Abstract
Introduction: Colorectal and stoma care nurses have been auditing their specialist services for years, but have contributed less frequently to colorectal surgical service-wide audit measuring clinical outcomes relating to surgical as well as nursing care. Nurse-led follow-up provides the ideal platform to measure key indicators of quality care and identify areas for both service improvement and future research activity.
Method: A nurse-led follow-up clinic at 30 days following patient discharge was used to audit 142 consecutive patients undergoing elective (n= 98) or emergency (n=44) colorectal resection over a three month period. Audit data were recorded at two time-points, discharge from hospital and at clinic, with audit templates developed using validated tools designed to measure general post-operative morbidity (Grocott et al, 2007; Dindo et al, 2004) and modified to include a focus on colorectal surgery-specific complications. Audit templates were tested during two clinics prior to full data collection to ensure they included all required variables.
Results: A wide range of anticipated and unanticipated findings were identified relating to both inpatient and early post- discharge morbidity. Findings were presented to the whole colorectal team, including upper GI and colorectal surgeons and their teams, specialist nurses, theatre-based and ward-based nursing staff. Areas of clinical practice identified by the audit as requiring improvement were identified and discussed, with immediate changes to surgical practice agreed by the whole team. Nurse-led follow-up for all colorectal patients was established as a potential goal for future service improvement.
Conclusion: This nurse-led audit enabled the whole colorectal team to scrutinise their clinical practice by comprehensively examining patient outcomes at two time-points following colorectal resection. Nurse-led follow-up using an auditable documentation template facilitates the recognition and reporting of a wide range of post-operative complications and provides valuable support for patients, particularly those who do not have routine access to specialist nursing services.
References: Dindo, D. et al (2004) Classification of Surgical Complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery 240(2):205-213
Grocott MPW et al (2007) The Postoperative Morbidity Survey was validated and used to describe morbidity after pelvic surgery. Journal of Clinical Epidemiology 60: 919-928
Method: A nurse-led follow-up clinic at 30 days following patient discharge was used to audit 142 consecutive patients undergoing elective (n= 98) or emergency (n=44) colorectal resection over a three month period. Audit data were recorded at two time-points, discharge from hospital and at clinic, with audit templates developed using validated tools designed to measure general post-operative morbidity (Grocott et al, 2007; Dindo et al, 2004) and modified to include a focus on colorectal surgery-specific complications. Audit templates were tested during two clinics prior to full data collection to ensure they included all required variables.
Results: A wide range of anticipated and unanticipated findings were identified relating to both inpatient and early post- discharge morbidity. Findings were presented to the whole colorectal team, including upper GI and colorectal surgeons and their teams, specialist nurses, theatre-based and ward-based nursing staff. Areas of clinical practice identified by the audit as requiring improvement were identified and discussed, with immediate changes to surgical practice agreed by the whole team. Nurse-led follow-up for all colorectal patients was established as a potential goal for future service improvement.
Conclusion: This nurse-led audit enabled the whole colorectal team to scrutinise their clinical practice by comprehensively examining patient outcomes at two time-points following colorectal resection. Nurse-led follow-up using an auditable documentation template facilitates the recognition and reporting of a wide range of post-operative complications and provides valuable support for patients, particularly those who do not have routine access to specialist nursing services.
References: Dindo, D. et al (2004) Classification of Surgical Complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Annals of Surgery 240(2):205-213
Grocott MPW et al (2007) The Postoperative Morbidity Survey was validated and used to describe morbidity after pelvic surgery. Journal of Clinical Epidemiology 60: 919-928
| Original language | English |
|---|---|
| Publication status | Published - 24 Jun 2015 |
| Event | 2nd Digestive-Disorders-Federation Conference - London, London, United Kingdom Duration: 22 Jun 2015 → 25 Jun 2015 |
Conference
| Conference | 2nd Digestive-Disorders-Federation Conference |
|---|---|
| Country/Territory | United Kingdom |
| City | London |
| Period | 22/06/15 → 25/06/15 |