GUEST EDITORIAL

Geriatric Perianesthesia Nursing Approach to CareMyrna E. Mamaril, MS, APRN, CPAN, CAPA

Nancy M. Saufl, MS, RN, CPAN, CAPA

favipa

NAmoMipgcp

Ttrc

Wegsnsdgcrtapip

si

Ca

THE DECISION TO PUBLISH the December 2004 issueof the Journal of Perianesthesia Nursing (JoPAN), whichfocuses on the specialty of geriatric perianesthesia nursing,was stimulated by our desire to provide a gerontologicalnursing resource to improve the clinical care of olderadults. This geriatric focus issue provides the reader withdiverse geriatric content/topics spanning the perianesthe-sia continuum of care from preadmission assessment topreanesthesia, day of surgery phase through the PACUPhases I, II, and III levels of care. Perianesthesia nursingpresents unique challenges when combined with age-related physical changes, altered illness presentations, anddiminished coping abilities that reveal some of the highestacuity and complex cases in our Phase I PACUs today.Consequently, effective nursing care of the older adultrequires a specialized knowledge base. Just as the pediatricspecialty has evolved, a new body of knowledge related togeriatric perianesthesia nursing is emerging. We are hope-ful that our geriatric specialty issue will cultivate a foun-dational understanding of the essential concepts of carefor the geriatric patient and provide our perianesthesianurses with practical nursing strategies.

This specialty issue features articles from preadmissionthrough discharge planning. “Preparing the Older Adultfor Surgery and Anesthesia,” by Nancy Saufl, describes theimportance of the preanesthesia nursing evaluation inhelping to identify potential problems so that a plan ofcare to help prevent those problems can be formulatedand communicated appropriately. Stephanie Monarch andKathleen Wren’s article, “Geriatric Anesthesia Implica-tions,” focuses on patients’ physiologic and anatomicalchanges affecting changes in tissue mass and major organsystem function. This article will assist the perianesthesianurse in developing a perianesthesia plan of care.

We are pleased to include a continuing education article inthis focus issue of the Journal. Pharmacists Ann Kuchtaand Julie Golembiewski have provided us with the article,“Medication Use in the Elderly Patient: Focus on the Peri-operative/PeriAnesthesia Setting.” The authors highlightthe differences in pharmacokinetics and pharmacodynam-ics, polypharmacy, inappropriate medications, adversedrug reactions, drug-diseases issues, and drug interactionsin the geriatric population. Instructions on how to obtaincontinuing education credits are included with the article.

The article, “When the Trauma Patient is Elderly,” by JudyStevenson, focuses on the treatment of the older adult

who suffers a traumatic injury and how that care differs

Journal of PeriAnesthesia Nursing, Vol 19, No 6 (December), 2004: p 371

rom other age groups. “Challenges in Geriatric Pain Man-gement,” by Doreen Paynter and Myrna Mamaril, pro-ides the reader with key factors to consider when assess-ng and managing different types of pain in the geriatricatient. Ethical considerations regarding pain managementre also discussed.

ancy Burden’s article, “Discharge Planning for the Elderlymbulatory Surgical Patient,” describes how nurses canake a difference in successful discharge planning for the

lder adult undergoing surgery in an ambulatory care.ary Asher provides the final original article in this focus

ssue, “Surgical Considerations in the Elderly.” This articleresents an overview of the challenges in caring for theeriatric surgical patient and how pensive care planningan lead to positive outcomes for the geriatric surgicalatient.

he JoPAN columnists have incorporated geriatric-relatedopics into their columns. These issues relate to the use ofestraints, obtaining informed consent, and identifyingommunity resources for the elderly.

hile people are living longer, there are also more dis-ases and other disorders in our aging population. Thus,eriatric nursing is rapidly developing as more and moretudies of the aged are being done. As perianesthesiaurses caring for the geriatric patient undergoing anesthe-ia and surgery, we must recognize that concomitantiseases exist and must be considered. It is our hope, asuest editors of this JoPAN focus issue, that these articlesentering on the older adult patient will provide theeaders with important information to improve perianes-hesia care and to enhance the outcomes for the olderdult, thereby affecting the patient’s quality of life in aositive manner. We thank you for your interest in this

ssue of your professional journal, and for the care yourovide our patients every day.

The ideas or opinions expressed in this editorial are thoseolely of the authors and do not necessarily reflect the opin-ons of ASPAN, the Journal, or the Publisher.

Address correspondence to Nancy M. Saufl, MS, RN, CPAN,APA, 114 Pinion Circle, Ormond Beach, FL 32174; e-mailddress: saufl23@aol.com.© 2004 by American Society of PeriAnesthesia Nurses.1089-9472/04/1906-0001$30.00/0

doi:10.1016/j.jopan.2004.10.001

371