Article type
Abstract
Background: The incidence of postoperative pulmonary complications (PPCs) is considerably high among patients undergoing surgery and they cause debilitating care burden and substantial health costs. Evidence has been established that multiple strategies, such as preoperative chest physical therapy, coughing exercise and early mobilisation, can reduce the risk of PPCs, and suggests that patients need to be taught on these strategies before their surgeries.
Objectives: To implement the best practice regarding the prevention of PPCs for patients undergoing general surgery in the clinical unit.
Methods:A clinical audit was conducted using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool in a 46-bed general surgical unit. Eight audit criteria were created based on evidence summary and they represent best practice recommendation for prevention of PPCs. A baseline audit was conducted followed by the implementation of multiple strategies, and then a follow-up audit was conducted to determine changes in practice. There were 20 patients and 18 nurses involved in baseline audit, and so did in the follow-up audit.
Results: Results from pre- and post-implementation audits shown significant improvements for all the criteria. There were substantial improvements for documenting risk assessment performed and implementation of chest physical therapy before surgery, with compliance rate increasing from 0% to 89% and 85%, respectively. Criteria regarding nurse training and preoperative patient education achieved 100% compliance.
Conclusions: The aim was successfully realised in this project. The knowledge and skills of nurses on prevention of PPCs and chest physical therapy were advanced. This project demonstrated that patient education with multiple strategies and multiple modes were helpful, effective and acceptable for patients. Future audits, possibly incorporating patient outcome data will need to be carried out in order to sustain evidence-based practice and concurrently improve patient and staff outcomes.
Objectives: To implement the best practice regarding the prevention of PPCs for patients undergoing general surgery in the clinical unit.
Methods:A clinical audit was conducted using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool in a 46-bed general surgical unit. Eight audit criteria were created based on evidence summary and they represent best practice recommendation for prevention of PPCs. A baseline audit was conducted followed by the implementation of multiple strategies, and then a follow-up audit was conducted to determine changes in practice. There were 20 patients and 18 nurses involved in baseline audit, and so did in the follow-up audit.
Results: Results from pre- and post-implementation audits shown significant improvements for all the criteria. There were substantial improvements for documenting risk assessment performed and implementation of chest physical therapy before surgery, with compliance rate increasing from 0% to 89% and 85%, respectively. Criteria regarding nurse training and preoperative patient education achieved 100% compliance.
Conclusions: The aim was successfully realised in this project. The knowledge and skills of nurses on prevention of PPCs and chest physical therapy were advanced. This project demonstrated that patient education with multiple strategies and multiple modes were helpful, effective and acceptable for patients. Future audits, possibly incorporating patient outcome data will need to be carried out in order to sustain evidence-based practice and concurrently improve patient and staff outcomes.