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PEDUCAT Trial Presentation PowerPoint Presentation

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Description : PEDUCAT Trial Presentation with Limitations

Tags : PEDUCAT

Published on : May 24, 2021 | Views : 1302 | Downloads : 6

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Slide 1-

Journal Club: Post-Op Complications William Geddings MS1, William Mo MS2 Impact of preoperative patient education on the prevention of postoperative complications after major visceral surgery: the cluster randomized controlled PEDUCAT trial
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Introduction Overview of Health Problem Poor efficacy for Preoperative Patient Education Post-operative complications lengthen intensive care unit and total hospital stay which drives up the morbidity, not only straining the health of the patient but the capacity of the hospital system Postoperative morbidity remains at a level of 24-44% for all surgical cases
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Introduction Risk Factors Patient Related: Gender, age, body mass index, procedure related factors – tumor localization and surgical site Preventable: Deep vein thrombosis, pulmonary embolism, pneumonia, burst abdomen, in-hospital falls Associated: Postoperative pain, coughing, atelectasis
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Introduction Aim of Trial – Post Operative Days 1-30 Preoperative Patient Education carried out by Nursing Staff in Cluster Randomization Investigation of Preoperative Patient Education on Postoperative Complications Pneumonia, DVT, Pulmonary Embolism, Burst Abdomen, in-Hospital Fall Investigation of Morbidity/Mortality Postoperative Pain, Quality of Life, Length of Hospital Stay
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Hypothesis Standardized patient education, when given as a supplement to preoperative informational brochures and standard communication with hospital staff, will significantly reduce post-operative complications as opposed to an informational brochure and standard communication.
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Methods Participants Patients 18 years or older scheduled for elective visceral surgery, separated into clusters of 5 avg as intervention or control groups Surgery lasting 180 minutes or more* Admitted to one of two predefined wards of the Department of General, Visceral and Transplantation Surgery, University of Heidelberg from Monday to Wednesday Written informed consent given *For purposes as defined in this study, Surgery lasting the equivalent of 180 minutes is seen as “Complex”
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Methods Exclusions/Terminations Impaired mental capacity, language barrier, physical constraints, infections requiring isolation, previous participation in the preoperative patient education program at Heidelberg University Hospital Cancelled operations, non-adherence to follow-up, non-attendance to seminar, duration of operation less than 180 minutes
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Methods
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Results
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Results Body Mass Index averaged 25% Most Patients had mild or severe systemic disease before surgery Highest Organ for Operation was the Pancreas High percentage of patients with previous history of surgical intervention Duration of Surgery averaged 211-216 minutes *Surgery lasting less than 180 minutes excluded from results as procedures were deemed inoperable and a palliative approach was sought instead
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Conclusion Patient Reported Outcomes Out of 524 patients, 111 were included in the analysis 50 patients were in the intervention group and 61 patients were in the control group The p values for both groups were low, with the intervention group significantly lower in areas like maximum pain value after 2 days of postoperative care There were no significant adverse events reported during this study
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Conclusion The results of this study indicate that certain postoperative complications such as Pneumonia, DVT, Pulmonary Embolism, Burst Abdomen, and in-hospital fall following major abdominal surgery may be prevented by professional patient care.
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Limitations Inclusive criteria Surgery time>180 min Tobacco & alcohol use Prior preoperative instructions Not blind RCT Small sample size Prior preoperative education Patient Consent
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