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abstract

412 - SPECIALIST NURSE VERSUS NON-SPECIALIST NURSE CARE FOLLOWING HYSTEROPEXY

412

SPECIALIST NURSE VERSUSNON-SPECIALIST NURSE CARE FOLLOWING HYSTEROPEXY

F. MURIITHI1, H.JEFFERIS 1, H. M. CHIN 1, N. PRICE 1,S. JACKSON 2, J. S. NICHOLLS 3;
1Gyneacology,Oxford Univ. Hosp. Trust, Oxford, United Kingdom, 2JohnRadcliffe Hosp., oxford, United Kingdom, 3Oxford Univ.Hosp. Trust, Oxford, United Kingdom.

Introduction: Beyond patientselection, appropriate procedure, and surgeon technique,post-operative care is important in the recognition of immediatepost-operative complications and patient support and optimisation fordischarge. Key in this process is the location where patients aremanaged post-operatively as well as the experience of nursing staffin their care. We present a comparative audit of post-operative careby surgical specialist nurses versus non-surgical nurses. Weillustrate that specialist post-operative care has a positive impacton overall care and outcomes.
Objective: To assess theeffects of specialist nursing care for early discharge followinghysteropexy.
Methods: Length of stay baseline auditfollowing hysteropexy surgery was designed prior to the introductionof the enhanced recovery programme. The Theatre InformationManagement System (TIMS) and operation registers were searched forall cases of sacrospinous and laparoscopic hysteropexy performed at alarge UK foundation trust between March and September 2016. Thepatient notes and electronic patient records were reviewed forinformation on age, additional procedures, if catheterised andduration of catheterisation, length of stay, co-morbidities, andintra-operative and post-operative complications. No ethical approvalwas required for this investigation as it was a simple observationalstudy (clinical audit).
Results: A total of 45 cases hadcomplete data and were included in the analysis. 27 patientsunderwent laparoscopic hysteropexy and specialist nursingpost-operative care. The remaining 18 had sacrospinous hysteropexyand non-specialist nursing post-operative care. The patients werecomparable in mean age (69 for sacrospinous vs. 67 for laparoscopic)and co-morbidities, and none had intra-operative complications. Themean length of stay for the specialist nurse care group was 1.5 days(mode of 1) vs. 2.1 days (mode of 2) for the non-specialist nursegroup. The key determinant of length of stay was duration ofcatheterisation with early removal of catheter seen in the specialistnurse group after 1 day vs. after 2 days in the non-specialist nursegroup. Early removal of catheter encouraged early mobilisation and inturn, reduced hospital stay.
Conclusions: Specialist nursepost-operative care reduces hospital stay compared to non-specialistnurse post-operative care. Specialist nurses may be better suited toensure a successful enhanced recovery programme.
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