Poster Presentation

Wednesday, July 11, 2007
9:00 AM - 9:45 AM

Wednesday, July 11, 2007
2:45 PM - 3:30 PM
This presentation is part of : Poster Presentation I
Specialist versus generalist nursing care:Impact on patient outcomes following robotic-assisted radical prostatectomy
Catherine Mary Reid, RN, BN, honours1, Mari Botti, RN, PhD2, Rosemary Watts, RN, PhD1, Libby Beale, RN3, and Helen Crowe, RN, BAppSci, GDip, Epi, Biostats, MNursSci4. (1) Centre for Clinical Nursing Research, Epworth Hospital/Deakin University, Richmond Victoria, Australia, (2) School of Nursing, Faculty of Health and Behavioural Science, Deakin University, Burwood, Australia, (3) Urology Department, Epworth Hospital, Richmond Victoria, Australia, (4) C/Professor A Costello Suite 8.6, Epworth Centre, Richmond Victoria, Australia
Learning Objective #1: identify 4 outcomes that are improved by specialised care for patients undergoing RARP.
Learning Objective #2: discuss the need for further research into specialization in the acute care environment for application of evidence based practice

Background: Specialised hospital wards are designed to group personnel, experienced and trained in a specific area of medicine and patients according to their care requirements providing treatment relevant to the patient cohort needs.  This paper reports an important secondary finding of a study centred on patient outcomes following robotic-assisted radical prostatectomy.Method: A prospective, descriptive, survey design was used to track patient recovery during two key transitions: acute (time in ward) and intermediate (7 days and 4 weeks) using the Urologic Surgery Patient Recovery Survey incorporating the Short Form 36, American Pain Society Patient Outcome Questionnaire, McGill-Melzack Pain Questionnaire and the Sexual Health Inventory for Men. Due to an organisational restructure patients’ data were considered according to postoperative care units: group one- specialist urology care, group two - generalist surgical care 

Results: Prospective data have been analysed during two trajectories of recovery. Mean duration of surgery was 204 (SD = 15) minutes. Length of stay was 3 (SD =0.716) days for both groups. In the acute phase, group one patients reported pain as being mild in intensity, while group two reported moderate to high pain.  Higher levels of mobility, mood and sleep were also evident for group one participants. In the intermediate phase key differences emerged, group one were better informed regarding wound care and pain management and hence better able to manage their recovery. Key intermediate trajectory qualitative themes to emerge from group two supported the acute trajectory findings.

Discussion: Findings suggest that RARP patient group cared for in a specialist postoperative nursing environment experience a faster recovery with the provision of more effective patient management and education. These results provide the basis for development of evidence based practice guidelines to optimise care for this patient cohort.