Congress Abstracts 2006

103

EDUCATING PATIENTS FOLLOWING BREAST SURGERY: A MULTIDISCIPLINARY NURSE DIRECTED BREAST SURGERY REHABILITATION GROUP. Elisheva Hertz, RN, Latasha Anderson, RN, OCN^®, Blanca Vasquez-Clarfield, RN, MA, and Dorothy Dulko, MS, PhD(c), RN, NP, AOCN^®, Memorial Sloan-Kettering Cancer Center, New York, NY.

Surgery for breast cancer often involves mastectomy or lumpectomy with axillary node dissection. These interventions require insertion of drains to prevent fluid accumulation in the wound post operatively. Although the physical recovery from breast cancer surgery is rapid, these drains may remain in place for 7-10 days. This results in most patients being discharged with their drains.

The objective of this pilot project is to determine patient perception of a nurse facilitated breast surgery group at this NCI-designated cancer center. The Breast Surgery Rehabilitation Group (BSRG) provides concrete information regarding self-care and a forum to discuss issues that accompany breast surgery. The class is offered in collaboration with physical therapy and social work. Understanding the patient's view of a tailored teaching methodology allows oncology nurses to customize educational interventions and to foster effective patient-provider partnerships.

Patients admitted for breast surgery are informed of the BSRG on postoperative day one. Classes are held five days per week. One-hour sessions include the topics of: (1) incision care and wound healing; (2) purpose of drains and drain care; (3) hand and arm care post axillary node dissection and; (4) breast prosthesis. Exercises for the postoperative period are presented. Time is allotted for patient prompted discussion of issues such as sexuality and body image. 100 patients attending the class will be surveyed to determine perceptions of the BSRG based on Bloom's Learning Domains.

Preliminary results for 45 patients revealed that 78% of patients felt prepared to empty their drains and 90% understood how to record drain output following the class. 76% of women stated decreased anxiety regarding care of drains at the end of the BSRG with 100% able to verbalize long-term safety measures to reduce lymphedema.

Oncology nurses are in a pivotal position to empower patients by instituting a multidisciplinary unit-based breast surgery rehabilitation group. Preliminary data indicates patients experience less anxiety and increased ability to perform self-care following group attendance. We plan to pursue controlled research with a tailored patient discharge education program to evaluate impact on perception of care and incidence of readmission.