Perioperative Family Updates Reduce Anxiety and Improve Satisfaction: A Randomized Controlled Trial

Howe, Lindsay S; Wigmore, Daniel; Nelms, Nathaniel J.; Schottel, Patrick C.; Bartlett, Craig S.; Halsey, David; Krag, Martin H.; Lunardini, David; Monsey, Robert D.; Beynnon, Bruce D.; Blankstein, Michael

doi:10.17294/2330-0698.1805

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…This effect was confirmed in the commentary that was freely provided in open-ended answers and was part of the reason a measure of anxiety was included after the pilot phase. The positive effect of reducing anxiety using SMS intraoperative updates has been demonstrated in a range of surgical specialties using controlled studies [ 33 , 34 , 36 ]; here, we confirmed their findings. It is important to address anxiety to reduce adverse outcomes seen in caregivers that persist postoperatively.…”

Section: Discussionsupporting

confidence: 89%

“…In line with Howe et al [ 36 ], overall satisfaction was assessed with the question “On a scale of 1 to 5, how would you rate your overall satisfaction with the SMS application? (with 1 being completely dissatisfied and 5 being completely satisfied)?” One open-ended question asked respondents whether they had any suggestions or comments following their experience with the messaging system.…”

Section: Methodsmentioning

confidence: 99%

“…Studies that use SMS-based communication to update family members and other caregivers during the intraoperative period are limited yet offer compelling evidence of their value as they produce positive outcomes [ 32 - 36 ]. Gordon et al [ 32 ] carried out a multicenter prospective study that connected surgical patients to any number of individuals designated as a contact.…”

Section: Introductionmentioning

confidence: 99%

“…Families were paged with 4 updates during surgery. Satisfaction with information increased over 30% for families, and 96% of nurses felt that “patients' families were getting the information that they desired.” In contrast, Howe et al [ 36 ] tested the effect of pager-based updates using a randomized controlled trial of adults admitted for orthopedic surgery. The families in the control group received care as usual, while the intervention group received a text message at the beginning, middle, and end of surgery.…”

Section: Introductionmentioning

confidence: 99%

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Automated Intraoperative Short Messaging Service Updates: Quality Improvement Initiative to Relieve Caregivers’ Worries

Mignault¹,

Tchouaket²,

Robins³

et al. 2022

JMIR Perioper Med

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Background Undergoing a surgical procedure is anxiety provoking for patients and their caregivers. During the intraoperative period, caregivers seek out informational updates from health care professionals, a situation complicated by COVID-19 health measures that require caregivers to wait outside the hospital. Short messaging service (SMS)-based communication that allows caregivers to follow their loved ones through surgery has shown promise in relieving anxiety and improving satisfaction with overall care. This form of communication is also well accepted by health care professionals and may be effective at relieving staff burden. Objective Here, we describe a quality improvement initiative of a standardized and integrated intraoperative SMS-based system to improve communication between surgical teams and caregivers. The main goal was to improve satisfaction with care, while the secondary goal was to reduce caregiver anxiety. Methods The initiative followed the framework of the Model for Improvement. A large tertiary care hospital offered the SMS to caregivers who were waiting for loved ones undergoing surgery. SMS messages were integrated into the clinical information system software and sent at key points during the surgical journey to phone numbers provided by caregivers. A satisfaction survey was sent to caregivers 1 business day after surgery. Data were collected between February 16 and July 14, 2021. Results Of the 8129 surgeries scheduled, caregivers waiting for 6149 (75.6%) surgeries agreed to receive SMS messages. A total of 34,129 messages were sent. The satisfaction survey was completed by 2088 (34%) of the 6149 caregivers. Satisfaction with messages was high, with the majority of respondents reporting that the messages received were adequate (1476/2085, 70.8%), clear (1545/2077, 74.4%), informative (1488/2078, 71.6%), and met their needs (1234/2077, 59.4%). The overall satisfaction score was high (4.5 out of 5), and caregivers reported that receiving text messages resulted in a reduction in anxiety (score=8.2 out of 10). Technical errors were reported by 69 (3.3%) caregivers. Suggestions for improvements included having messages sent more often; providing greater patient details, including the patient’s health status; and the service being offered in other languages. Conclusions This digital health initiative provided SMS messages that were systematically sent to caregivers waiting for their loved ones undergoing surgery, just as COVID-19 restrictions began preventing waiting onsite. The messages were used across 15 surgical specialties and have since been implemented hospital-wide. Digital health care innovations have the capacity to improve family-centered communication; what patients and their families find useful and appreciate will ultimately determine their success.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Automated Intraoperative Short Messaging Service Updates: Quality Improvement Initiative to Relieve Caregivers’ Worries

Mignault¹,

Tchouaket²,

Robins³

et al. 2022

JMIR Perioper Med

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show abstract

“…Another major novel finding of the present study was oral DEX premedication might improve preoperative satisfaction of patients’ family members who accompanying with these patients. Although family members of patients undergoing surgery could experience serious anxiety, there is lack of study with respect to perioperative anxiety and satisfaction of patients’ family [ 36 ]. In fact we considered the higher satisfaction from patients’ family members could encourage them to give more support to these patients.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine premedication increases preoperative sedation and inhibits stress induced by tracheal intubation in adult: a prospective randomized double-blind clinical study

et al. 2022

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Objective The aim of this prospective randomized double-blind study is to evaluate whether oral dexmedetomidine (DEX) premedication could increase sedation in order to reduce preoperative anxiety and inhibit stress response during general anesthesia tracheal intubation. Materials A total of 100 ASA I and II adult patients undergoing elective neurosurgery were randomly divided into the control group (C group, n = 50) and the oral DEX premedication (DEX group, n = 50). Patients were administrated 4 μg/kg dexmedetomidine orally pre-anesthesia 120 min. Hemodynamic variables were monitored and recorded from premedication to 10 min after tracheal intubation. The primary outcome, the sedation level of all participants, was evaluated by Richmond Agitation Sedation Scale (RASS), and Numerical Rating Scale was to measure their intensity of thirst and satisfaction of patients’ family members. During general anesthesia induction, the total dosage of induction anesthetics and complications relative to anesthesia induction were recorded. After tracheal intubation, blood sample was drain from radial atrial line to measure levels of adrenocorticotropic hormone (ACTH) and cortisol. Results RASS scores at 60 min after premedication and on arrival in the operating room were significantly reduced in the DEX group (P < 0.001). Oral DEX premedication not only increased the intensity of thirst but also the satisfaction of their family members (P < 0.001). The cortisol level after tracheal intubation was deduced by oral DEX premedication (P < 0.05). Oral DEX premedication reduced heart rate (HR) and mean arterial pressure (MAP) on arrival in the operating room, and HR when tracheal intubation (P < 0.05). During the whole process of anesthesia induction, although the lowest MAP in two groups were not significantly different, the lowest HR was significantly lower in the DEX group (P < 0.05). Oral DEX premedication might reduce HR from premedication to 10 min after tracheal intubation. However MAP was reduced just from premedication to on arrival in the operating room. Total induction dosages of propofol, midazolam, sulfentanil and rocuronium were similar in two groups (P > 0.05), as well as the complications relative to anesthesia induction and cases of rescue dopamine therapy were similar (P > 0.05). Conclusion Oral DEX 4 μg/kg premedication was an efficient intervention to increase preoperative sedation and reduce stress reaction induced by general anesthesia tracheal intubation, but also it was with the stable hemodynamic during the process of general anesthesia tracheal intubation, and improved the satisfaction of patients’ family members. In this study, the sparing-anesthetic effect of 4 μg/kg DEX oral premedication was not significant, and this would be needed to study in future. Trial registration This trail was registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn, Jie Gao) on 15/04/2021, registration number was ChiCTR2100045458.

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Effect of Informing Patient Relatives by Short Message (SMS) on Their Anxiety and Satisfaction Level During Orthopedic Surgical Intervention: A Randomized Controlled Trial

Baydemir,

Metin Akten

2023

Journal of PeriAnesthesia Nursing

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Perioperative Family Updates Reduce Anxiety and Improve Satisfaction: A Randomized Controlled Trial

Cited by 14 publications

References 10 publications

Automated Intraoperative Short Messaging Service Updates: Quality Improvement Initiative to Relieve Caregivers’ Worries

Automated Intraoperative Short Messaging Service Updates: Quality Improvement Initiative to Relieve Caregivers’ Worries

Dexmedetomidine premedication increases preoperative sedation and inhibits stress induced by tracheal intubation in adult: a prospective randomized double-blind clinical study

Effect of Informing Patient Relatives by Short Message (SMS) on Their Anxiety and Satisfaction Level During Orthopedic Surgical Intervention: A Randomized Controlled Trial

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