Date of Award

Spring 2023

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Marguerite Ambrose, PhD, RN, ACNS, BC, CNE

Committee Member

Cheryl Schlamb, DNP, CRNP

Committee Member

Jacquelin Owens, DNP, RN, FNP-BC

Committee Member

Veronica Wilbur, PhD, APRN-FNP, CNE, FAANP

Abstract

The purpose of this quality improvement project was to see if there were improved outcomes for patients undergoing head and neck surgery requiring free flap reconstruction and a tracheotomy who completed digital preoperative education versus those that did not complete the education. The design was a retrospective, cohort study and was conducted in Philadelphia, Pennsylvania at a large academic institution with a total sample was 122 patients. All patients in the Department of Otorhinolaryngology scheduled for surgery requiring free flap reconstruction and a tracheotomy were offered the digital preoperative education with participation being voluntary. Data was collected from the electronic medical record on all patients who had the specific surgery. Outcomes studied included length of hospital stay, 30-day readmissions, 30-day emergency room visits, and discharge destination. The outcomes of the two study groups were then compared. There were no statistically significant results. Patients that completed the preoperative education had an average length of stay of 7.6 days compared to the control group of 7.8 days. Patients that completed the preoperative education had less 30-day readmissions (19.7%) compared with the control group (21.6%). Patients that completed the preoperative education went home more than the patients in the control group (74.6% compared to 74.5%). The emergency room visit rate for patients that completed the preoperative education was 22.5% compared to the control group rate of 19.6%. The results had a positive trend and were clinically significant and support that digital preoperative education improves outcomes.

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