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November 2017 VOL 8, NO 11

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Category II: Care Coordination/ Care Transitions, Eighth Annual AONN+ Conference Abstracts

Improving Compliance and Patient Outcomes with a Presurgery Gynecologic Oncology Educational Video and Survey

Antoinette Solnik, RN, BSN, ONN-CG, RYT-200; Allison Steinberg, MSN, MPH, RN, OCN
The Johns Hopkins Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Sibley Memorial Hospital
Washington, DC
 

Background: The Johns Hopkins Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Sibley Memorial Hospital, performs more than 500 surgeries annually. After creating an initial written postoperative educational tool, the team determined that a better job could be done of educating patients prior to surgery to improve compliance in postoperative instructions and patient outcomes.

To do this, a gynecologic oncology nurse navigator and oncology nurse specialist developed a 30-minute pre- and postoperative educational video to watch before surgery and survey to measure the effectiveness of the video.

Objectives: The purpose of this project was to develop a new multimedia process with which to better inform patients prior to surgery about pre- and postoperative care and to determine: (1) Patient satisfaction regarding their education and understanding of preparing themselves for surgery—what is involved in their hospital stay, what is involved in their recovery, and how best to be successful as they move through a wellness process; and (2) Compliance watching the video through completion of an online survey tool.

Methods: (1) Literature search performed on the effectiveness of patient education prior to surgery using multimedia tools; (2) Buy-in and program creation with the help of physicians, 5th floor oncology nurses, hospital management, Sibley Innovation HUB, and Sibley Marketing and Communications; (3) Video creation with a narrative for voiceover, audio and video B-roll, and survey development; (4) Two focus groups held before completing the video to get valuable feedback on the video and survey questions. The groups consisted of 14 women who completed GYN oncology surgeries at Sibley Memorial Hospital; (5) Creation of online weblink for educational video and survey: www.hopkinsmedicine.org/sibley-memorial-hospital/patient-care/specialty/cancer/types/gynecologic-oncology/training.html; (6) Rollout began mid-November 2016 and continued through mid-February 2017, with 102 participants reviewing the video and completing the survey; (7) Once a patient was scheduled for surgery, she received a follow-up e-mail from her GYN oncology surgeon prompting her to view the video and complete the survey. Patients were instructed that viewing the video and completing the survey were part of preoperative work; (8) A survey was created to determine the patient’s satisfaction regarding her understanding of what was involved preoperatively, day off, postoperatively, and into recovery, and generally to assess the program’s effectiveness; and (9) Hospital oncology staff made postdischarge phone calls to assess patient perspectives of additionally needed information after discharge.

Results: A total of 102 women were sent the video and survey via e-mail, with 95 completing the survey, demonstrating a 93% compliance rate in preoperative education. Of these, 90.52% stated a preoperative educational video is a useful tool in preparation for surgery, and 87.36% of patients felt they had a solid understanding of what was involved in their recovery process and whom they should call with further concerns or issues. Anecdotally, patients stated they felt more informed and less anxious after watching the vide­o—“I feel more relaxed about the surgery knowing that so much thought and care goes into my surgery and hospital stay.” In addition, as encouraged in the video, the medical team noted patient’s compliance getting out of bed and walking earlier postoperatively, which helps in speeding recovery and moving toward a timely discharge.

Conclusion: The video pilot was extremely successful in helping the team achieve the aforementioned objectives. As well, the postvideo viewing survey was an easy and effective way to measure patient compliance and gather anecdotal information to enhance best practices.

Implications for Next Steps and Future Studies: (1) The educational video is now available for view on Sibley Hospital’s inpatient units through the patient education video library; (2) Based on patient feedback, a Gynecologic Surgery Patient Calendar/Checklist customizable for laparoscopic and open surgical procedures has been created and is currently under review; and (3) Possible planned look at clinical outcomes such as referrals to rehab or fewer readmissions due to small bowel obstructions or to work with the GYN ONC office nurse to evaluate efficiencies that might have been created in the office because of the video.

Sources

Carli F, Brown R, Kennepohl S. Prehabilitation to enhance postoperative recovery for an octogenarian following robotic-assisted hysterectomy with endometrial cancer. Can J Anaesth. 2012;59:779-784.
Jlala HA, French JL, Foxhall GL, et al. Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anesthesia. Br J Anaesth.2010;104:369-374.
Nielsen PR, Andreasen J, Asmussen M, et al. Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine. BMC Health Serv Res. 2008;8:209.
Silver K, Baima J. Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes. Am J Phys Med Rehabil. 2013;92:715-727.
Silver J, Mayer RS. Barriers to pain management in the rehabilitation of the surgical oncology patient. J Surg Oncol. 2007;95:427-435.
Tou S, Tou W, Mah D, et al. Effect of preoperative two-dimensional animation information on perioperative anxiety and knowledge retention in patients undergoing bowel surgery: a randomized study. Colorectal Dis. 2013;15:e256-e265.

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