Early Identification of Postoperative Surgical Site Infections Through Nurse-Led Telehealth Assessments
Elizabeth W Good1, Florence E Turrentine, Ishan C Williams
1Author Affiliations: Surgical Oncology, University of Virginia Health System, Charlottesville, Virginia (Good), Department of Surgery, University of Virginia, Charlottesville, Virginia (Turrentine), and School of Nursing, University of Virginia, Charlottesville, Virginia (Williams).
Background:
Patients undergoing hepato-pancreato-biliary (HPB) surgery are at high risk of readmissions and complications, including surgical site infections (SSI).
Local Problem:
Our local institution had not implemented a consistent strategy for identifying HPB SSIs post-discharge.
Methods:
Quality improvement methods using Plan-Do-Study-Act cycles were implemented.
Interventions:
Nurse practitioner (NP)-led telehealth visits were incorporated for early detection of SSIs and to promote patient satisfaction. Evaluation occurred through standardized documentation and post-visit patient satisfaction surveys.
Results:
Thirty-six telehealth visits were conducted; 8 SSIs were identified (1 during the telehealth visit and 7 during subsequent clinic visits). Most patients (n = 7, 88%) with SSIs were re-hospitalized. Undergoing Whipple surgery (n = 5, 62.5%) and incisional drainage (n = 3, 37.5%) were the most common SSI indicators. Survey respondents (n = 28) validated usefulness and satisfaction with telehealth visits.
Conclusions:
SSIs were identified early in the post-discharge period through NP-led telehealth visits, positively impacting patient satisfaction.
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