Preoperative and postoperative patient education: an audit
J.K.V Madhushanka, H.D.K.Chinthana, K.Karunaratne
The aim of the study was to find out whether the patients who have undergone the gynecological surgeries are properly informed and educated regarding the procedures and complications.
An interviewer based questionnaire was designed to assess the level of patient information.
Questionnaire contains components of personal data (BHT number, age), type of surgery, type of pathology and preoperative and post operative explanation of procedure and complications.
Ward 8 (gynecology ward)
National Cancer Institute, Maharagama.
First hundred surgical cases were interviewed from the date of audit started (march 27th).Patients were interviewed using the above mentioned questionnaire preoperatively and postoperatively after ward rounds. Preoperative patients were interviewed on the same day prior to surgery and postoperative were interviewed after 24 hours from the surgery which is full recovery for them after surgical anesthesia and after the following day when the ward round is over.
The first data collected in the preoperative auditing process showed that sample contained 48% of laparotomy for ovarian carcinoma, 11% of RH and PND for cervical carcinoma 18% of TAH/PND for endometrial carcinoma, 5% of vulvectomy for vulval carcinoma, 4% laparoscopic surgeries and 14% of other procedures(Dilatation and curettage etc ). 77% of patients were properly educated about the procedures that they were going to face but 64% have not explained the complications of the surgery preoperatively. 52 % patients have not informed the necessity of colostomy if relevant.
Majority (77 %) have not informed the procedures post surgically. Overall 8% got complications during surgery (5% bowel injuries,2% bladder injuries and 1% vessel injuries ) but only 4% out of them were explained about the surgical complications post operatively.
Preoperative patient education is adequate only explaining the procedures and explaining the complications and other procedures as colostomy if relevant is grossly inadequate. Overall the demand of ideal informed written consent was not met. Post operative patient education is poor as majority has not informed the procedures or complications.
The inadequacy of patient communication may be due to lack of space allocated for patient communication, poor staff training on communication, language barriers and high number of patients.
Allocating a proper place for patient communication and staff training strategy can lead to educate patients adequately help them make feel secure and confident about their treatment.