Domain 11. Safety-protection
Class 2. Physical injury
Diagnostic Code: 00100
Nanda label: Delayed surgical recovery
Diagnostic focus: Surgical recovery
Delayed surgical recovery is a preventable condition that occurs commonly in hospitals and surgical centers. It is characterized by an extended time to recuperate and heal from the surgery, which may result in prolonged hospital stays and additional costs. NANDA (North American Nursing Diagnosis Association) has defined Delayed Surgical Recovery as a nursing diagnosis which involves a patient’s delayed physical, psychological, or social recovery following a surgery.
NANDA Nursing Diagnosis Definition
The official definition of NANDA nursing diagnosis of Delayed Surgical Recovery as stated by NANDA is “the state in which a person is experiencing an interruption or delay in reaching the expected level of physical and/or psychosocial recovery following a surgery”. This diagnosis has been further divided into four phases, prior to surgery, post-operative, intraprocedural, and discharge.
Subjective characteristics for this diagnosis include the patient expressing feelings of frustration, anxiety, uneasiness, confusion and other negative emotions related to the delay in recovering from surgery. Objective characteristics observed by the medical team include decreased range of motion in affected body area, difficulty with normal activities of daily living, pain and discomfort, slowed healing process, and post-operative mental distress associated with a delayed postop recovery.
There are numerous factors that can contribute to a delayed surgical recovery. These can include pre-existing conditions, such as diabetes, heart disease and hypertension, complications during surgery due to an unexpected illness or injury, infection or blood loss, and medications that slow the healing process, such as steroids or painkillers. In addition, lifestyle factors such as smoking, drinking, poor nutrition and lack of exercise can also contribute to delayed recovery. It is important to note that the more complex the surgery and the longer the patient is required to remain in the hospital under anesthesia, the more at risk the patient is for a slowed recovery.
At Risk Population
Certain populations are at increased risk of delayed recovery following a surgery. These include people who are elderly, obese, have a history of substance abuse, those with chronic medical conditions such as diabetes, heart disease and hypertension, those who are taking certain medications, and those with poor nutrition or an unhealthy lifestyle.
When a patient experiences a delayed surgical recovery, they may be at risk for other associated health issues. This includes but is not limited to: infection, deep vein thrombosis (DVT), respiratory failure, pneumonia, septic shock, dehydration, and loss of muscle tone or strength.
Suggestions of Use
Nurses should be able to apply the NANDA nursing diagnosis of Delayed Surgical Recovery to their patients to recognize and identify risk factors, evaluate best practice interventions to promote a faster recovery, provide education on proper post- surgical care, and devise a plan of care to meet the patient’s needs.
Suggested Alternative NANDA Nursing Diagnoses
There are a variety of other alternative NANDA nursing diagnoses for delayed surgical recovery. These include: Impaired Physical Mobility, Activity Intolerance, Risk for Infection, Deficient Knowledge, Risk for Impaired Skin Integrity, Damaged Tissue, Pain, Fatigue, and Anxiety.
It is important for nurses to use the NANDA nursing diagnosis of Delayed Surgical Recovery in their practice to identify patients at risk, evaluate and assess the best practices of care to promote a faster recovery, and provide the appropriate nursing interventions. Furthermore, nurses should be aware of the various factors that may contribute to delayed recovery, including the patient’s overall health and lifestyle, as well as any complications that may arise during and after the surgery. Nursing interventions should focus on optimizing the patient’s activities of daily living, providing education on proper post-surgery care, and decreasing the amount of time spent in the hospital.
The NOC outcomes for a patient experiencing a delayed surgical recovery are: Mobility, Anxiety Level, Pain Management, Comfort Level, Self-Care: Ambulation, and Sleep. Mobility is the ability to move from one place to another in a specified time. Anxiety Level is the ability to relate to stressful situations in a calm and controlled manner. Pain Management is the ability to take responsibility for managing and monitoring the pain. Comfort Level is the ability to maintain or alter environmental factors to achieve personal safety and comfort. Self-Care: Ambulation is the ability to walk without assistance. Sleep is the ability to rest and recover.
Evaluation Objectives and Criteria
When evaluating a patient for delayed surgical recovery, nurses need to establish goals, objectives, and criteria to measure and evaluate progress. Goals should focus on achieving improved outcomes and desired functional, cognitive, and emotional states. Objectives should specify measurable outcomes, desired progress, and expected behaviors. Criteria should help the nurse evaluate improvement in meeting those objectives. Evaluation should focus on identifying the patient’s risk factors, assessing their condition before and after the surgery, and measuring their response to treatment and interventions.
Nursing Interventions Classifications System (NIC) interventions include: Pain Management, Education regarding Post-operative Care, Risk Analysis and Reduction, Activity Intolerance Management, Falls Prevention Intervention, Preventive Maintenance Treatment, Reduction of Anxiety, Electrolyte Balance Monitoring, Homeapathy Procedures, Nutrition Management, Psychomotor Skill Retraining, Body Positioning, and Abduction Reduction Teaching. Pain management involves providing strategies to improve pain experience through the use of medications, pain management techniques, anti-inflammatory agents, and heat and cold therapies. Education regarding Post-operative Care assists the patient in understanding what will occur during and after their surgery. Risk Analysis and Reduction helps minimize complications and potential harm. Activity Intolerance Management is the ability to identify and reduce physical activity when it is too strenuous for the patient. Falls Prevention Intervention assists patients in identifying potential falls risks and avoiding falls. Preventive Maintenance Treatment focuses on the prevention of postoperative complications and the restoration of the individual’s preoperative level of function. Reduction of Anxiety involves helping the patient relax and cope with stressors. Electrolyte Balance Monitoring is used to maintain the patient’s homeostasis. Homeapathy Procedures involve the use of natural remedies to assist the patient in healing. Nutrition Management focuses on providing nutritional guidance and food plans to assist the patient in recovery. Psychomotor Skill Retraining is used to help the patient relearn skills that were lost due to the surgery. Body Positioning is used to protect the body from further injury and to promote proper healing. Abduction Reduction Teaching focuses on reducing excessive movements in the joints that can cause stretching and tearing of the ligament fibers.
Nursing activities related to delayed surgical recovery should focus on providing comprehensive patient assessments and collecting data to evaluate the patient’s risk factors, developing a plan of care tailored to the patient’s individual needs, establishing pre- and postoperative interventions, providing education and skills training to encourage healing, assessing the patient’s psychosocial needs, and encouraging follow-up visits after the surgery.
Delayed surgical recovery is a common yet preventable condition that can have a significant effect on patient outcomes. The NANDA nursing diagnosis of Delayed Surgical Recovery provides nurses with the tools necessary to identify patients at risk, assess risks and develop plans of care to improve outcomes, and use evidence-based interventions to promote faster recovery.
- What is the NANDA nursing diagnosis for delayed surgical recovery? The official NANDA nursing diagnosis for delayed surgical recovery is “the state in which a person is experiencing an interruption or delay in reaching the expected level of physical and/or psychosocial recovery following a surgery”.
- What are some factors that can contribute to delayed recovery? Factors that can contribute to a delayed surgical recovery include pre-existing conditions, complications during surgery, medications that slow the healing process, and lifestyle factors like smoking and inadequate nutrition.
- Who is at higher risk of having a delayed recovery after a surgery? People who are elderly, obese, have a history of substance abuse, those with chronic medical conditions, and those with poor nutrition or an unhealthy lifestyle are at higher risk of having a delayed recovery following a surgery.
- What type of nursing interventions can be used to promote faster recovery? Nursing interventions should focus on optimizing the patient’s activities of daily living, providing education on proper post-surgery care, and decreasing the amount of time spent in the hospital.
- What type of evaluation should be conducted on a patient with delayed surgical recovery? Evaluation should focus on identifying the patient’s risk factors, assessing their condition before and after the surgery, and measuring their response to treatment and interventions.