ABSTRACT
Purpose
The purpose of this project was to improve the consistency of verbal and written discharge
instructions for women of childbearing age (13-55 years) taking hormonal contraceptives
who receive aprepitant perioperatively, to address the need to use a secondary form
of birth control for 28 days, as well as to increase the knowledge and confidence
of Registered Nurses when providing discharge instructions.
Design
This quality improvement project used a pre/post design to evaluate two separate groups
of patients and registered nurses.
Methods
The patient sample consisted of 30 total women of childbearing age who received aprepitant
during the perioperative period (15 pre and 15 post). The PACU nurse sample included
15 ambulatory surgery center nurses and 58 main hospital nurses for a combined sample
of 73 PACU nurses. The PACU nurses were provided with educational in-service regarding
information about aprepitant and its drug interactions. PACU nurses were additionally
instructed to provide patient discharge instructions using both a written and verbal
format. Patients were called postoperatively before and after both the written after
visit summary (AVS) changes and the PACU nurse in-services, PACU nurses were evaluated
on their knowledge, confidence, and frequency of discharge teaching before and after
their educational in-service. The PACU nurses were surveyed 90 days after the intervention
to assess their long-term knowledge retention.
Findings
There was a significant increase in nurse knowledge about aprepitant from preimplementation
to postimplementation (61.39% vs 81.95%, P < .001). Nursing knowledge showed a non-significant decline at 90-days postimplementation
(81.95% vs 73.68%, P = .096) although remained significantly higher than preimplementation scores (73.68%
vs 61.39%, P = .003). There was an overall 33.3% increase in the percentage of patients who were
able to recall receiving aprepitant and the need to use a secondary form of birth
control when comparing the preintervention group to the postintervention group (26.7%
vs 60%, P = .123).
Conclusions
The findings suggest that providing a standardized presentation about aprepitant may
improve the PACU nurses’ ability to verbalize key information about aprepitant, including
the need for patients to use a secondary form of birth control. This increase in nursing
knowledge and confidence, along with improved written discharge instructions, may
have led to improved patient comprehension of aprepitant discharge education. Additionally,
there was an increase in the percentage of patients who were able to recall the need
to use a secondary form birth control for 28 days, to reduce the likelihood of an
unintentional pregnancy.
Keywords
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Article info
Publication history
Published online: January 02, 2023
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: None to report.
Identification
Copyright
© 2022 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
