutic communication, patient teaching, relaxation and breathing strategies, environment modification, and when to escalate to pharmacologic anxiolysis while maintaining safety and informed participation.
Validated anxiety screening toolsBuilding rapport and active listeningPreoperative education and expectationsGuided imagery and relaxation methodsBreathing exercises and coping plansLesson 2Infection prevention and skin prep: chlorhexidine bathing, hair removal policies, antibiotic prophylaxis timing and documentationCovers infection prevention measures including chlorhexidine bathing, hair removal methods, timing and selection of antibiotic prophylaxis, and documentation requirements to reduce surgical site infections.
Preoperative chlorhexidine bathingHair removal methods and timingAntibiotic choice and timingMRSA screening and decolonizationDocumentation of prophylaxis stepsLesson 3Pre-transfer safety checks: ID band, verbal identity confirmation, surgical site marking, consent, allergy check, checklist reconciliationDetails standardised pre-transfer safety checks, including identity verification, consent confirmation, surgical site marking, allergy review, and checklist reconciliation to prevent wrong-patient, wrong-site, and documentation errors.
Two-identifier patient verificationConsent presence and completenessSurgical site marking standardsAllergy and alert band reviewFinal pre-transfer checklist useLesson 4Preoperative laboratory and diagnostic review: glucose, HbA1c, electrolytes, renal function, coagulation, ECG and chest imaging indicationsOutlines appropriate selection and timing of preoperative labs and diagnostics, including glucose, HbA1c, electrolytes, renal function, coagulation tests, ECG, and chest imaging, based on patient risk factors and procedure type.
Indications for serum glucose and HbA1cElectrolytes and renal function panelsCoagulation studies and bleeding riskPreoperative ECG indicationsChest imaging criteria and yieldLesson 5Comprehensive preoperative nursing assessment: vital signs, medication reconciliation, fasting status, functional status, allergies, advanced directivesDescribes a structured nursing assessment covering vital signs, medication reconciliation, fasting status, functional and cognitive baseline, allergies, and advance directives to inform perioperative planning and handoffs.
Baseline vital signs and pain levelMedication reconciliation processVerifying fasting and last intakeFunctional and cognitive assessmentAllergies and advance directivesLesson 6Pre-anesthesia evaluation: airway assessment (Mallampati, neck mobility), anesthesia risk stratification, ASA classificationExplores systematic pre-anesthesia evaluation, including airway assessment tools, ASA classification, comorbidity review, functional capacity, and risk stratification to guide anaesthetic planning and perioperative monitoring needs.
Focused pre-anesthesia historyAirway exam and Mallampati scoringNeck mobility and dentition assessmentASA physical status classificationFunctional capacity and risk indicesLesson 7Informed consent verification and legal documentation: elements of consent, capacity checks, interpreter needsClarifies essential elements of informed consent, assessment of decision-making capacity, documentation standards, interpreter use, and verification steps to ensure ethical and legal compliance before surgery.
Required elements of consentAssessing capacity and voluntarinessRole of surrogate decision makersUse of interpreters and language accessDocumentation and form reviewLesson 8Fasting and carbohydrate-loading protocols: NPO timing, clear fluid rules, preop carbohydrate drink indicationsExplains evidence-based fasting intervals for solids and clear fluids, indications and contraindications for preoperative carbohydrate drinks, and strategies to reduce aspiration risk while minimising discomfort and insulin resistance.
Standard NPO timing for solidsClear fluid rules and exceptionsCarbohydrate drink indicationsContraindications to carb loadingPatient instructions and adherenceLesson 9Specific assessments for comorbidities: diabetes history, insulin regimen, blood pressure control, cardiovascular risk assessmentFocuses on targeted assessment of key comorbidities, including diabetes, hypertension, and cardiovascular disease, to refine perioperative risk, guide medication changes, and plan monitoring and postoperative disposition.
Detailed diabetes and insulin historyBlood pressure trends and controlCardiovascular risk scoring toolsPulmonary and sleep apnea screeningRenal and hepatic function reviewLesson 10Preoperative medication management: metformin, insulin glargine, ACE inhibitors and perioperative adjustment algorithmsReviews perioperative adjustment of metformin, insulin glargine, and ACE inhibitors, with emphasis on timing, dose modification, hypoglycaemia prevention, and use of clear algorithms to standardise safe medication management before surgery.
Risk of metformin and lactic acidosisAdjusting long-acting and basal insulinsManaging ACE inhibitors and ARBsDay-of-surgery medication holding rulesSample perioperative dosing algorithms
