An Evaluation of Timing of Discharge Instruction and the Impact on Patient Satisfaction.

PURPOSE: Surgical patients face unique challenges with discharge instructions and retention. The volume of information provided to patients, frequently combined with sedatives and opioids, leads to failure to retain this crucial information needed for home care. The purpose of this project was to implement a preoperative teaching intervention to provide written and verbal discharge instructions in the preoperative area before the administration of anesthetic agents to improve patient retention of information, and improve percentile ranking on the Outpatient Ambulatory Surgery- Consumer Assessment of Health Care Providers and Systems (OAS-CAHPS) survey. DESIGN: Cross-sectional descriptive METHODS: An additional educational intervention was implemented to provide discharge instructions in the preoperative area. Data was collected from the Press-Ganey database on patient responses to questions 13, 14, 15, 17, 19, and 21 and the global discharge domain scores of the OAS-CAHPS survey over a period of 12 weeks. This data was compared to the patient responses to the same questions over the same date range in the year time prior. FINDINGS: Statistical analysis demonstrated significant change in the percentile rank scores for the intervention period (P = .0024). Average percentile rank change on discharge domain questions was an increase by 50 points. Patient and staff feedback further demonstrated value to the intervention. CONCLUSIONS: Providing discharge instructions in the preoperative area in addition to providing instructions immediately before discharge can improve the percentile rankings associated with OAS-CAHPS questions related to discharge.

Primary care management of women with persistent vaginal discharge.

Vaginal discharge is a common complaint managed by NPs in ambulatory settings. This article reviews noninfectious etiologies of vaginal discharge with diagnostic criteria and recommended treatment to aid the NP in correctly managing these patients.

Primary care management of the female patient presenting with nipple discharge.

Nipple discharge is a common primary care finding in female patients. The nurse practitioner must possess the skills and knowledge to correctly and safely manage this clinical finding. The following is a review of the etiology of nipple discharge, the differential diagnoses, and treatment modalities.