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Abstract
outcome.
Samia Youssef Sayed
Abstract Aim of the study is to design a teaching protocol for nurses working with patients undergoing microvascular free tissue transfer surgeries, and the second is to evaluate the effect of implementing the designed teaching protocol on nurse’s knowledge, practices as well as on patient’s out come.
Hypotheses:
1. The post mean knowledge scores of nurses who will be exposed to a designed teaching protocol will be higher than their pre mean knowledge scores.
2. The post mean practice scores of nurses who will be exposed to a designed teaching protocol will be higher than their pre mean practice scores
3. The incidence of post operative microvascular free tissue transfer complications for patients cared by nurses after protocol implementation will be lesser than that developed pre-protocol implementation.
4. A positive relationship will exist between knowledge and practice score obtained by nurses receiving the designed teaching protocol.
A study was conducted in Assiut University Hospitals. A sample of convenience including all nurses working in Reconstructive Microsurgical Unit (10) & Trumatology Care Unit (20) in addition to (30) patients with free tissue transfer surgeries. Tools utilized were:-a) Questionnaire sheet to assess nurse’s knowledge in addition to some sociodemographic data.b) Observational checklist to assess nurse’s skills .c) Vascular assessment sheet for postoperative monitoring. D) Patient’s assessment sheet.
Results:
The first and the second hypotheses were supported as a sharp improvement in the mean knowledge & practice scores were found after the application of the teaching protocol. The third hypothesis was supported, as the flap failure was improved from (20%) pre-protocol to (3.3%) after protocol implementation. The fourth hypothesis was supported as a positive correlation was found between nurse’s knowledge and practice scores immediately and 2 months after application of the teaching protocol. A significant relationship was found between flap failure and other complications as regards hyperthermia, pain, venous and arterial obstruction. Venous and arterial obstructions are significantly correlated with ischemia time.
Conclusions:
Patients with free tissue transfer surgeries are at high risk for postoperative complications, which in turn increase the development of the flap failure. These complications include hyperthermia, pain, infection, venous and arterial obstructions and need effective measures to prevent/reduce this considerable profound problem. Improving nurses’ knowledge and practice can favorable affect the incidence and outcome of flap failure.