Determining the influence of preoperative nursing Assessment on patients’ surgical outcomes and anxiety at Kenyatta National Hospital, Kenya.

*Lilian Adhiambo Omondi

(PhD Student, UoN, MScN , UoN, BScN, UoN, ORN, KNH, RN)

Lecturer, School of Nursing, College of Health sciences, University of Nairobi

Co authors

Prof. Mary Wangari Kuria

(PhD, Psychiatry, UoN, M.Med Psych UoN, M.BChB. UoN).

Associate Professor – Department of Psychiatry, College of Health sciences, University of Nairobi,.

Dr. Peter Wanzala

(PhD, Epidemiology, MPH, BDS, UoN)

Research Scientist, Centre for Public Health Research, Kenya Medical Research Institute (KEMRI).

*Corresponding Author

This publication is part of PhD thesis of University of Nairobi ethical permit Ref. KNH/UON ERC- P396/11/2010

Determining the Influence of Preoperative Nursing Assessment on Patients’ Surgical Outcomes and Anxiety at a National Hospital

Abstract

For quality surgical interventions and outcomes preoperative patient assessment by perioperative nurses is imperative yet the practice is dwindling.

Aim: To determine the influence of nursing assessment on patients’ surgical outcomes and anxiety

Design: Randomized controlled trial.

Study population: Mothers delivered by elective caesarian.

Sampling method and size: Single blinding and random assignment; 60 participants.

Method: Thirty participants were assessed preoperatively using a tool as study intervention. Surgical outcomes of anxiety, care satisfaction, pain experience and wound healing process were measured and compared with that of 30 participants prepared preoperatively using the Hospital’s standard practices. Pre and postoperative anxiety levels were assessed using Y form on day 1and 2, care satisfaction using structured questionnaire, postoperative pain and wound healing progress using international pain scale 1-10 and observation chart respectively for 3 days. All ethical principles were observed.

Data analysis: Multivariate non parametric statistics using statistical package for social sciences (SPSS) version 17.

Results: Mann-Whitney U Test showed p<0.05 for five pre-and postoperative anxiety statements except “feeling worried” (z = -1.58, p = 0.114) postoperatively; p >0.05 for pain experience and wound healing progress, Wilcoxon W Test showed p< 0.05 for five care satisfaction statements, except for desire to be visited by theatre nurses before surgery (p = 0.49 > p = 0.05).

Discussion: Intervention group had better surgical outcomes compared to the control group even though there were no significant differences in pain experience and wound healing progress probably because of already established care standards.

Conclusion: Preoperative nursing assessment positively influences patients’ surgical outcomes

Recommendation: Preoperative nursing assessments for surgical patients require restructuring to revamp the dwindling practice.

Key words Anxiety, preoperative assessment, perioperative nurses, elective surgery, surgical outcomes.

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