ORLANDO, FL—Results of a questionnaire revealed patients with head and neck cancer prefer a written educational tool that addresses their questions and concerns prior to surgery for microvascular reconstruction, a study reported at the ONS 40th Annual Congress.

“Microvascular reconstruction is a high-risk, complex procedure with minimal information regarding postoperative care available in the literature,” said Eugene Terkoski, RN, of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida. Assessment of the educational tools available to patients in the head and neck clinic “revealed a lack of materials related to microvascular reconstruction surgeries,” he said, leading to nonstandardized preoperative education of patients and their families.

Specifically, “the lack of information related to the postoperative course—nutrition, pain management, and wound care—caused unnecessary uncertainty and anxiety,” said Terkoski. “The impact of the lack of formal information on nursing was a higher volume of calls related to wound care questions from the patients, families, and home health nurses.”


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To determine areas of weakness in the current educational processes and identify preferred presentation mode, an interdisciplinary team of nurses, physicians, social workers, speech pathologists, and dieticians met to develop an educational needs questionnaire, which was administered at a long-term follow-up clinic visit to patients who had previously undergone the procedure.

“We targeted previous patients less than 1 year status postvascular free flap reconstruction,” Terkoski said during the presentation.

When results of the questionnaire were analyzed, the team found that “patients preferred a written educational tool, provided during the clinic appointment when surgery is discussed and scheduled, that addressed their questions around the topics of expectations related to surgery and the immediate postoperative care, and home care,” Terkoski reported. “Specific topics include wound care, diet, hygiene, tube feeding, tracheostomy care, and pain management.”

Subsequently, with the support of clinical nurse and patient education specialists, two written educational tools were developed, which were also translated into Spanish with professional medical illustrations.

Patient and nursing satisfaction was found to have improved during the follow-up assessment.

By identifying specific areas of concerns to patients and families, patient satisfaction was improved,” he concluded.

“The collective efforts of the interdisciplinary team to standardize patient education and nursing practice were another positive outcome of this project. Future collaborative team work to utilize the educational tools to reinforce patient teaching on the inpatient units is underway.”