A qualitative study of patient and provider experiences during preoperative care transitions

Abstract

Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes.

Clinical efficacy of anesthesia with intensive care nursing in attenuating postoperative complications in patients with breast cancer

“…All patients received preoperative care (preoperative visit, medical observation, and anesthetic instruction) before surgery. 14 This study was approved by the ethics committee of Mudanjiang Affiliated Hongqi Hospital of Medicine University (clinical trial registration number: CHMDJAHMU20140511X).…”

“…All patients received preoperative care (preoperative visit, medical observation, and anesthetic instruction) before surgery. 14 Patients with breast cancer underwent surgery with or without an axillary procedure. All procedures were performed as described previously.…”

Avaliação do risco para o desenvolvimento de lesões perioperatórias decorrentes do posicionamento cirúrgico

“…The management of pain is more effective when interventions are not used precociously. Pre-operative Nursing interventions in health education about the surgical process, preoccupations and expectancies for the treatment, can make the situation easier, diminishing the length of exposure to pain, and optimizing the satisfaction of the patient by increasing the quality of the perioperative care (18,20) .…”

A qualitative study of older adults’ and family caregivers’ perspectives regarding their preoperative care transitions

“…Older adults and their family caregivers in our study described a multitude of providers involved in the preoperative care environment and numerous dimensions of care coordination that was imposed on caregivers due to a lack of coordination in their preoperative processes. In a recent study (Malley & Young, ), preoperative patients presenting for elective surgery described preoperative care in terms of learning what to expect with the surgical procedure and the entire perioperative care trajectory. Both patients and providers described the need for care coordination, access to resources and the capacity of providers to partner and communicate effectively with their multidisciplinary care team members as well as with patients.…”

“…The first transition in care for patients undergoing elective joint replacement occurs when the patient confers with an orthopaedic surgeon and the decision is made to have surgery. This initial or preoperative phase of care becomes the genesis of the care trajectory for the joint replacement patient (Malley & Young, ). The preoperative transition in care for older adults with multiple chronic conditions involves multiple specialists.…”