Physiotherapy Prevention of Post-operative Pulmonary Complications in the Upper Abdominal General Surgical Patient – Are we doing enough?
Jasmyn Burnett1, Carol Watson1, Brittany Fergusson1, Kirstie Harrison11Royal Perth Hospital, Perth , WA, Australia
Abstract
At Royal Perth Hospital one of the most common hospital acquired complications (HAC) reported amongst the upper abdominal surgery (UAS) patient population is post-operative pulmonary complications (PPCs). The average respiratory HAC costs the healthcare service $7,471 per patient. A review was needed to evaluate whether RPH physiotherapists were providing pre- and post-operative management in adherence with best practice recommendations. A literature review was completed to identify recommendations for physiotherapy management of elective UAS patients. The literature reviews findings guided the implementation strategies formulated. Areas for improvement in the management of elective UAS patients were identified via a process mapping session involving key stakeholder physiotherapists. A pre-implementation clinical audit of physiotherapy management provided baseline data for comparison post-implementation. Multiple strategies were implemented to create change. Pre-operative education was restructured, with additional educational tools developed. Screening criteria to identify patients at risk of developing PPCs were updated, assisting the Pre-operative Anaesthetic Assessment Service (PAAS) physiotherapist in prioritising patients to receive education. Post-operative mobility targets were formulated to prescribe mobility frequency and intensity for the prevention of PPCs. Increased physiotherapy assistant staffing and staff education were provided to achieve these targets. Favourable outcomes were achieved as a result of the implemented strategies, with preliminary re-audit results demonstrating increased adherence to mobility targets, and hospital incident data showing a reduction in PPCs amongst UAS patients. Future plans for this project include developing a pre-habilitation service for UAS patients and ongoing evaluation of the effectiveness of implemented strategies.
Biography
biographies to come