Developing Clinical Guidelines to Improve Home Care for Patients After Prostatectomy

2.50
Hdl Handle:
http://hdl.handle.net/10755/621699
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Developing Clinical Guidelines to Improve Home Care for Patients After Prostatectomy
Author(s):
Chen, Hui-Tzu; Hsu, FangHua; Yen, Miaofen
Lead Author STTI Affiliation:
Lambda Beta-at-Large
Author Details:
Hui-Tzu Chen, BS, RN, Professional Experience: 2005-14 Chi Mei Medical Center, Taiwan Urology ward nurses 2012-15 Responsible for promoting the quality of clinical care unit convener 2014-16 served as deputy chief care urological ward Author Summary: I am a Urology nurse and supervisor, gas nearly 11 years of clinical care experience, and proficient in urinary tumors related to surgery and care.
Abstract:

Purpose:

This study aims to develop clinical guidelines for both patients and their families with regard to taking care of those with prostatectomy home care (PHC). This would help to improve the quality of PHC and reduce the re-admission rate due to the complication of hematuria.

Methods:

This study was an action research. The subjects were post-prostatectomy patients without complication. A task force was composed of three urologiests, five nurses, and two administrators. The postoperative care procedure was analyzed by the task force using a quality control circle approach, while references were cross-checked and charts were reviewed. The care processes used were carefully examined. Regular meetings were held among the five nurses and three urologists to delineate the care quality indicators. Three dimensional models were applied to analyze the care process, staffing, and patient characteristics. An analysis of the results showed three factors related to poor quality care: (1) with regard to the process, there was lack of monitoring standards for postoperative care quality; (2) with regard to the nursing staff, there was a the lack of coherence and integrity in the content of the guidance guidelines; and, (3) with regard to the patients, there was a lack of knowledge about hematuria, and thus greater anxiety. We thus develop a guidelines for caregiver education, including an innovative urinary color card and educational tools. Interventions include: (1) The development of clinical guidelines for post-prostatectomy care, focusing on six aspects, such as diet, exercise, Foley care, incontinence care with Kegel exercise (pelvic floor), urine color differentiation (for hematuria), and re-scheduling for subsequent diagnosis. (2) The innovative design of a urine color education card (UCEC) for urine color differentiation. And (3) organizing in-service education on prostatectomy home care (PHC)

Results:

A total of 525 subjects were included from February 2014 to May 2016, and an analysis of their data showed the completion rate of PHC was 99.5% (with the threshold set at 90%). Meanwhile, the percentage of telephone consultations for home care service after discharge was 10%, down from 25%, indicating an improvement of 60%. The re-admission rate for hospitalization due to hematuria in the 14 days after discharge was 2%, down from 9%, indicating an improvement of 78%.

Conclusion:

This research focused on the development of clinical care guidelines for PHC. Care service quality could be closely monitored and regularly checked for improvement. The innovative urine color education card designed as part of this work could be applied in the home care guide for post-prostatectomy patients, in order to effectively improve self-care and reducethe re-admission rate due to hematuria. The development of guidelines for home care education had the following benefits: (1) Integration of disease care service for more comprehensive post-discharge care; (2) preparation of the urine color education card, inspiring creativity in health care workers and providing a standard tool for educating patients; and (3) from the perspective of risk management, the introduction of clinical care guidelines could identify individual cases at high risk of re-admission and so assist the medical team in establishing systematic preventive measures, and serve as a reference for the effects and quality of post-prostatectomy home care services.

Keywords:
clinical guideline; innovative design; prostatectomy
Repository Posting Date:
6-Jul-2017
Date of Publication:
6-Jul-2017
Other Identifiers:
INRC17PST77
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titleDeveloping Clinical Guidelines to Improve Home Care for Patients After Prostatectomyen_US
dc.contributor.authorChen, Hui-Tzuen
dc.contributor.authorHsu, FangHuaen
dc.contributor.authorYen, Miaofenen
dc.contributor.departmentLambda Beta-at-Largeen
dc.author.detailsHui-Tzu Chen, BS, RN, Professional Experience: 2005-14 Chi Mei Medical Center, Taiwan Urology ward nurses 2012-15 Responsible for promoting the quality of clinical care unit convener 2014-16 served as deputy chief care urological ward Author Summary: I am a Urology nurse and supervisor, gas nearly 11 years of clinical care experience, and proficient in urinary tumors related to surgery and care.en
dc.identifier.urihttp://hdl.handle.net/10755/621699-
dc.description.abstract<p><strong>Purpose:</strong></p> <p>This study aims to develop clinical guidelines for both patients and their families with regard to taking care of those with prostatectomy home care (PHC). This would help to improve the quality of PHC and reduce the re-admission rate due to the complication of hematuria.</p> <p><strong>Methods:</strong></p> <p lang="EN-US">This study was an action research. The subjects were post-prostatectomy patients without complication. A task force was composed of three urologiests, five nurses, and two administrators. The postoperative care procedure was analyzed by the task force using a quality control circle approach, while references were cross-checked and charts were reviewed. The care processes used were carefully examined. Regular meetings were held among the five nurses and three urologists to delineate the care quality indicators. Three dimensional models were applied to analyze the care process, staffing, and patient characteristics. An analysis of the results showed three factors related to poor quality care: (1) with regard to the process, there was lack of monitoring standards for postoperative care quality; (2) with regard to the nursing staff, there was a the lack of coherence and integrity in the content of the guidance guidelines; and, (3) with regard to the patients, there was a lack of knowledge about hematuria, and thus greater anxiety. We thus develop a guidelines for caregiver education, including an innovative urinary color card and educational tools. Interventions include: (1) The development of clinical guidelines for post-prostatectomy care, focusing on six aspects, such as diet, exercise, Foley care, incontinence care with Kegel exercise (pelvic floor), urine color differentiation (for hematuria), and re-scheduling for subsequent diagnosis. (2) The innovative design of a urine color education card (UCEC) for urine color differentiation. And (3) organizing in-service education on prostatectomy home care (PHC)</p> <p><strong>Results:</strong></p> <p>A total of 525 subjects were included from February 2014 to May 2016, and an analysis of their data showed the completion rate of PHC was 99.5% (with the threshold set at 90%). Meanwhile, the percentage of telephone consultations for home care service after discharge was 10%, down from 25%, indicating an improvement of 60%. The re-admission rate for hospitalization due to hematuria in the 14 days after discharge was 2%, down from 9%, indicating an improvement of 78%.</p> <p><strong>Conclusion:</strong></p> <p><span lang="EN-US">Th</span><span lang="EN-US">is</span><span lang="EN-US"> research focused on</span><span lang="EN-US"> the</span><span lang="EN-US"> development of clinical care guideline</span><span lang="EN-US">s</span><span lang="EN-US"> for PHC. Care service quality could be closely monitored and regularly checked for improvement. The innovative urine color education card designed as part of this work could be applied in the </span><span lang="EN-US">home</span><span lang="EN-US"> care guide for post-prostatectomy</span><span lang="EN-US"> </span><span lang="EN-US">patients, in order to effectively improve self-care and reduce</span><span lang="EN-US">the</span><span lang="EN-US"> re-admission rate due to hematuria. </span><span lang="EN-US">The d</span><span lang="EN-US">evelopment of guideline</span><span lang="EN-US">s</span><span lang="EN-US"> for </span><span lang="EN-US">home</span><span lang="EN-US"> care education had the following benefit</span><span lang="EN-US">s</span><span lang="EN-US">: (1) Integration of disease care service for more comprehensive post-discharge care; (2) </span><span lang="EN-US">p</span><span lang="EN-US">reparation of </span><span lang="EN-US">the </span><span lang="EN-US">urine color education card, inspiring creativity in health care worker</span><span lang="EN-US">s</span><span lang="EN-US"> and provid</span><span lang="EN-US">ing</span><span lang="EN-US"> a standard tool for educating patients; and (3) </span><span lang="EN-US">f</span><span lang="EN-US">rom the perspective of risk management, the introduction of clinical care guideline</span><span lang="EN-US">s</span><span lang="EN-US"> could identify individual cases at high risk of re-admission and so assist the medical team in establishing systematic preventive measure</span><span lang="EN-US">s,</span><span lang="EN-US"> and serve as a reference for the effect</span><span lang="EN-US">s</span><span lang="EN-US"> and quality of post-prostatectomy </span><span lang="EN-US">home</span><span lang="EN-US"> care service</span><span lang="EN-US">s</span><span lang="EN-US">.</span></p>en
dc.subjectclinical guidelineen
dc.subjectinnovative designen
dc.subjectprostatectomyen
dc.date.available2017-07-06T20:09:46Z-
dc.date.issued2017-07-06-
dc.date.accessioned2017-07-06T20:09:46Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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