Duke University School of Nursing, Durham, NC.
Duke University Hospital, Durham, NC.
J Perianesth Nurs. 2021 Aug;36(4):351-358. doi: 10.1016/j.jopan.2020.10.007. Epub 2021 Mar 18.
The purpose of this quality improvement project was to improve consistency of discharge teaching in women who used progesterone-containing hormonal contraceptive medications and received sugammadex during general anesthesia, as there is a risk of unintended pregnancy for 1 week after administration of sugammadex.
This project used a predesign and postdesign using two separate sample groups of patients and postanesthesia care unit (PACU) nurses.
The sample consisted of 31 total women of childbearing age and 59 PACU nurses. Simplification of sugammadex discharge instructions was achieved by incorporating evidence-based recommendations for electronic discharge instructions and nursing education. PACU nurses were educated and surveyed before and after regarding frequency of discharge teaching, clarity, and comprehension of the after-visit summary and knowledge of sugammadex. Patients were called via telephone postoperatively to assess recall of sugammadex discharge teaching.
Postoperative patient phone calls identified a small increase in patient recall of discharge instructions from 5 of 14 patients (35.7%) before implementation to 7 of 17 after implementation (41.2%). PACU nurse surveys indicated an increase in self-reported frequency of sugammadex discharge teaching (34.8% vs 64.2%, P = .024) and that new discharge instructions contained more clear, comprehensive information as compared with previous instructions (29.4% vs 75.5%, P = .001).
This quality improvement project successfully implemented more consistent and comprehensive discharge instructions for women who receive sugammadex intraoperatively. Limitations of the project included a small sample size and short implementation intervals. As a result of switching to uniform discharge instructions, more patients received important discharge teaching from PACU nurses, and the percentage of patients who recalled this information increased.
本质量改进项目旨在提高使用孕激素类激素避孕药并在全身麻醉下接受琥珀酸舒更葡糖钠的女性出院教学的一致性，因为在给予琥珀酸舒更葡糖钠后 1 周内存在意外怀孕的风险。
该项目使用预设计和后设计，使用两组不同的患者样本和麻醉后护理单元（PACU）护士。
样本包括 31 名育龄妇女和 59 名 PACU 护士。通过将基于证据的电子出院说明建议纳入其中，并进行护理教育，简化了琥珀酸舒更葡糖钠的出院说明。在教育前后，PACU 护士接受了关于出院教学频率、清晰度、术后随访摘要的理解以及对琥珀酸舒更葡糖钠的了解的调查。术后通过电话对患者进行随访，以评估对琥珀酸舒更葡糖钠出院教学的回忆情况。
术后患者电话随访发现，与实施前的 14 名患者中的 5 名（35.7%）相比，实施后的 17 名患者中有 7 名（41.2%）对出院指导的回忆有所增加。PACU 护士调查显示，与实施前相比，琥珀酸舒更葡糖钠的出院教学频率有所增加（34.8%比 64.2%，P=0.024），且新的出院指导包含了更清晰、全面的信息，而不是之前的说明（29.4%比 75.5%，P=0.001）。
本质量改进项目成功地为接受术中琥珀酸舒更葡糖钠的女性实施了更一致和全面的出院指导。该项目的局限性包括样本量小和实施时间短。由于切换到统一的出院指导，更多的患者从 PACU 护士那里获得了重要的出院教学，并且回忆这些信息的患者比例增加。
