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The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

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The goals for completing this assignment are to:

formulation of a PICO question
demonstrate proficiency in critically analyzing research evidence
demonstrate the ability to synthesize the literature
distinguish quality evidence
discuss the characteristics of research articles
integrate multiple pieces of evidence into a literature review format
identify gaps in areas of scientific investigations
Literature reviews in published studies provide what is known, what is not known, and what the possible contribution is of a study. APRN’s review the literature to synthesize the available evidence to find a solution to a problem in practice or to remain current in their practice. During the interpretation of the findings, the researcher may review the literature again to determine if additional relevant studies have been published. Reviews of the literature in published studies can be critically appraised for current, quality sources; relevant content; and synthesis of relevant content. A checklist for reviewing the literature includes preparing, conducting the search, processing the information, and writing the review. A written review of literature should be grammatically correct with a logical flow and a reference list that is accurate and complete. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

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Evidence-based practice involves a great deal more than simply reading nursing periodicals on a regular basis. Advanced Practice Nurses can take a more proactive approach to evidence-based practice by identifying authentic problems and concerns, and then using that to guide their inquiries into current research. In this way, APRNs can connect the results of relevant research studies to their nursing practice.

For the EBP Project, you identify and apply relevant research to a specific patient problem or topic of your choosing. You begin by formulating an answerable question that is relevant to nursing and evidence-based practice. Next, you need to conduct a Literature Review on the topic and then determine how the evidence from the literature can be applied to nursing practice. You will submit a paper (see formatting instructions below) that includes the content below. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Please review the grading rubric for greater details.

Introduction (30%)

Background knowledge and significance (10%)
Local problem (5%)
Intended Improvement (5%)
PICO question (5%)
Conceptual Model or Framework (5%)
Methods (50%)

Presentation of Search Strategy (10%)
Presentation of Evidence to Answer your PICO Question (40%)
Discuss Critical Appraisal of varying Evidence (RCTs, CDSS, Economic, Clinical Prediction)
Quality of Evidence and Strength of Recommendations
Conclusion/Recommendation (10%)

This recommendation should be for the improvement project to be carried out in your assigned clinical agency.

Grammar and reference style (10%)

FORMATTING

APA formatted (double-spaced, 12-pt Times New Roman font or 11-point Calibri font ONLY, section headers, page numbers, title page, reference page, 1-inch margins (all), 4 page maximum, excluding the title page and reference page. You should have, at the minimum, 5 references. More resources may be used, if necessary. Every reference listed must have a corresponding in-text citation. Each research article should be cited in your paper. Do not include an abstract and do not include additional section headers. Use the headers that are outlined above. Use APA 7th edition format for section header levels p. 48 of your manual. Submit your assignment as a WORD document or PDF ONLY. No other format will be accepted. Articles need to have been published within the last 5 years.  The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Introduction

It is commonly acknowledged that improving pre-operative patient education is essential to maximizing post-operative results for surgical patients (Kim et al., 2021). Surgery can result to feelings, such as anxiety, fear, and uncertainty, that can have a serious impact on a patient’s potential to recuperate and overall health. To address these issues, reduce anxiety, improve patient knowledge, and eventually improve post-operative outcomes, comprehensive pre-operative education programs must be made available. The objective of this work is to examine the complex relationship between pre-operative patient education and post-operative outcomes by a critical examination of research findings and a systematic assessment of the literature.

Background Knowledge and Significance

Patients who undergo surgical operations frequently experience both physical and psychological stress, which can have a variety of negative effects after the procedure, including increased pain thresholds, longer hospital admissions, and psychological discomfort. A narrative review by Darville-Beneby et al. (2023) shown the beneficial effects of preoperative education in reducing postoperative pain, psychological distress, and opioid use. In a similar vein, studies by Brodersen et al. (2023) and Klaiber et al. (2018) showed that pre-operative education promoted medication adherence, decreased postoperative pain, and enhanced psychological well-being all of which led to shorter hospital stays. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Local Problem

In our clinical setting, there have been cases where patients who are having surgery have higher worry and uncertainty, which results in worse than ideal outcomes after the treatment. Improving patient outcomes and experiences requires addressing these concerns through efficient pre-operative education. Pre-operative education is acknowledged to be important, however implementing comprehensive programs consistently across all patient demographics and surgical specialties may provide difficulties. The standardization of pre-operative education techniques may be hampered by differences in staffing, resources, and patient demographics.

Intended Improvement

Our improvement project’s main goal is to improve post-operative outcomes by putting in place pre-operative patient education measures that are specifically designed to meet the needs of the patients in our patient population. We seek to prevent negative consequences like worry, pain, and prolonged hospital stays by proactively addressing patient concerns, reducing anxiety, and encouraging informed decision-making. This will eventually improve patient satisfaction and well-being. Furthermore, our goal is to create sustainable methods that can be incorporated into standard care procedures to provide pre-operative education delivery that is consistent and uninterrupted. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

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PICO Question

In patients going through procedures of surgery (P), does education of pre-operative (I) in comparison to care that standard(C) lead to better outcomes after surgery(O) like a shorter hospital stay, less discomfort following surgery, and decreased anxiety? This PICO question serves as the foundation for our inquiry into the effectiveness of pre-operative education interventions and their impact on specific post-operative outcomes. By framing our investigation within this structured format, we aim to systematically evaluate the existing evidence base and draw meaningful conclusions to inform clinical practice. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Conceptual Model or Framework

Our initiative examines the effect of preoperative patient education on postoperative outcomes by utilizing well-established models for theory, like the model for health belief  and the planned behavior theory. These theoretical frameworks offer a prism through which we can view the psychological aspects affecting patient behavior, pain control, and treatment adherence following surgery. We hope to create focused interventions that meet the complex needs of surgical patients by using a holistic approach based in behavioral theory, which will ultimately result in better outcomes. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Methods

Presentation of Search Strategy

A comprehensive search strategy aimed at relevant papers published within the last five years was meticulously executed across multiple databases, such as PubMed, CINAHL, and Cochrane Library. To guarantee targeted and effective results, Boolean operators were utilized to methodically integrate keywords like “pre-operative education,” “surgery,” and “postoperative outcomes.” To find other sources of literature, subject matter experts’ advice and a manual search was conducted through the reference lists of relevant articles.

Presentation of Evidence to Answer your PICO Question

22 of the 147 articles that the first search produced were chosen for full-text inspection in accordance with predetermined inclusion criteria. In the evidence appraisal, fifteen articles largely focused on RCTs and comprehensive evaluations/meta-analyses met the required requirements. Pre-operative education treatments have been linked to a considerable reduction in anxiety, postoperative discomfort, and length of hospital stay (Ng et al., 2022)The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion. Randomized controlled trials have provided strong evidence supporting the usefulness of these interventions. Additionally, subgroup and analysis on sensitivity were done for results evaluation across various patient demographics and study designs and investigate possible causes of heterogeneity.

Discuss Critical Appraisal of varying Evidence

RCTs are often regarded as the gold standard in clinical research because they provide high-quality data with little bias. By offering a thorough synthesis of the body of research, systematic reviews and meta-analyses strengthen the body of evidence even further by enabling the analysis of patterns and trends in several studies. Furthermore, economic assessments shed important light on the cost-effectiveness of pre-operative education programs by pointing out possible financial savings linked to better post-operative results. The limitations of the current body of data, such as variations in patient groups, study designs, and outcome measures, must be acknowledged since they may affect how broadly applicable the results are.

Quality of Evidence and Potency of Suggestions

The overall evidence quality on the effect of pre-operative education on postoperative outcomes was evaluated using the GRADE framework, and it was found to vary from moderate to high. Comprehensive pre-operative education programs should be strongly recommended to be incorporated into routine care procedures, especially for the purpose of addressing patient fear (Torres et al.,2020)The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion. To address knowledge gaps on the ideal timing, format, and delivery modalities of pre-operative education treatments, as well as to investigate long-term impacts and cost-effectiveness across a variety of patient populations, more study is necessary.

Conclusion/Recommendation

Finally, it can be said that enhancing post-operative outcomes for surgical patients is significantly influenced by pre-operative patient education. According to our research, extensive pre-operative education programs should be put in place in order to lessen anxiety, lessen discomfort, and decrease hospital stays. To maximize patient experiences and outcomes, we advise making pre-operative education a normal procedure in our clinical context (McLaughlin et al., 2021). Furthermore, we stress the significance of ongoing studies to investigate cost-effectiveness and long-term impacts in various patient populations, guaranteeing the continuous improvement of clinical practice. We can improve pre-operative education delivery and surgical patient outcomes by adopting evidence-based practices and utilizing theoretical frameworks (Dore et al., 2022)The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion.

References

Doré, C. D. (2022). Preparation before the operation: pre-assessment clinic continuing education course for rural perioperative nurses. https://opus.uleth.ca/handle/10133/6374

Kim, N., Yang, J., Lee, K. S., & Shin, I. S. (2021). The effects of preoperative education for patients with cancer: a systematic review and meta-analysis. Cancer Nursing44(6), E715-E726. https://journals.lww.com/cancernursingonline/_layouts/15/oaks.journals/downloadpdf.aspx?an=00002820-202111000-00046

McLaughlin, J., Palmer, C., Redwood, S., Kipping, R., Owens, L., Reynolds, R., … & Owen-Smith, A. (2021). Commissioner, clinician, and patient experiences of a pre‐surgical health optimisation programme–a qualitative study. BMC Health Services Research21(1), 1-10. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06434-z

Ng, S. X., Wang, W., Shen, Q., Toh, Z. A., & He, H. G. (2022). The effectiveness of preoperative education interventions on improving perioperative outcomes of adult patients undergoing cardiac surgery: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing21(6), 521-536. https://academic.oup.com/eurjcn/article-abstract/21/6/521/6486867

Torres, G. C. S., Relf, M. V., & Tuazon, J. A. (2020). The mediating role of pre‐operative patient readiness on surgical outcomes: A structural equation model analysis. Journal of advanced nursing76(6), 1371-1383. https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.14339?casa_token=dnktGL55ZYIAAAAA:q_Ri4nFduKX0io07dGBVwUKgFG-Kh1Y98ojnTygdNJvhI8IsKWoJJivPwpdt3FKjLwto4dQRPCWG_21fFA The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

Background Knowledge and Significance

Surgical procedures of any kind can be an emotionally heavy experience for patients. The anxiety and fear surrounding the procedures are attributable to adverse postoperative outcomes such as complications that may include mortality, chronic post-operative pain, restlessness, infections, and vomiting from the anesthesia, among other outcomes. As such, providing pre-operative patient education for these outcomes is crucial. Darville-Beneby et al. (2023) did a narrative review on the impact of preoperative patient education on postoperative pain, psychological outcomes, and opioid use. Based on their findings, the researchers argue that preoperative education led to reduced pain in patients in the preoperative period, as well as significantly reduced opioid use during this period. The researchers also established that the most common outcomes reported were improved psychological outcomes, such as reduced anxiety. This is because the patients were well-informed before the surgery, anticipated certain outcomes such as pain, and received reassurance about the safety of the procedures (Darville-Beneby et al., 2023)The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion.

Brodersen et al. (2023) investigated the impact of preoperative education on the recovery process of patients undergoing abdominal surgery. Their findings showed that this type of education was crucial in improving the patient’s psychological status. This finding augurs with Darville-Beneby et al. (2023) on improved psychological outcomes after preoperative education. Additionally, the patients experienced less postoperative pain because the education provided before surgery helped them enhance their medication adherence and overall adherence to postoperative interventions since they understood their benefits (Brodersen et al., 2023). Klaiber et al. (2018) did a similar study that had similar results where they established that patient education before major visceral surgeries was instrumental in reduced pain experience for the patients because they understood the purpose of the postoperative interventions and adhered to them, which enhanced their recovery process and reduced their length of stay in the hospital.

In their preoperative education and patient preparedness study, Khorfan et al. (2020) established that those who received education before surgery used fewer pain pills than those who did not experience preoperative education. This outcome is attributable to the fact that with preoperative education, the patient becomes more prepared to handle the postoperative pain, increasing their adherence to interventions proposed in the postoperative period (Khorfan et al., 2020)The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion. This dynamic leads to less reliance on pain pills and ultimately leads to reduced length of stay in the healthcare facility.

Ng et al. (2021) introduce a fresh perspective in their study on the impact of preoperative education on cardiac surgery patients. According to their review, the researchers found that patients who underwent preoperative cardiac surgery education had reduced preoperative and postoperative anxiety and depression, which are expected outcomes. The researchers explain that the anxiety and depression emanate from the fear of the unknown, such as mortality during or after the surgical procedure, making a full recovery, or the adverse impacts that the surgery would have on their lives. As such, Ng et al. (2021) found that with patient education before the surgical procedure, patients experienced less anxiety because it evoked a sense of control and safety as they learned more about the dynamics of the procedure and the self-care process during recovery.

Overall, the research studies examined above indicate a positive impact of preoperative education on the postoperative periods for patients. The expected impacts include reduced anxiety and depression, reduced pain, reduced LOS, and reduced reliance on pain because the patients develop a sense of control and safety, as well as increased intervention adherence. The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

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References

Brodersen, F., Wagner, J., Uzunoglu, F. G., & Petersen-Ewert, C. (2023). Impact of Preoperative Patient Education on Postoperative Recovery in Abdominal Surgery: A Systematic Review. World journal of surgery, 47(4), 937–947. https://doi.org/10.1007/s00268-022-06884-4

Darville-Beneby, R., Lomanowska, A. M., Yu, H., Jobin, P., Rosenbloom, B. N., Gabriel, G., Daudt, H., Negraeff, M., Di Renna, T., Hudspith, M., & Clarke, H. (2023). The impact of preoperative patient education on postoperative pain, opioid use, and psychological outcomes: A narrative review. Canadian Journal of Pain, 7(2). https://doi.org/10.1080/24740527.2023.2266751

Khorfan, R., Shallcross, M. L., Yu, B., Sanchez, N., Parilla, S., Coughlin, J. M., Johnson, J. K., Bilimoria, K. Y., & Stulberg, J. J. (2020). Preoperative patient education and patient preparedness are associated with less postoperative use of opioids. Surgery, 167(5), 852–858. https://doi.org/10.1016/j.surg.2020.01.002

Klaiber, U., Stephan-Paulsen, L. M., Brückner, T., Müller, G., Auer, S., Farrenkopf, I., Fink, C., Dörr-Harim, C., Diener, M. K., Büchler, M. W., & Knebel, P. (2018). Impact of preoperative patient education on preventing postoperative complications after major visceral surgery: the cluster randomized controlled PEDUCAT trial. Trials, 19(1). https://doi.org/10.1186/s13063-018-2676-6

Ng, S. X., Wang, W., Shen, Q., Toh, Z. A., & He, H. (2021). Preoperative education interventions’ effectiveness in improving perioperative outcomes of adult patients undergoing cardiac surgery: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 21(6), 521–536. https://doi.org/10.1093/eurjcn/zvab123 The Role of Pre-operative Patient Education In Post-Operative Outcomes Discussion

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