The Impact of a Visual Information Sheet for Post-operative Patients on Diet Progression

By Chan Po Chu, Isabel, 23/F

Background

In the General Surgical Ward, there were total 45 beds with a nurse to patient ratio of 1 to 5 or 6. Diet progression varies depending on the type of surgery after operation, basically form Nil by mouth, Sips of water, Fluid diet, Soft diet to Diet as tolerated. Patient education is vital on diet progression. 

Post-operative diet is important to patients as it enhances recovery. Nutrition is an integral part of post-operative care, patients request additional information and reassurance on being able to eat after surgery. One of the important of postoperative education is written resources such as brochures or pamphlets. It helps to facilitate teaching and learning, hence it improves the effectiveness of communication.

Problem Statement

In the current practice, nurses receive doctors' orders, are responsible to educate patient verbally and then put the reminder on the bedside. However, patients always cannot remember all the details and do not fully understand what is the meaning of different diet. As a result, post-operative patients continually ask what kinds of food they should order and sometimes order the incorrect meal. Furthermore, nurses usually receive request from patient again after providing information.

Over 80% of the nurses received request from patient again after providing information, patient ordered the incorrect meal during self-ordering meal post-operatively. And nurses agreed that it was a disturbance if patient keep questioning on them.

Purpose

The study aimed to develop and evaluate the impact of using a visual information sheet for educating post-operative patient on diet progression.  It helps patients to recognize the post-operative diet advancement. Therefore it promotes post-operative patient recovery in a timely manner.

Implementation Plan

An evidence based information sheet for post-operative patient on diet progression had been designed. Comments received from doctors by circulating the information sheet in Surgery Centre and modified it accordingly. Afterwards, educated patients and their family’s members preoperatively with the information sheet. Reminded patient to read the information sheet if diet changes post-operatively.

Results

The study was evaluated by the same questionnaire to test the understanding of different diet before and after using the information sheet pre-operatively. A total 16 patients mostly aged 65 or above from the pre-data stage, the concept of fasting, fluid diet and soft diet was not clear. There were 31% of patients claimed that they were fully understand of fluid diet, however, none of them identify all the items correctly. Plain congee, Chinese soup and Pumpkin soup were commonly chosen wrongly. Regarding to soft diet, although there were 19% of patients claimed that they were fully understand what was soft diet, they chosen some incorrect items, like Oatmeal was the common wrong items.

After that, a total 10 patients aged 65 above most had been interviewed in the post-data stage. The result shown that all patients understood the meaning of fasting and fluid diet. 60% of patients claimed that they were fully understand what were the fluid diet and 40% of patients were mostly understand. For soft diet, there were also 60% of patients claimed that they were fully understand and 40% of patients were mostly understand. However, there were still 20% chosen Oatmeal in the soft diet items. Most of the patients replied that they received the information from doctors, nurses and information sheet, they all found that the information sheet was useful.

Recommendations and Next Steps

After giving the information sheet for patient, they have a better understanding on the definition of different diet. The visual information sheet is a good reference for the post-operative patients. Meanwhile, patients receive the information sheet pre-operatively and therefore they have enough time to read it and then they can easily refer to the diet post-operatively. Hence, it increases post-operative knowledge of patent.

By receiving more comments from different doctors and having discussion with the dietitian, gathering all useful information from different parties, fluid diet menu and soft diet menu will be the next step. Different diet menu helps patient to choose the meal easily and minimize the self-ordering errors.