University of Pittsburgh, USA
Lisa Foertsch has completed her MSN in 1989 and she has recently completed DNP with Adult Medical Surgical Clinical Nurse Specialist Concentration. She has 25 years of teaching experience in nursing primarily caring for surgical patients.
Purpose: Th e purpose of this project was to develop, implement and evaluate a teaching tool for self assessment of the surgical incision aft er laparotomy surgery. Background: Hospitalized patients have an increased level of acuity and are discharged earlier. Shorter length of stay limits the nurses’ ability to provide comprehensive discharge instructions and validate understanding of surgical incision care.
Description: Two sets of discharge instructions, one with text only and one with text and pictures were used in this project with post-operative exploratory laparotomy patients. A total of 60 patients were recruited over a 3-month period. Th e fi rst 30 patients received standard discharge instructions (text only). Th e next 30 patients received discharge instructions utilizing the new tool and a hand held mirror (text, pictures and mirror) to assist with visualization of the incision. A follow up phone questionnaire was completed on day seven post surgery to assess patient’s ability to inspect their incision for infection and confi dence with discharge instructions.
Outcome: Th e group receiving text, pictures and mirror had improvement in comprehension of the instructions. Th is group of patients felt that the instructions were clearly stated and confi dent in their ability to identify normal healing versus a surgical site infection and felt confi dent about notifying physicians. Th e intervention group felt that the pictures helped in identifying normal healing versus a surgical site infection (SSI) and the mirror assisted with visualization.
Conclusion: Th e revised teaching tool (pictures and text) and use of a hand held mirror improved patient ease and confi dence for early detection of a surgical site infection.
Implications: Clinical nurse specialists can infl uence the patient, nursing staff and health care system as a change agent making a signifi cant impact on patient outcomes.
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