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K.O. Kuhns
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NU02 - Preparing Patients for Treatment (ID 270)
- Event: WCLC 2016
- Type: Nurses Session
- Track: Nurses
- Presentations: 1
- Moderators:D. Borthwick, A. Fraser
- Coordinates: 12/05/2016, 16:00 - 17:30, Schubert 5
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NU02.02 - Preoperative Thoracic Surgery Patient Education Program Development (ID 6454)
16:20 - 16:40 | Author(s): K.O. Kuhns
- Abstract
- Presentation
Abstract:
Purpose: To develop a cost-effective preoperative patient teaching program that includes a patient teaching video along with written material that improves patient satisfaction, decreases patient anxiety, decreases readmission rates associated with post-operative complications, and optimizes overall outcomes of thoracic surgery patients. Overview: Patients undergoing surgery usually have little knowledge of what to expect during the preoperative, postoperative, and recovery period following thoracic surgery. Multiple studies have shown that good quality preoperative teaching increases patient satisfaction, improves patient outcomes, and decreases patient readmission rates following surgery. Although the benefit of preoperative education is widely recognized in the literature, finding the resources available to provide efficient and effective teaching is a challenge. Patients who are diagnosed with a suspicious lung nodule or lung cancer are usually overwhelmed when attempting to navigate through the health care system. During the initial surgical visit a battery of studies and often additional diagnostic procedures are ordered for staging and surgical clearance. The details of the surgery are discussed and the surgical consent is obtained. The patient and family are inundated with so much information that pre-operative teaching is not effective at this time. Further, in outpatient health care settings there is a finite amount of time within a visit for a provider to promote all of the pre-operative patient education. It has been the experience of this thoracic surgery practice that providing the patients and families an opportunity to undergo pre-operative teaching in another setting, such as in their own homes, typically results in increased retention of the information, and patients do better not only in the pre-operative period but in the post-operative and recovery stages as well. Developing a well-designed preoperative teaching program requires a multidisciplinary approach and utilization of resources already available to build upon and promote better programs that optimize patient and caregiver learning and retention. Pre-operative education and teaching is not just to provide information, but also to help patients acquire the knowledge needed to change behaviors and to promote better health. Individuals within the care team with particular interest in patient education should be utilized in helping to develop an effective preoperative teaching program. Collaborating with nurses and advanced practice providers across the care continuum is ideal: these members of the team have both the knowledge base and the access to patients and their families needed to provide effective patient education. Method: “A Patient’s Guide to Thoracic Surgery” is a thoracic teaching manual that was customized to fit our thoracic patient population. It was developed by a group of nurses and advanced practice providers who were interested in developing thoracic patient education at our institution. The booklet includes basic information concerning how to prepare for thoracic surgery, as well as what to expect before and after the surgery. Our thoracic team saw the need for additional education and developed a patient education video, “A Patient’s Guide to Thoracic Surgery Video” that includes pre-operative teaching, what to expect after surgery, and after discharge. The video was funded by a grant that our hospital provides annually, funding various projects that support research, education, and clinical care. The team wrote a script and worked with the hospital IT department to create the video. Patients receive both the pre-operative teaching booklet and video during the initial office visit and the major points of the teaching material are reviewed at this time. The patient is instructed to read through the information and watch the video at their convenience. They are also encouraged to call the office to discuss what they learned and answer any questions they may have. The outpatient nurse practitioner calls and sometimes meets with the patients at least once again prior to surgery to review the patients’ pre-operative studies, update their pre-operative paperwork, and to answer any questions or concerns about their upcoming surgery. The patients are asked if they have read through the material and watched the video. During this encounter, updates on smoking cessation and exercise are documented and discussed. Following surgery, additional teaching is done by the nursing staff and the teaching video and discharge instructions are again reviewed. Furthermore, the patient is phoned for a “day after discharge” call by a thoracic team member to check on the patient’s progress and answer any questions the patient or family may have. The patients and their families are seen in the office for a post-operative visit usually 2-3 weeks after discharge. A 10 question “Thoracic Video Patient Satisfaction Survey” is completed during this initial post-op visit. This survey asks the patients to rate the educational video on content and how helpful they felt the video was in preparing them for surgery and for what to expect after surgery. Results: A “Thoracic Video Satisfaction Survey” has been given to all patients undergoing thoracic surgery at Penn Presbyterian Medical Center; Philadelphia, Pennsylvania over the past several months. Preliminary results have shown that since the implementation of the thoracic teaching video in conjunction with the written material there has been an increase in patient’s satisfaction and a decrease in anxiety associated with thoracic surgery Conclusion: Providing patients with multi-format education materials and the ability to review them on their own time has proven successful at achieving the stated goals. Moving forward we intend to build upon this resource to improve the patient education program at our institution. Additionally, we hope to conduct a formal research project in conjunction with other institutions such as the University of Maryland to continue to develop thoracic patient education and to help identify which programs work best in promoting patient education and changing behaviors in the thoracic surgery population.
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