Congress Abstracts 2003

50

PROVIDING INFORMATION FOR PATIENT RECOVERY: CREATION OF AN EDUCATION BOOKLET FOR BLADDER CANCER PATIENTS FOLLOWING CYSTECTOMY WITH NEOBLADDER RECONSTRUCTION. Mary Ellen Haisfield-Wolfe, RN, MS, OCN^®, The James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, MD.

As health care continues to shift from shorter inpatient hospital stays to outpatient care, patient education increasingly is an important strategy in achieving a complication free and complete recovery. Treatment for organ-confined muscle invasive bladder cancer requires bladder removal and construction of a urinary diversion. A commonly performed urinary diversion is an orthotopic neobladder, which is the construction of a new bladder using a piece of intestine to construct a reservoir, which is anastomosed to the urethra. Even though a neobladder is a standard reconstruction, there is a deficit of literature and educational materials for patients. Providing patients with a booklet at the time of hospital discharge, explaining the immediate post-operative discharge instructions, symptom management guidelines, information on bladder retraining to recover continence, neobladder sexuality issues, and a follow-up surveillance schedule for cancer recurrence, can promote patient autonomy and improve the experience for patients and their families. A performance improvement project was initiated to develop a patient information booklet. The goal was to reduce fragmented and inconsistent care. Information to create the booklet was drawn from articles, procedure manuals, experts in urologic-oncology care, and physical therapy. The booklet was peer-reviewed and revised. Currently, 15 patients have used the booklet. After 20 patients have evaluated the booklet, it will again be revised and peer-reviewed. Patient evaluation results have been favorable. All 15 patients have rated the booklet as extremely helpful. Patients have asked for more information regarding incontinence supplies, sexual continence, mucous in the urine, and continence physical therapy. Information addressing these suggestions is currently being written and will be included in the revision. This project has created an educational booklet, which is literature based and peer reviewed. Although the booklet will only be used by a small percentage of bladder cancer patients, those with a neobladder reconstruction, all patients need quality educational materials to facilitate their recovery. Patients have reported routinely sharing the booklet with healthcare providers not familiar with neobladder reconstruction. Consequently, future plans include using the booklet to educate oncology nurses regarding the care of these patients and providing the information on-line.