(Poster 20) Determining the Effectiveness of Preoperative Nursing Visits
Objectives: The preoperative period is a vital time in a patient's surgical course. However, there is no standard recognized best practice for preoperative visits, and these practices often differ between provider and department. This study reviewed all surgical cases of a surgeon who performed the same surgeries within the Urogynecology division of the Obstetrics and Gynecology department and the Urology department. The patients undergoing surgery within Urogynecology had a nursing preoperative visit, whereas those within the Urology department did not. Specifically, this project aimed to evaluate postoperative outcomes compared between patients who received and those who did not receive a preoperative nursing visit.
Methods: A retrospective study was conducted at a single academic institution over a 6 months period that included women aged 23-93 who underwent a surgery with a single surgeon with dual appointments in the Urogynecology division and Urology department. Group demographics and type of procedure were analyzed using a chi squared test. The number of times patients contacted the healthcare system postoperatively was analyzed with a welch’s t-test. Healthcare contacts included: clinic appointments, urgent care visits, emergency room visits, primary care doctor visits, phone calls, and electronic medical record messaging. The level of significance was set at 0.05.
Results: In total there were 46 patients in the Urogynecology group and 26 in the Urology group. Groups did not differ on age, race, ethnicity, insurance, or home support (p= 0.938, p= 0.184, 0.395, 0.792, and 0.377, respectively). Of note, when investigating which procedures were performed in each group, the Urogynecology patients were more likely to have a mesh placed (p= 0.002) as well as have a procedure with a vaginal approach (p=0.013). In terms of postoperative outcomes, patients who had a preoperative nursing visit did not differ from those with no nursing visit (p=0.128). The average number of contact points postoperatively for patients with a preoperative nursing visit was 4.3 and compared to 2.9 in the no preoperative visit group (p=0.059). However, patients without a nurse visit were more likely to visit the ED (p=0.013) and seek questions through the EMR messaging system (p=0.024).
Conclusions: This project aimed to evaluate postoperative outcomes compared between patients who received and those who did not receive a preoperative nursing visit. There does not appear to be a benefit for patients scheduling a preoperative nursing visit when it comes to the number of health care system contacts. While this could be extrapolated to mean there is high cost to the healthcare system with no benefit, this study did not evaluate patient understanding and awareness of their operation or patient satisfaction with their medical care. Further analyses are therefore warranted to corroborate the results presented here as well as further elucidate benefits of preoperative counseling and planning.
