Original article
Follow-up Phone Calls After Pediatric Ambulatory Surgery for Tonsillectomy: What Can We Learn From Families?

https://doi.org/10.1016/j.jopan.2007.05.004Get rights and content

The purpose of this quality improvement study was to describe families’ responses regarding the adequacy of the preoperative preparation provided in the Preoperative Assessment Clinic, and the necessity of two follow-up phone calls after pediatric ambulatory surgery for tonsillectomy with or without adenoidectomy (T±A). Using a questionnaire developed for the study, 90 families were contacted by phone on the first postoperative day and, of them, 73 were contacted a second time between the ninth and twelfth postoperative days. Families’ responses were reported in four categories: (1) concerns, (2) use of resources, (3) adequacy of the preoperative teaching, and (4) necessity of the two postoperative phone calls. Results showed that, at the first phone call, a sore throat was reported as the most important concern followed by a decreased oral intake (ie, fluid, food, medicine), vomiting, and fever or “perceived fever.” During the second phone call, a sore throat remained the most important concern followed by a decreased intake. Earache was the third highest concern and vomiting was then reported of concern by a minority of families. The most frequently consulted resource person for concerns was the physician on call for the otolaryngology service. Eighty-seven percent of families felt the preoperative preparation was adequate. For reasons of instructional and/or emotional support, 94% of families who responded reported that the first phone call was necessary and 68% reported that the second call was as well.

Section snippets

Purpose

The purpose of this quality improvement study was twofold: to describe families’ responses regarding the adequacy of the preoperative preparation provided at the Preoperative Assessment Clinic and to explore the necessity of two follow-up phone calls after their child’s T±A ambulatory surgery.

Study Group

The study group consisted of families whose children underwent ambulatory surgery for T±A. These children were categorized as class 1 or 2 (low risk) according to the American Society of Anesthesiologists Physical Status.16 The children were between 3 and 18 years of age (children under the age of 3 years were admitted to the hospital per institutional practice presently supported by the literature).17 The Montreal Children’s Hospital (McGill University Health Centre), Quality Improvement

Results

Data collection was carried out over a period of five months. Ninety five families met the inclusion criteria. Ninety families (95%) were reached for the first postoperative call, and 73 (77%) for the second (42/73 on postoperative day 9 and 10, 31/73 on postoperative day 11 and 12). Families spoke English (75%) or French (25%); 81% of the children were between three and eight years of age; 63% of the children were boys and 37% were girls. Families’ responses were reported in four categories:

Discussion

During the follow-up of 90 families with children who had undergone ambulatory surgery for T±A, the families identified several issues regarding postoperative care. In the present quality improvement study, a postoperative phone call was found to be an effective means to evaluate the adequacy of the preoperative teaching and identify the concerns of the families after an ambulatory T±A procedure. The findings of this study suggest that after a T±A, two follow-up phone calls from a nurse were

Conclusion

The families of ambulatory surgery patients for T±A stated that the preoperative preparation was adequate to help them care for their child postoperatively. The majority felt that the first follow-up phone call was necessary for instructional and emotional support and more than two thirds of the families stated that the second call was beneficial for the family. This family survey provided important feedback that could be used to improve the care of children undergoing ambulatory T±A

Acknowledgments

We thank the children and their families for their participation in this study. We also acknowledge the contribution of the nursing staff in the Post-Anesthesia Care Unit, McGill University Health Centre, The Montreal Children’s Hospital. We are also grateful to Judy Collinge, RN, MBA, and former Director of Nursing Research at the Montreal Children’s Hospital for her advice and guidance. Last, we thank Peggy Jensen, RN, for her participation in the pilot study.

Thao Le, RN, BSc(N), is a Nurse Clinician in the Preoperative Assessment Clinic, Postanesthesia Care Unit and Day Surgery Centre, The Montreal Children’s Hospital, Montreal, Quebec, Canada

References (22)

  • 2004 Standards of Perianesthesia Nursing

    (2004)
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    Thao Le, RN, BSc(N), is a Nurse Clinician in the Preoperative Assessment Clinic, Postanesthesia Care Unit and Day Surgery Centre, The Montreal Children’s Hospital, Montreal, Quebec, Canada

    Julie Drolet, RN, BSc(N), is a Nurse Clinician in the Preoperative Assessment Clinic, Postanesthesia Care Unit and Day Surgery Centre, The Montreal Children’s Hospital, Montreal, Quebec, Canada

    Elvie Parayno, RN, BSc(N), is Head Nurse in the Preoperative Assessment Clinic, Postanesthesia Care Unit and Day Surgery Centre, The Montreal Children’s Hospital, Montreal, Quebec, Canada

    Christina Rosmus, RN, MSc, is a Nursing Research Associate in the Nursing Research Department, The Montreal Children’s Hospital, Montreal, Quebec, Canada

    Sonia Castiglione, RN, MSc(A), is a Research Assistant in the Nursing Research Department, The Montreal Children’s Hospital, Montreal, Quebec, Canada.

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