Improving Culturally Sensitive Care in Digit Amputations: A Quality Improvement Project

Many patients have spiritual or cultural preferences regarding the disposal and reclamation of amputated parts, yet little is known about the current process. Our goal was to understand patient preferences and increase patient education regarding amputation disposal and reclamation.

A quality improvement approach was used. Stakeholders were interviewed to process map current methods. Amputation patients were surveyed to determine preferences for amputation disposal and reclamation. Using the Plan-Do-Study-Act, change concepts were applied and outcomes measured through the same survey. Descriptive methods, analysis of variance, unpaired t-tests, and run/statistical process control charts were used for analysis.

Stakeholders identified barriers against amputation reclamation, including lack of patient access to resources, limited provider clarity surrounding the process, and no standardized policies. Baseline preferences were first gathered from 31 patients: 42% felt educated about the disposal process, 42% were concerned about the treatment of their amputated part, 74% wished to be more informed, and 16% wanted to reclaim their part. Change concepts were then implemented. First, a presentation was given at teaching rounds for medical trainees and staff. Results showed no significant change. Second, an educational handout about amputation disposal was distributed to patients. This showed a significant improvement in patient education, decreased concern for the management of amputated parts, and decreased needs for further discussion with health care providers.

Many patients have preferences for amputation disposal. Patients mostly value education and awareness. The format through which education is provided is important-access to educational material may be most beneficial for patients.