Improving Discharge Teaching for Adult Patients with an Ileostomy.


Journal

The American journal of nursing
ISSN: 1538-7488
Titre abrégé: Am J Nurs
Pays: United States
ID NLM: 0372646

Informations de publication

Date de publication:
01 Jan 2024
Historique:
medline: 21 12 2023
pubmed: 21 12 2023
entrez: 21 12 2023
Statut: ppublish

Résumé

Discharge teaching is essential to the self-care and successful recovery of colorectal surgery patients, yet the trend toward shorter hospital stays for patients with new ileostomies limits opportunities for patient education. As a result, discharged patients at our institution are initiating calls to providers with questions that could have been addressed prior to discharge. The aim of this quality improvement (QI) project was to decrease patient-initiated postdischarge inquiries using a frequently asked questions (FAQs) handout at discharge. A retrospective chart review of inquiries to the outpatient clinic over the six-month period between July 2020 and January 2021 revealed common concerns, among them bowel movements, home health care, medications, wound care, stoma issues, pathology reports, diet, and activity-related issues. Based on these concerns, a FAQs handout was developed to review with patients prior to discharge. Data from three postdischarge time periods (0 to 72 hours, 72 hours to 21 days, and 0 to 21 days) in the three months from June to September 2021 were analyzed to determine the impact of the intervention on the frequency and content of the patient inquiries. Use of the FAQs handout led to a decrease in total patient-initiated postdischarge inquiries from 46 in the preintervention period to five in the postintervention period, and fewer topics of concern prompted patients' postintervention inquiries. There was also a pre-to-postintervention reduction in the proportion of patients who made calls to the outpatient clinic in each of the three postdischarge time periods, the greatest of which-from 49% to 15% of patients-was significant and occurred in the 72-hour-to-21-day period. This QI project demonstrated that a change in discharge teaching by adding a FAQs handout to the protocol could be effective.

Identifiants

pubmed: 38126833
doi: 10.1097/01.NAJ.0001004936.98276.ad
pii: 00000446-202401000-00019
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

41-46

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Références

Prinz A, et al. Discharge planning for a patient with a new ostomy: best practice for clinicians. J Wound Ostomy Continence Nurs 2015;42(1):79–82.
Coleman EA, et al. Understanding and execution of discharge instructions. Am J Med Qual 2013;28(5):383–91.
Jones D, et al. Ready to go home? Patients' experiences of the discharge process in an enhanced recovery after surgery (ERAS) program for colorectal surgery. J Gastrointest Surg 2017;21(11):1865–78.
Wennström B, et al. Patient experience of health and care when undergoing colorectal surgery within the ERAS program. Perioper Med (Lond) 2020;9:15.
Reid R, et al. Factors associated with patient-initiated telephone calls after spine surgery. World Neurosurg 2017;98:625–31.
Hadeed MM, et al. Factors associated with patient-initiated telephone calls after orthopaedic trauma surgery. J Orthop Trauma 2017;31(3):e96–e100.
Horstman MJ, et al. Patient experience with discharge instructions in postdischarge recovery: a qualitative study. BMJ Open 2017;7(2):e014842.
Poland F, et al. Developing patient education to enhance recovery after colorectal surgery through action research: a qualitative study. BMJ Open 2017;7(6):e013498.
Sayin Y, Aksoy G. The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study. AORN J 2012;95(6):772–87.
Jayakody A, et al. Effectiveness of interventions utilising telephone follow up in reducing hospital readmission within 30 days for individuals with chronic disease: a systematic review. BMC Health Serv Res 2016;16(1):403.
Wennström B, et al. Patient symptoms after colonic surgery in the era of enhanced recovery—a long-term follow-up. J Clin Nurs 2010;19(5–6):666–72.
Huber K, et al. Interdisciplinary teams and home-based medical care: secondary analysis of a national survey. J Am Med Dir Assoc 2019;20(6):770–4.

Auteurs

Sophany Roeung (S)

Sophany Roeung is an NP in the Department of Colorectal Surgery at the University of California San Francisco Medical Center. Teri G. Lindgren is an associate clinical professor at the University of California San Francisco School of Nursing, where Annette Carley is a clinical professor and associate director of the DNP program. Contact author: Sophany Roeung, sophie.roeung@ucsf.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Classifications MeSH