Interdisciplinary preoperative patient education in cardiac surgery.
BACKGROUND
In 1998, we carried out a study of interdisciplinary preoperative education in cardiac surgery given by nurses, physicians and health educators. Overlaps were found in gathering and providing information by physicians, nurses and health educators, and gaps were found in providing psychosocial information and emotional support. Based on these findings, an information protocol was developed.


OBJECTIVE
This paper reports a study examining the effects of the implementation of the information protocol on the content and process of preoperative education.


METHODS
Dialogues between health educators and patients were videotaped at the preoperative clinic (n = 54) and on the day of admission (n = 53), and analysed using a checklist of 123 specific topics.


RESULTS
The information given by health educators at the outpatient clinic and on the day of admission accorded with the information protocol to a large extent. There was also an increase in the number of psychosocial issues raised. Nurses raised significantly more psychosocial issues in comparison with before implementation of the protocol. After implementation, patients spent approximately 3 minutes less talking with the health educator and about 7 minutes less talking with a nurse. This suggests that on the day of admission a more time-efficient co-ordination in patient education was achieved.


CONCLUSIONS
Implementation of the information protocol led to a better interdisciplinary division of labour. The education is tailored more to the needs of the patient, and psychosocial items are mentioned more frequently. This straightforward intervention gave very positive results. Inconsistencies, gaps and overlaps in information provision can be avoided by the unambiguous delineation of responsibilities and tasks in information provision by different health care providers.
Tromp
Fred
F
Netherlands Institute for Health Services Research, Utrecht, The Netherlands. f.tromp@nivel.nl
Dulmen
Sandra
S
Weert
Julia
J
D000554:Ambulatory Care Facilities; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D011300:Preoperative Care / Q000379:methods; D013903:Thoracic Surgery / Q000193:education*; D014743:Videotape Recording / Q000295:instrumentation