Purpose: It has been well documented that providing comprehensive and effective preoperative education to patients and families has reduced postoperative
complications. This poster aims to describe the development and implementation of a thorough, nursing-led preoperative education process for patients undergoing melanoma surgery and its impact on patient outcomes.
Description: In August 2021, the nurse navigator project lead and subject matter expert identified several gaps in patient care in the melanoma surgical oncology department. After prioritizing these gaps through the lens of both the patient experience and quality and safety, she set out to develop and implement a net new preoperative education process for all patients undergoing melanoma surgery. She first developed a reader-friendly patient education packet, which included information on critical topics such as incision and wound care, prevention and identification of potential complications, lifestyle and behavior modifications, resources, and instructions for contacting the care team. The surgeon and her clinical nurse educator reviewed and edited the packet and ultimately approved it for use by our central patient education committee in October 2021. Using a flipped classroom methodology, she established a collaborative workflow utilizing the practice coordinator to ensure each surgical patient was provided with the educational packet to review before the formal teaching session. During the 1:1 education with the patient, she reviewed and reinforced vital teaching points, answered questions, and validated the patient’s comprehension of the instruction.
Evaluation/outcomes: When comparing pre- vs. post-intervention results, we noted a 5.6% decrease in post-op surgical site infection cases within 30 days and a 12.6% decrease in seromas and incision dehiscence. Additionally, the nurses reported receiving fewer messages and phone calls with questions from melanoma surgery patients in the postoperative period. These encouraging results have inspired other teams within our cancer center, as they highlight the need to prioritize patient education in nursing.
References
1) Ariyo, P., et al. (2019). Implementation strategies to reduce surgical site infections: A systematic review. Infection Control & Hospital Epidemiology, 40(3). doi:10.1017/ice.2018.355
2) Eastwood, D. et al. (2019). Improving postoperative patient reported benefits and satisfaction following spinal fusion with a single preoperative patient education session. The Spine Journal, 19(5). https://doi.org/10.1016/j.spinee.2018.11.010
3) Klaiber, U. et al. (2018). Impact of preoperative patient education on the prevention of postoperative complications after major visceral surgery. Trials, 19. https://doi.org/10.1186/s13063-018-2676-6
4) Koivisto, J-M., et al. (2019). Patient education in relation to informational needs and postoperative complications in surgical patients. International Journal for Quality in Health Care, 32(1). https://doi.org/10.1093/intqhc/mzz032
