Title : Development of a surgical liaison nurse program to increase patient/Family satisfaction and decrease anxiety during surgical procedures
Patients and their families are separated from each other during the surgical process by time and space, a situation that creates stress for both the family and their loved one. The author’s position of Director of Surgical Services offers a unique opportunity to examine the situation in which families find themselves when a family member comes to the hospital for surgery.
The hospital facility discussed in this Practicum Report is a not-for-profit member of a group of five facilities, each offering different specialties, but together providing surgery covering the entire scope of modern surgical processes and procedures. The University Community Hospital (UCH)-Carrollwood is licensed for 120 beds. Medical patients, telemetry, and surgical patients are cared for in their respective units. In addition, an intensive care unit and a progressive care unit complete the in-house part of the facility.
Surgery patients may either come in, have their procedure, and go home on the same day or be admitted to one of these units for further care and observation. During the time the surgery takes place and the hours immediately after surgery when the patient is in the Post-anesthesia Recovery Unit (PACU), the patient is separated from his/her family. This time of separation produces anxiety in the members of the patient’s family. There is a gap or gulf between them, that seems to stretch for many hours. The intervention of the surgical liaison nurse bridges this gap and provides communication between the surgical suite and the family.
The liaison nurse recognizes that patients are assessed, treated, and healed in the context of family and culture. This author used this context to develop the protocols for a trial Surgical Nurse Liaison Program at UCH-Carrollwood. This program aimed to increase patient and family satisfaction, decrease anxiety and promote holistic care. Development of the program involved recognition of the need for appropriate communication with the family members before, during, and after the surgical procedure, and, frequently, after the patient was admitted to the post-surgical unit.
Increasing patient satisfaction is a goal of the Carrollwood organization. Therefore, this program has significance to the hospital as it increases communication with patient families. Past surveys have shown that families believe they do not receive enough information about the surgery and the condition of the patient before, during, and after the surgery. Through the Surgery Liaison Nurse Program, information about their loved one and the progress of the procedure reaches the family during a time of separation and stress.
Examples in the literature emphasize the caring model as it supports the families in self-care. They will soon take over the duty of ensuring the return to health and previous level of functioning of the surgical patient, so this support of the family by the healthcare community is a necessary and important activity. Education of the family on all aspects of the process for that particular medical problem assisted them in viewing their role in supporting the patient through the preparation for surgery, the time in surgery, and the recovery period.
The follow-up phone call continued the connection with family members as the liaison nurse gave the family the opportunity to ask questions during the healing phase. It was also a chance to give feedback concerning the care the patient received during the hospital stay. The six, brief, open-ended questions elicited answers that guided the nursing staff in designing improvements in nursing care throughout the next patient’s hospital experience.
A welcome letter and pamphlet provide written information concerning whom to call if there are questions or concerns during the patient’s hospital stay, a description of the facility and waiting rooms, and how the family would be contacted when the surgery is completed. This letter was printed both in English and in Spanish, the dominant languages of the area serviced by Carrollwood Hospital. As the director of surgery in the role of the liaison nurse handed the letter and pamphlet to the family, he/she introduced themselves to the family. The director explains that the telephone number on the letter is a way that the family can contact the director at any time during the surgical and/or recovery process, including after the patient was relocated to the post-surgical nursing unit.
The liaison nurse can be with the family as they hear from the surgeon what procedures were performed and the anticipated results. Families often have further questions they did not ask the physician, but felt comfortable in asking the liaison nurse. The family members developed trust in the liaison nurse throughout the day of surgery. They had confidence in the answers they received to their questions and believed that he/she respected their culture and family dynamics when relaying information to them.
The trial program demonstrated steady gains in patient satisfaction. These early results indicate that this is a valuable program toward increasing patient and family satisfaction. Families require and deserve support for their role in healing of the patient. This program is a recognition of that role, and one that should be supported by administration and continued by trained and committed nursing staff.