Improving Peri-Operative Nursing Leadership of Alzheimer’s Patients

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NURSING LEADERSHIP OF ALZHEIMER’S PATIENTS
Improving Peri-Operative Nursing Leadership of Alzheimer’s Patients
Name of the Student
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Author Note

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NURSING LEADERSHIP OF ALZHEIMER’S PATIENTS
Introduction
It is the duty of the nursing professionals to conduct proper pre-operative assessment
in order to avoid physiological and bio-ethical complications during and after the surgery.
The older adults who are suffering from AD are associated with numerous co-morbidities
apart from having neurological complications like cardio-vascular disease, pulmonary
complications along with asthmatic problems and cognitive impairment and thus
complicating the process of the pre-operative surgical condition and taking informed consent
form the patient (Kassahun, 2018). The following nursing leadership management project
will focus on the nursing leadership strategies that will help in improving the peri-operative
care and assessment of the AD patients who are older adults. Such that, nursing leadership
change management will help to improve the overall quality of care of the AD patients The
paper will initiate via review of literature about the selected topic, followed by reference to
the best practice for improving the overall quality of care, stakeholders involved, resources
that will be important along with expected outcome.
Review of literature
The older adults who are suffering from the neurological complications like
Alzheimer Disease (AD) or progressive dementia are often required to undergo surgery under
various pathological conditions. The surgical procedures among the patient suffering from
AD have a significant risk like complications associated with high mortality rate or delay in
recovery from the anaesthesia. In order to avoid such complications, detailed physiological
assessment must be undertaken under peri-operative condition (Kassahun, 2018). The study
undertaken by Alcorn and Foo (2016) highlighted that dementia is a growing problem among
the older adults with AD. It is the duty of the nursing professional to access the cognitive and
critical thinking skills for the patient in order make valid treatment choices that is in

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NURSING LEADERSHIP OF ALZHEIMER’S PATIENTS
accordance with the principles of the Mental Capacity Act. Proper assessment of the critical
thinking skills and cognitive level of the patient is important for obtaining informed consent
before the initiation of the surgery. However, majority of the nurses in the peri-operative
ward fail to judge the whether the patient can understand and retain the information relevant
to the case study in order to provide consent for the surgical procedure (Alcorn & Foo, 2016).
All peri-operative nurses must be aware about the advance directives along with living wills
among older adults with AD. The nursing professional must consult to patient’s next of kin if
the patient lacks the required cognitive and critical thinking skills to provide consent.
Surgical patient of AD are also likely to develop post-operative complications like delirium.
A multimodal approach like training and education of the nurses about sedative drugs and
assessment of the cognitive level of the patient is important for improving the overall
outcome of care (Alcorn & Foo, 2016).
Best practice recommendations
An increasing numbers of the older adults with dementia or AD patient with mild to
moderate cognitive impairment are more likely to present for surgery. Thus it is imperative
that the peri-operative nurses are well-aware of the potential pitfalls in delivering safe care to
these neurologically vulnerable patients. The current trends in practice highlight that proper
training of the nurses in conducting assessment of the cognitive functioning of the patient in
the peri-operative ward is important to estimate whether the patient is capable to provide
informed consent (Needham, Webb & Bryden, 2017). Best leadership measures in geriatric
ward will include training of the prei-operative nursing professionals in order to improve
patient’s pre and post surgical outcome. Education of the nursing professional about the
undertaking consent/capacity, peri-operative risk assessment and management and potential
drug interactions along with sensitivity to the anaesthetic agents during the peri-operative