A nationwide study of the quality of surgical guidelines and written patient information

Clinical practice guidelines (CPGs) support enhanced post-operative recovery and decrease morbidity. In addition, patient information leaflets (PILs) are associated with enhanced overall outcomes and improved patient satisfaction. The aim of this study was to provide an overview of the quality of CPGs and PILs in cancer surgery departments undertaking pulmonary lobectomy, nephrectomy, cystectomy, whipples, colorectal and ovarian surgery.

We conducted a cross-sectional descriptive study within 44 surgical departments in six cancer subspecialties: lung (n = 4), kidney (n = 9), bladder (n = 5), pancreas (n = 4), colorectal (n = 18) and ovarian (n = 4). Local CPGs were assessed according to nine key elements, i.e. discharge criteria and plans for mobilisation, pain management, nutrition, fluid, nausea and vomiting, antibiotics, bowel movements and urinary drainage. The PILs were evaluated using the DISCERN tool.

All departments had CPGs and PILs. Overall, 43% of the departments incorporated all nine key elements in the CPGs. Yet, a third of the CPGs lacked well-defined discharge criteria, and half of the PILs were of poor/very poor quality (48%); the remainder were fair (43%) or good (10%).

CPGs and PILs are highly available in Danish departments that perform cancer surgery. However, this study revealed that local CPGs lacked discharge criteria, and the majority of the PILs were considered of poor quality, suggesting that post-operative management after cancer surgery is of varying quality.

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