Improving the Patient and Staff Experience of Laceration Repair in the Urgent Care Clinic Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/162746
Type:
Presentation
Title:
Improving the Patient and Staff Experience of Laceration Repair in the Urgent Care Clinic Setting
Abstract:
Improving the Patient and Staff Experience of Laceration Repair in the Urgent Care Clinic Setting
Conference Sponsor:Emergency Nurses Association
Conference Year:2000
Author:Gunter, Pamela, RN, MSN, BS
P.I. Institution Name:Kaiser Permanente Mid-Atlantic
Contact Address:2100 W. Pennsylvania Avenue, NW, Washington, DC, 20037, USA
Contact Telephone:(202) 872-7280
Co-Authors:David L. Evans and Debbie L. Royalty
Purpose: Lacerations have been repaired using sutures as a standard practice. However, this highly effective technique is often painful for the patient, time-consuming for the staff, and may contribute to extended clinic wait times. The purpose of this study was to determine if an alternative laceration repair method would result in less pain for the patient and in time savings for staff and patients.

Design/Setting/Sample: A retrospective chart review and patient phone interviews were completed for 80 randomly selected adult and pediatric patients experiencing tissue adhesive laceration repair over a twelve month period in five Urgent Care Clinics. Lacerations selected for tissue adhesive repair fit inclusion parameters for size ½3"), age ½ 6 hours), location (not over a mucocutaneous junction or an extensor surface), mechanism of injury (not a human or dog bite) and appearance (non-infected).

Methodology: Demographic data and clinical descriptions of lacerations were extracted from the chart. Patients (or parents of young children) were phoned post-repair and asked the following:
I. Was there pain during the repair?
2. Are the edges of the wound together?
3. Are there signs of infection (swelling, redness, heat, discharge, or pain)?
4. How does the scar look?
5. How did the tissue adhesive experience compare with any previous suture experience?
Answers to questions were recorded as yes or no; or as descriptions of a negative or positive appearance or experience, as appropriate. Percentages were calculated for 'yes' responses and for numbers of positive experiences. Physicians and nurses were asked to estimate the amount of time spent in each stage of the process for the actual tissue adhesive repair and for a similar suture repair. Times were totaled and averaged.

Results: For the time period from repair to follow-up call, patient perceptions of both the pain experience and the quality of the repair reflected high percentages of positive feedback:
Q 89% reported no pain during repair.
Q 91 % reported that the wound edges remained approximated.
Q 96.5% reported no signs of infection.
Q 95% reported satisfactory appearance of the scar.
Q 89% of those with previous suture experience rated tissue adhesive repair a better experience.

Time savings for tissue adhesive use (30 minutes) versus suture repair (55 minutes) were significant. Suture repair involves time expenditure for anesthetic agent use and tissue adhesive repair does not involve a follow-up visit for removal.

Conclusions: For certain wound types, tissue adhesive can be a less painful substitute for suturing which provides good wound outcomes for patients. With shortened repair times, patients and staff may enjoy the benefit of reduced patient wait time. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving the Patient and Staff Experience of Laceration Repair in the Urgent Care Clinic Settingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162746-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving the Patient and Staff Experience of Laceration Repair in the Urgent Care Clinic Setting</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2000</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gunter, Pamela, RN, MSN, BS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Kaiser Permanente Mid-Atlantic</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2100 W. Pennsylvania Avenue, NW, Washington, DC, 20037, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(202) 872-7280</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Landlady20@hotmail.com</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">David L. Evans and Debbie L. Royalty</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Lacerations have been repaired using sutures as a standard practice. However, this highly effective technique is often painful for the patient, time-consuming for the staff, and may contribute to extended clinic wait times. The purpose of this study was to determine if an alternative laceration repair method would result in less pain for the patient and in time savings for staff and patients.<br/><br/>Design/Setting/Sample: A retrospective chart review and patient phone interviews were completed for 80 randomly selected adult and pediatric patients experiencing tissue adhesive laceration repair over a twelve month period in five Urgent Care Clinics. Lacerations selected for tissue adhesive repair fit inclusion parameters for size &frac12;3&quot;), age &frac12; 6 hours), location (not over a mucocutaneous junction or an extensor surface), mechanism of injury (not a human or dog bite) and appearance (non-infected).<br/><br/>Methodology: Demographic data and clinical descriptions of lacerations were extracted from the chart. Patients (or parents of young children) were phoned post-repair and asked the following:<br/>I. Was there pain during the repair?<br/>2. Are the edges of the wound together?<br/>3. Are there signs of infection (swelling, redness, heat, discharge, or pain)?<br/>4. How does the scar look?<br/>5. How did the tissue adhesive experience compare with any previous suture experience?<br/>Answers to questions were recorded as yes or no; or as descriptions of a negative or positive appearance or experience, as appropriate. Percentages were calculated for 'yes' responses and for numbers of positive experiences. Physicians and nurses were asked to estimate the amount of time spent in each stage of the process for the actual tissue adhesive repair and for a similar suture repair. Times were totaled and averaged.<br/><br/>Results: For the time period from repair to follow-up call, patient perceptions of both the pain experience and the quality of the repair reflected high percentages of positive feedback:<br/>Q 89% reported no pain during repair.<br/>Q 91 % reported that the wound edges remained approximated.<br/>Q 96.5% reported no signs of infection.<br/>Q 95% reported satisfactory appearance of the scar.<br/>Q 89% of those with previous suture experience rated tissue adhesive repair a better experience.<br/><br/>Time savings for tissue adhesive use (30 minutes) versus suture repair (55 minutes) were significant. Suture repair involves time expenditure for anesthetic agent use and tissue adhesive repair does not involve a follow-up visit for removal.<br/><br/>Conclusions: For certain wound types, tissue adhesive can be a less painful substitute for suturing which provides good wound outcomes for patients. With shortened repair times, patients and staff may enjoy the benefit of reduced patient wait time. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:33:27Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:33:27Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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