Authors (including presenting author) :
Choi KH, Cheung KW
Affiliation :
Department of Surgery, Caritas Medical Centre
Introduction :
An Early ambulation after surgery is a central concept in fast-track surgery results in shorter hospital stay and better recovery. Prolonged immobilisation after surgery has been shown to have deleterious effects on pulmonary function, muscle power and skin integrity. Poor physical functioning is due to fatigue and muscle weakness due to prolonged bedrest after operation. Nurses play an important role to help patients post-operatively. Furthermore, prolonged immobilisation is associated with increased risk of deep venous thrombosis (DVT), chest infection, urinary tract infection as results to prolonged hospital stay. DVT is a major source of postoperative morbidity and mortality and is currently a major quality improvement initiative. The morbidity and mortality associated with thromboembolic events is high, with 28-day fatality rates reported as 9% for DVT.
Objectives :
Using mechanical prophylaxis device (Pressure stocking +/- Pneumatic pump) for patient undergone lower GI operation to enhance better recovery and regain patient’s physical functioning after operation.
Methodology :
Program is introduced to patient on admission day. Education by nurse is given to patient about how to wearing the GCS and the care of GCS. Education leaflet is also given to patient. Then patients started to wear GCS according to their sizes on admission day until patients mobile after operation. Briefing session and in-service training are provided to all nursing staff and health care assistance for this program. Guideline and protocol are also provided and all staff should read and sign. In this program, below knee GCS is selected to patients.
Result & Outcome :
Total 41 patients were included in the program until end of August, with 97.6% patients not developed DVT or Pulmonary embolism during hospitalization. 73% of patients can be mobilized within 3 days after operation. The program can promote early mobilization after operation with specialty nurse attends the patient daily to observe patient condition. Early ambulation results in shorter hospital stay. Patient had a good recovery and lower incidence rate of DVT related to prolong bed rest after operation. Shorter hospital stay leads to benefits for patients, their families, and the hospital contributing to save healthcare costs. It is a world-wide trend to promote prophylactic DVT prevention program. The program will be further implemented to upper GI & Urology operation in the department DVT prevention.
