The following article features coverage from the Oncology Nursing Society (ONS) 2019 Annual Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

ANAHEIM, CA — Evidence-based nursing assessment and care is imperative for optimal patient outcomes after Da Vinci robotic surgery. A journal club presentation with a poster and handouts has successfully helped nurses in a surgical oncology unit better understand post robotic surgery patient assessment and care, a poster presentation at the Oncology Nursing Society (ONS) 44th Annual Congress has shown.

Robotic surgery was first performed in the 1990s in academic medical centers in Europe, and the modality has evolved across surgical oncology subspecialties in the United States since 2000. Currently, the number of institutions that offer this modality and surgeons who can work with it are limited. In addition, nurses need training in robotic procedures to provide quality postoperative care to patients.

At our institution, robotic surgery has been performed for approximately 1 year in gastrointestinal oncology surgery, explained Rebecca Grimmett, RN, OCN®, of The Ohio State University Wexner Medical Center James Cancer Hospital in Columbus, Ohio. Ms Grimmett and colleagues designed this project to educate the nursing staff on a surgical oncology unit on nursing assessment and management of patients undergoing robotic surgery vs traditional open surgery.

The educational event was conducted as a journal club presentation with a poster of robotic surgery nursing assessment and care; all members the health care team were included in the event. Key points from evidence-based literature were used in the discussions. Attendees were given a copy of the poster and asked to complete a posteducation quiz to assess knowledge gained. Results of the posteducation quiz were analyzed and used to revise continuing staff education for an annual surgical nursing competency.

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Postoperative nursing care has basic similarities across all oncology subspecialties, but robotic surgery has some specific concerns. Ms Grimmett pointed out that the shorter length of stay requires immediate postoperative patient and family teaching, whereas a traditional open surgical approach allows several days for postoperative patient education.

Unique patient complaints included pain in the shoulders, arms, and wrists as a result of the positioning. Patients may complain of gas pain — a lot of gas pain — because of all the air used to create the visual field, she noted. In addition, patients need to be prepared for early ambulation and feeding, as well as going home within hours rather than days after surgery.

Our posteducation quiz was completed by 100% of attendees, and the feedback was positive. Nurse-attendees’ comments reflected having gained a better understanding of robotic procedures (“This program helped me become more knowledgeable regarding robotic Whipple procedures”) and postoperative nursing assessment and care of patients (“I now have better knowledge”).

Reference

Grimmett R, Parks L, De Villiers A. Da Vinci: Advancing the future of nursing assessment and education in robotics. Poster presentation at: ONS 44th Annual Congress; April 11-14, 2019; Anaheim, CA.