Objective: Realizing that the recommended hospital length of stay (LOS) for patients undergoing radical retropubic prostatectomy (RRP) was to be decreased to 1-2 days, the objective was to determine associated best nursing practice, inclusive of patient teaching strategies.
Design: Evidence which supports a 1-2 day LOS for the RRP patient includes definitive patient teaching instructions to assure a safe and effective recovery and minimize recidivism. This evidence was utilized by our interdisciplinary team to design clinical practice guidelines and standards of care, inclusive of the recommended patient teaching.
Population: The clinical practice guidelines and standards of care are utilized for all RRP patients.
Concepts: A primary focus needs to be effective teaching by all caregivers pre- and throughout hospitalization. The patient discharged in one day (or significant other) must, among other things, demonstrate correct catheter and incision care. In addition, literature emphasizes the need for optimum pain control to facilitate the patient's ability to perform specific care.
Methods: Based on the evidence, patient interventions include careful screening of candidates for the recommended LOS, extensive pre-operative education by physician office staff, admission to a single, urology patient care unit, strict adherence to post-operative clinical practice guidelines to insure uniform, evidence-based care management, and a collaborative approach to self-care.
Findings: For the first 6 months following institution of the decreased LOS, the average LOS for RRP patients was 1.8 days (N=69), with 2 readmissions.
Conclusions: The first 6 month LOS and readmission results suggest that the evidence-based clinical practice guidelines and standards of care, inclusive of the recommended patient teaching, support achievement of the recommended length of stay.
Implications: Best practice necessitates evaluation of patient satisfaction with preparation for discharge as a next step. A twelve question telephone survey will be conducted to discharged patients to investigate this aforementioned question.
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Sigma Theta Tau International
9 July 2003