Preoperative nursing education is a very crucial step undertaken before any surgical operation procedure. The effects of preoperative nursing education have been shown to almost always affect the outcomes of the operation(Ronco et al. 2012,312). The preoperative nursing education for men undergoing implantation of artificial urinary sphincter has been shown to reduce patient anxiety before and after the operation. Patient anxiety during surgery often results in reduced patient satisfaction after Artificial Urinary Sphincter implantation surgery (Zarei et al., 2018,12). Improved knowledge about what to expect after the operation will, therefore, be very instrumental in reducing post operational anxiety among patients. However, despite urologists dedicated efforts to provide preoperative nursing education using a variety of teaching activities, patients often feel unprepared to cope with the postoperative experience (Guo et al. 2012,132). This challenge is caused by insufficient knowledge retention of the preoperative nursing education. Therefore, there is a need for patient re-education after the surgery. This paper will examine patient satisfaction with the conventional oral preoperative consultation, and the effect of video and class assisted teaching style on men receiving preoperative information about implantation of artificial urinary sphincter during consultation and related outcome measures. The current process undergone by potential patients for the Artificial Urinary Sphincter implantation surgery follows the common scenario that leads to treatment. The patient is referred to the hospital after experiencing the ever humiliating uncontrollable leakage of urine from the bladder. The patient is referred to hospital to be seen by the surgeon who then goes on to review the history of the disease and assess the strength of the urinary sphincter through urodynamic imaging. Once the patient gives consent for surgery, there follows a pre-assessment for work up and aesthetics information on the patient. After all the pre-operation procedures are complete, the patient is booked for an operation.
The current conventional methods used to conduct nursing education for patients include the use of leaflets which are handed over to the patients to read and encouraging the patient to make visits to the hospital for counseling and educational sessions. The main challenge with the face to face talks and education a surgeon conducts on the patients is that the patient cannot retain all the information in a few sessions(Polit,2008,56). There are often deficits in retention for verbally delivered medical information.
The problem with the leaflets is that they are often too wordy and bulky and may put off the patients from reading them. There are also concerns that the information contained in the leaflets may provide insufficient knowledge, with critical information almost always missing. Bulky leaflets are costly to print regularly. There is growing evidence that patients with heightened pre-surgical anxiety have acquired little pre-operative education. Effective means of instilling pre-operative nursing based knowledge on patients should be realized to improve the recuperation speeds of patients after the operation(Boltz, 2016 ,11).. The main aim of this evidence-based improvement project is to determine the effectiveness of preoperative nursing education using take-home video versus class assisted teaching among men undergoing implantation of the artificial urinary sphincter. Other potential methods of delivering nursing based pre-surgical operation to be examined during the research would include the use of audio tapes, mobile and tablet applications and animated tutorials. The project outcomes will be used to implement a successful pre-operative nursing education among patients who are to undergo implantation of the artificial urinary sphincter. This will result in improved retention of pre-surgical nursing education for patients and also lead to a reduction of pre-surgical anxiety.
There is sufficient evidence to show that take home videos and audio tapes are more cost-effective as compared to class assisted teaching(Kehler,2008,32).By creating and utilizing take home video discs in the course of the research, it is anticipated that patients will be more likely to enjoy acquiring presurgical education in the comfort of their homes rather than having to attend class assisted education and counseling programs.The other advantage of using videos is that they are suitable for use in the outpatient department(Guo P.,2015,36).This method is also a promising one since it exploits technological advancements to educate patients who have been booked for operations.Furthermore, since videos are continuously available for viewing in patients home, there is good chance that they will be exploited well pot-operatively.Videos are the proper tools that will help the patients to share the proper information concerning their condition with their significant ones.Videos also aid in the formulation of any questions and concerns that the patients can raise to be addressed by the medical professionals.
Main themes derived from reading literature
Video instruction and education are crucial in alleviating a patient's overall anxiety and also reducing the stress levels(Zarei, 2018,12).
Pre-surgical education improves the chances of success of an operation, saves patient's time and also boosts the satisfaction of the patient's pre- and post-operatively(Lee,2013,22).
Pre-operative education conducted via take home videos and animations is reported to have more successful outcomes as compared to class assisted teaching and the use of literature(Brown S., 2013,43).
Insufficient knowledge retention of the preoperative nursing education is the main obstacle that increases pre-operative and post-operative stress levels and anxiety in patients(Van Dijk,2015,142).
Objectives of the project
The main aims of this project are;
To review recent literature on the essential role of Clinical Nurse Specialist in educating patient before surgery.
To review the literature about the elements that can be included in preoperative nursing education
To formulate and write an evidence-based preoperative education protocol for a patient who is planned to have implantation of artificial urinary sphincter(AUS) surgery.
To assess the feasibility of implementing evidence-based Preoperative nursing education program on patient undergoing AUS insertion
To apply and evaluate the evidence in nursing education program in real clinical setting
To assess the impact of take-home video-based learning on patient outcomes in such areas as the retention of knowledge, anxiety reduction and the level of satisfaction of the patients after surgery. The project would also seek to evaluate the importance of this approach in saving patients time taken to learn.
Significance and benefits of this research
This research will help improve the chances of success of clinical nurse specialist education on the patients before surgery
The discovery of the effectiveness of take-home videos in as a means of offering preoperative education will help to boost knowledge retention of the patients when it is realized fully in a real clinical setting (Ronco et al.2012,332)
The formulation of evidence-based preoperative education protocol after the will help as importance reference to nurses seeking to educate their patients better (Boltz, 2016 ,12).This research will point out some of the most feasible evidence-based preoperative learning techniques for patients set to undergo the AUS implantation surgery.
The research outcomes will be very crucial in the implementation of a successful pre-operative nursing education among patients who are to undergo implantation of the artificial urinary sphincter. This teaching protocol realized would, therefore, be useful to Clinical Nursing Specialists in hospitals. The research would also be safe a lot of patients time and money that will have been spent on ineffective in trying to acquire preoperative education using ineffective methods.This research is highly necessary for improving the performance of patients undergoing the AUS implantation. Furthermore, the study is going to point out the importance of take-home videos in educating patients thus utilizing the current technology to help in saving and improving lives.
Guo, P., 2015. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomized controlled trials. Journal of clinical nursing, 24(1-2), pp.34-46.
Polit, D.F., and Beck, C.T., 2008. Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins.
Kehlet, H. and Wilmore, D.W., 2008. Evidence-based surgical care and the evolution of fast-track surgery. Annals of surgery, 248(2), pp.189-198.
Zarei, B., Valiee, S., Nouri, B., Khosravi, F. and Fathi, M., 2018. The effect of the multimedia-based nursing visit on preoperative anxiety and vital signs in patients undergoing lumbar disc herniation surgery: A randomized clinical trial. Journal of Perioperative Practice, 28(1-2), pp.7-15.
Van Dijk, J.F., van Wijck, A.J., Kappen, T.H., Peelen, L.M., Kalkman, C.J. and Schuurmans, M.J., 2015. The effect of a preoperative educational film on patients' postoperative pain in relation to their request for opioids. Pain Management Nursing, 16(2), pp.137-145.
Ronco, M., Iona, L., Fabbro, C., Bulfone, G. and Palese, A., 2012. Patient education outcomes in surgery: a systematic review from 2004 to 2010. International Journal of EvidenceBased Healthcare, 10(4), pp.309-323.
Lee, C.K. and Lee, I.F.K., 2013. Preoperative patient teaching: the practice and perceptions among surgical ward nurses. Journal of clinical nursing, 22(17-18), pp.2551-2561.
Guo, P., East, L. and Arthur, A., 2012. A preoperative education intervention to reduce anxiety and improve recovery among Chinese cardiac patients: a randomized controlled trial. International Journal of Nursing Studies, 49(2), pp.129-137.
Boltz, M., Capezuti, E., Fulmer, T.T. and Zwicker, D. eds., 2016. Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company.
Brown, S.J., 2013. Evidence-based nursing: The research-practice connection. Jones & Bartlett Publishers.
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