Aarhus University Hospital Skejby Juni 2010 Caretech SundhedsITnet Fast-track Effekt af telenursing efter radikal prostatektomi Bente Thoft Jensen Forskningssygeplejerske-MPH Urinvejskirurgisk Afdeling K Århus Universitetshospital -Skejby

Aarhus University Hospital Skejby Juni 2010 •Peri-operative enhed ( Pleje og behandling af patienter efter radikal prostatektomi-2007 ) •Udvikling i indlæggelsestid –Åbne –Robot ( PAS Juni 2010) Fast track i urologisk sygepleje

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Baggrund telenursing studie •Sikre rehabilitering –Ændringer i trends –Patientinformation tilstrækkelig? –Patient-uddannelse tilstrækkelig? –Løsning Tele-nursing?

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Effekt af Tele-Nursing Konsultation efter radikal prostatektomi Jensen B.T Kristensen S Vistoft S Urology Department K Aarhus University Hospital, Skejby Denmark

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Formål Effekt af tele-nursing •Patient tilfredshed •Sikre rehabilitering •Håndtering ADL •Reduktion i postoperative gener •Ændringer i behov for assistance

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Materiale og Metode 1 Figur 1. Flowchart Start: 142 Consecutive patients 39 8 Included Excluded End: 95 patients

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Materiale and Metode 2 Figur 2. Randomisering 95 inklud. patients 63 Robot Kirurgi 32 Åben Kirurgi 15 + Tele 32 - Tele 31 + Tele 17 - Tele Randomisation

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Materiale og Metode 3 •Samme uddannelse •Mundtlig og skriflig information •Randomisering externt kontrolleret •Tele-nursing 3 dage efter udskrivelse Interview efter manual samt ad hoc sp. Sp-skema to uger post-op ved ambulant besøg

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Outcome •Patient tilfredshed •Sikre rehabilitering Reduktion af postoperative gener Håndtering af ADL

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Karakteristik Modality N+ Tele-Tele Åben3216%18% Robot6332%34% 48%52% Indlagt (dage) Dage 16130%34% 22917%14% 351%4% 48%52% Civil Status Hustru/ samlever8742%50% Single76%1% Not indicated10%1% 48%52% Table 1. Fordeling blandt intervention og kontrol gruppen hvad angår modalitet, Indl. tid og civil status

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Tid med kateter Tabel 2. Fordeling blandt intervention og kontrol gruppen Median: 13 n= Time with catheter Median: 13 n=49 No tele consult Plus tele consult

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Alder Tabel 3. Aldersfordeling blandt intervention og kontrolgruppen Mean: n=49 Mean: n= Age No tele consult Plus tele consult

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Effekt Tabel 4. Assciation mellem Tele-nursing konsultation, Patient tilfredshed og oplevet tryghed. Logistisk regressionsanalyse. Tele-nursingnOR95% CIP Patient-tilfredshed941.00* All replied satisfied Tryghed

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Effekt Tabel 5. Association mellem tele-nursing konsultation og kateter-relateret gener. Logistisk regressions analyse. Tele-nursingnOR95% CIP Katheter Begrænset aktivitet Katheter block Placering af urin poser Management af urin poser

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Rehabilitering Tabel 6. Nytte i interventions-gruppen, logistisk regressions analyse. + Tele-nursing (N=49)nOR95% CIP Kateter Sår Stomach * Smerter Activities in daily life *Significant

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Assistance Assistance (N=94)OR95% CIP Kirurgisk modality * Tele-Nursing Civil status Alder Indlæggelsestid Tid m. kateter * Significant Tabel 6. Association mellem behovet for assistance og Co-Variable. Logistic Regressions-analyse.

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Konklusion •Tryghed •Patienttilfredshed •Sikre rehabilitation •Reduktion af gener •Assistance

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Perspektiv •Største problem for recover er tradition (læge, sygeplejersker, fysioterapeuter) •Byrden, hvis der er nogen, forskubbes til primær sektor?

Aarhus University Hospital Skejby Efficacy of tele-nursing after radical prostatectomy Tak for opmærksomheden Denmark