These authors contributed equally to this work.
Evaluation of nurse-led discharge following laparoscopic surgery
Article first published online: 18 NOV 2010
© 2010 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 18, Issue 1, pages 19–24, February 2012
How to Cite
Graham, L., Neal, C. P., Garcea, G., Lloyd, D. M., Robertson, G. S. and Sutton, C. D. (2012), Evaluation of nurse-led discharge following laparoscopic surgery. Journal of Evaluation in Clinical Practice, 18: 19–24. doi: 10.1111/j.1365-2753.2010.01510.x
- Issue published online: 5 JAN 2012
- Article first published online: 18 NOV 2010
- Accepted for publication: 28 April 2010
Introduction The United Kingdom's Department of Health has identified reducing delays in patient discharge as a key aim for Health Service development. Laparoscopic cholecystectomy and laparoscopic inguinal hernia repair may be safely performed on a short stay basis, but day case rates remain low, with delays in discharge identified as a major contributing factor. Nurse-led discharge has been widely advocated to speed patient discharge across varied specialities, but objective evidence to support its use is lacking. This study aimed to assess the effectiveness of nurse-led discharge following laparoscopic surgery.
Methods A retrospective comparison of doctor-led and nurse-led discharge following laparoscopic surgery was performed by analysis of two consecutive 4-month periods, prior to and following the introduction of nurse-led discharge by a laparoscopic nurse specialist. Outcomes assessed included time to discharge, reasons for delayed discharge, hospital readmissions and primary care episodes following discharge.
Results A total of 128 patients were included in the study, with each discharge group containing 64 patients. Patients in the nurse-led discharge group were significantly more likely to be discharged on the day of surgery than patients in the doctor-led discharge group (17.2% vs. 4.7%; P = 0.023), with a highly significant difference in same day discharge rates noted among patients operated on during morning theatre lists (44.0% vs. 10.7%; P = 0.006). There was no significant difference between the discharge groups in readmission rates or in the number of patients seeking primary care attention following discharge.
Conclusions Nurse-led discharge may speed discharge following laparoscopic surgery with no apparent detriment to patient care.