Authors (including presenting author) :
Chung KS, Chan CH, Tam WY, Ng MW, Lau CF, Leung YY, HS So
Affiliation :
Department of surgery, TKOH
Introduction :
As the top ranking cancer in Hong Kong, the number of newly diagnosed colorectal cancer has reached a historical high of 5,635 cases (Hong Kong Cancer Registry 2018). In Tseung Kwan O Hospital, the number of colorectal surgeries raised from 90 in 2015 to 115 in 2020 with a 27.8% increase within recent years. To serve the increasing service needs and facilitate post-operative recovery, Perioperative Surgical Nurse Clinic (PSNC) has been launched to provide comprehensive pre-operative assessment and education, post-operative ward visit and post-discharge phone follow-up. Sharing the same goal of Enhanced Recovery After Surgery (ERAS) program, we aim to improve the surgical outcome and better utilize health care resources.
Objectives :
The objective of PSNC is to prepare patient physically and psychologically before the operation, so as to facilitate same day admission and enhance patient’s post-operative recovery. By providing comprehensive perioperative assessment and care in multidisciplinary approach, patients’ post operative recovery can be enhanced with a better surgical outcome and satisfaction. Our ultimate goal is to improve the cost-effectiveness of the health care resources.
Methodology :
(1) A patient satisfaction survey was conducted in 2020 to evaluate PSNC patients’ feedback on pre-operative information delivery, same day admission arrangement, anxiety relieving, post-operative visit and overall performance of our nursing service. In order to evaluate the effectiveness of PSNC, two groups of 50 colorectal surgery patient were randomly invited to take part in the survey: One group of patients who had operation before the establishment of PSNC, while the other group were patients who had operation after that. (2) We measure the effectiveness of PSNC by comparing the median post operative length of stay of patients undergoing elective colorectal surgeries before and after the establishment of PSNC. (3) We also evaluate the success of PSNC by comparing the same day admission rate of patient undergoing elective colorectal surgeries before and after PSNC is launched.
Result & Outcome :
The patient satisfaction survey has demonstrated that the PSNC service has enhanced patient’s satisfaction in both pre- and post-operative periods. The percentage of patients who responded positively to clear delivery of pre-operative information raised from 78% to 100% after PSNC is set up. The percentage of patients who expressed that our service helped them to relieve operation stress and anxiety raised from 50% to 98% after PSNC is established. The percentage of patients who agreed that post operative nurse visit enhanced their recovery raised from 76% to 82% after PSNC is launched. 100% of patients answered “Excellent” and “Very good” on our overall nursing service impression, while it was 74% before PSNC is set up. The result reflected that PSNC service has raised patient’s satisfaction of our nursing service. Furthermore, the same day admission rate of colorectal surgeries was raised from 2.7% in 2017 to 88% in 2020 with PSNC. The median post-operative length of stay is also shortened notably from 9 days in 2015 to 5 days in 2020 (SOMIP Report Vol 12 2019-2020).
