Knowledge, practice, and associated factors of preoperative patient teaching among surgical unit nurses, at Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022.

BACKGROUND: Preoperative teaching practice is very important to surgical clients in freeing them from anxiety and post-operative complications. The preoperative education received by the patients depends on the knowledge and experience of nurses. The diversity in the degree of knowledge and experience possessed by nurses may result in inadequate and ineffective preoperative preparation of patients. Therefore, this study aimed to assess the knowledge, practice, and associated factors of preoperative patient teaching among nurses working at surgical units in Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022. METHOD: An institutional-based cross-sectional study triangulated with a qualitative approach was conducted from April to June 2022. The data were collected using a semi-structured self-administered questionnaire and in-depth interviews. The descriptive statistics were presented in text and tables. Analytical analysis schemes including bivariable and multivariable logistic regression were computed considering P-value < 0.05 to identify statistically significant factors. Qualitative data were analyzed with thematic analysis. RESULT: A total of 406 participants were involved in this study with a 95.8% response rate. The adequate knowledge of nurses was 61.6% with 95% CI: (56.7, 66.3) and significantly associated with being male, nurse use of guidelines, nurses they have been trained, and nurses' who say they do not a staff shortage had good knowledge than the counterparts. Good practice of nurses regarding preoperative patient education was 46.3% with 95% CI (41.4, 51.0) significantly associated with the presence of preoperative teaching guidelines, took training on patient education, nurses who said no staff shortage, and knowledge of preoperative patient education.. Nurses have a positive interaction with the patient and much work experience had good practice but lack of training; inadequate supplies and lack of professional prerequisites are some of the barriers identified. CONCLUSION: Nurses' knowledge and practice regarding preoperative patient teaching were found to be inadequate. So, it is better to strengthen training, adequate staffing, equip wards with standardized guidelines and teaching materials, motivate and create a safe working environment. Most nurses explore factors of preoperative patients' teaching as institutional, Nurse's related, and patient-related factors.

Preparedness for Surgery: Analyzing a Quality Improvement Project in a Population of Patients Undergoing Hepato-Pancreatico-Biliary Surgery.

BACKGROUND: Approximately 20% of patients diagnosed with pancreatic cancer will be eligible for hepato-pancreatico-biliary (HPB) surgery. Studies indicate that high-quality patient education is pivotal in reducing anxiety, improving clinical and performance outcomes, and increasing patient satisfaction. OBJECTIVES: This quality improvement project sought to determine the perceived level of preparedness for patients undergoing HPB surgery and to identify information and knowledge gaps in preoperative education. METHODS: Convenience sampling was used to collect postoperative information via questionnaire from 50 patients regarding areas of importance. FINDINGS: Preoperative information gaps for patient and family education were identified. Improving preparedness for HPB surgery has the potential to improve clinical outcomes, increase quality and patient satisfaction, decrease length of stay, and reduce time to adjuvant therapy.

Development and Evaluation of Preoperative Teaching Materials for CABG/Valve Surgery Patients.

BACKGROUND: Patients often experience anxiety and feel overwhelmed by the prospect of undergoing open-heart surgery. Randomized controlled trials have found preoperative education materials and counseling to reduce levels of patient anxiety, depression, and perioperative complications following coronary artery bypass grafting (CABG)/valve surgery. OBJECTIVE: The purposes of this performance improvement project were to develop preoperative teaching materials for cardiac surgery inpatients and evaluate their usability. METHODS: Existing CABG/valve teaching materials were evaluated. A new booklet was developed through an iterative process. An expert panel reviewed the final draft using the patient education materials assessment tool for printable materials (PEMAT-P). Patients were surveyed for usability and usefulness. RESULTS: Expert reviewer results for using the PEMAT-P tool for understandability and actionability were 99% and 100%. Of 62 teaching booklets and patient preparedness questionnaires distributed, N = 11 (17.7%) were returned. Nearly all respondents (90.9%) agreed or strongly agreed for questions related to how well the booklet prepared them for surgery. Likewise, 90.9% of respondents agreed or strongly agreed with statements about design and content of the booklet. The hospital consumer assessment of healthcare providers and systems performance reports from October 1, 2016 to December 31, 2016 showed improvement for discharge information (96.2% from 92.2%), symptom to look for (100% from 94.9%), and care transitions (66.2% from 54.3%). CONCLUSIONS: The development and implementation of evidence-based preoperative teaching materials help patients and families prepare for open-heart surgery and self-care after discharge. IMPLICATIONS FOR NURSING: Nurses' utilization of preoperative teaching materials improves patient satisfaction, preparedness, and usefulness.

Preoperative patient teaching: the practice and perceptions among surgical ward nurses.

AIMS AND OBJECTIVES: To explore the consistency between the perceptions and actual practice of preoperative patient teaching and also the factors affecting the provision of teaching from the perspective of nurses working in surgical wards. BACKGROUND: Preoperative teaching is beneficial to surgical patients in alleviating their anxiety and promoting their postoperative recovery. Despite the leading role in patient teaching by nurses, sparse studies have been addressed the consistency between nurses' perceptions and their actual practice of preoperative teaching in surgical wards. DESIGN: A cross-sectional survey. METHOD: Data were collected by using self-reported preoperative teaching questionnaires together with nurse demographic data sheets. Sampling setting was an acute public hospital and all nurses working in surgical wards (n = 100) were approached in the study. RESULTS: A total of 86 nurses returned the questionnaires. 'Details of anaesthesia' was the most prominent preoperative teaching component rated by nurses although their major teaching was pertained to 'preoperative preparation'. In addition, oral explanation was reported as the most prevalent way of information delivery and internet was the least preferred method. Discrepancies between nurses' perceptions and actual practice were found in this study. Moreover, nurses' time availability, language barriers and tight operation schedules were perceived as top factors affecting the provision of preoperative teaching. Furthermore, nurses' satisfaction with such patient teaching was significantly associated with their professional training and their daily workload in the clinical setting. CONCLUSIONS: Preoperative patient teaching was not fully achieved by nurses in this study, and the results highlighted the conflicting issues related to the implementation process that could be resolved by means of proper planning and management in clinical practice. RELEVANCE TO CLINICAL PRACTICE: Healthcare organisations and nurse managers should periodically review the existing clinical resources so that sufficient preoperative teaching strategies can be provided. Nurses' perceptions and satisfaction towards preoperative teaching can be compared with those of the patients in further studies so that the insights for developing an effective preoperative teaching programme can be more comprehensive.

Patient perception about preoperative information to allay anxiety towards major surgery

Abstract: Surgeries are seen as stressors that trigger preoperative anxiety. Preparing the patients for surgery through preoperative teaching becomes crucial to allay anxiety level. In a cross sectional descriptive study conducted on eighty patients (age: 18–65 yr) who had undergone open abdominal surgery, 78.8% (n=63) stated that they experienced anxiety prior to surgery. Among these anxious respondents, 47.5% (n=38) experienced high state anxiety. Three of the top information that patients perceived as important to allay anxiety towards major surgery were: details of surgery, details of nursing care to surgery and information on anaesthesia. Nurses working in the surgical wards need to proactively address patients’ psychological concerns towards surgery and provide preoperative information based on patients’ needs to allay anxiety.

The Effect of Preoperative Teaching on the Emotional Status of Patients Prior to Surgery / 성인간호학회지

The purpose of this study was to examine the effect of preoperative teaching as a nursing intervention on the emotional status of the patients prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronize Design. The data were selected from H universuty hospital in Seoul, and they consisted of an experimental group-30patients, and a control group-30 patients. The questionnaire consisted of 28 Preoperative Stress Inventory(Kang, 1998), and 16 State-Trait Anxiety Inventory(Spielberger, 1972). The collected data were analized by means of frequency, percentage, x2 test, t-test and paired t-test with SPSS WIN. The results of this study were as follows: 1. The level of stress prior to surgery was significantly lower for the preoperative teaching group than for the control group(t=2.61, p< .01). 2. The level of anxiety prior to surgery was not significantly lower for the preoperative teaching group than for the control group. 3. The difference level of the anxiety level the prior to surgery was significantly higher for the preoperative teaching group than for the control group(t=2.82, p< .01). In conclusion, preoperative teaching is a beneficial nursing intervention that has a positive effect on the stress and anxiety of patients prior to surgery. Therefore it is recommended to use the preoperative teaching program as a nursing intervention for patients prior to surgery.