▪ explain the pre- and postoperative routines to the patient and answer any questions appropriately; the discussion of any fears or anxieties that the patient may have should be encouraged. Studies have demonstrated that patients’ anxiety levels are reduced by receiving information and explanation. Preoperative reduction of anxiety may affect postoperative analgesia use, wound healing and length of hospital stay (Boore 1975, Hayward 1978, Fyffe 1999)

▪ record the temperature, pulse, respiration rate, blood pressure and urinalysis results, if required, to give baseline findings with which to compare postoperative observations and detect abnormalities. Any abnormalities should be discussed with the nurse in charge and medical staff

▪ carry out an evacuation of the patient’s bowel using suppositories or the specific bowel preparation requested by the surgeon. This is usually requested if the surgical procedure involves the bowel as evacuation helps to reduce the risk of contamination of the wound by intestinal organisms. Intravenous fluids may be required during this time to ensure patient hydration prior to surgery

▪ offer the sedative that was ordered by medical staff the night before surgery in order to help the patient sleep well

▪ fast healthy adult patients of oral clear fluids 2 hours prior to induction of anaesthesia to reduce the risk of aspiration pneumonitis. Healthy adults are defined as healthy patients without gastrointestinal disease or disorders (Royal College of Nursing 2005). Clear fluids include tea and coffee (without milk)

▪ solid foods, including milk, should be withheld for six hours prior to induction of anaesthesia in order to avoid the risk of regurgitation and the inhalation of gastric contents while under the anaesthetic (National Association of Theatre Nurses 2004a)

▪ prepare the skin according to health authority policy. This may involve the removal of an area of body hair by shaving or depilatory cream, showering or bathing using an antiseptic soap and putting on a theatre gown and perhaps socks and paper pants. These actions may reduce the risk of a postoperative infection. However, research into the removal of body hair and the use of antiseptic preparations in baths and showers has, however, produced contradictory findings (Brown 2002)

▪ ensure that all underwear has been removed, although paper pants may be worn on some occasions. Nail varnish should be removed from fingernails and toenails and make-up removed so that these sites can be used by the anaesthetist to assess for signs of hypoxia. Dentures must be removed because of the danger of inhaling them, causing asphyxiation. Health authority policies on the removal of spectacles, hair grips, contact lenses, hearing aids and other prostheses, e.g. wigs and artificial eyes or limbs, vary