Release: Embargoed until September 24, 2000Contact: Kenneth Satterfield(202) 371-4517 (9/23-9/27703-519-1563[email protected]
TELEPHONE SURVEY BY NURSE FOUND APPROPRIATE FOR TONSILLECTOMY POSTOPERATIVE FOLLOW-UP
Washington, DC -- When a child is sent home shortly after receiving a tonsillectomy and/or adenoidectomy, how satisfied are the parents with the postoperative care? This question is becoming more relevant as day surgery, without a subsequent office follow-up visit to a physician, is becoming a standard treatment of care for this most common of pediatric surgical procedures.
A team of otolaryngologist--head and neck surgeons from the Department of Pediatric Otolaryngology--Head and Neck Surgery, Children's Hospital Medical Center, Cincinnati, OH, set out to determine if parents were satisfied with the opportunity to discuss, by phone, their postoperative concerns with a qualified otolaryngology nurse. If so, then an office visit would not be necessary.
The authors of the study, "Day Surgery and Telephone Evaluation After Adenotonsillectomy: A Satisfaction Survey," are James H. Liu, MD, Christopher J. Hartnick, MD, Robin T. Cotton, MD, Charles M. Myer, MD, Benjamin E. J. Hartley, MBBS Bsc FRCS, and Joey Wolfenbarger. The findings will be presented Tuesday, September 26, at the American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting/Oto Expo, being held September 24-27, 2000, at the Washington, DC Convention Center.
Methodology: Six hundred and fifty-two patients who underwent a tonsillectomy with or without an adenoidectomy between January 1, 1999, and October 31, 1999, were identified. Exclusions, based on age (18 and older) and other procedures performed, resulted in 453 patients in the research effort.
The primary caregiver of the patients was contacted three weeks after surgery and asked six yes/no questions. They were:
1. Does the patient have snoring/airway obstruction?2. Is the patient eating/drinking normally?3. Is the patient sleeping well?4. Are there any voice changes?5. Are there any complaints?6. Do the parents desire a follow-up appointment?
Questionnaires were then sent to these parents. The results were tabulated anonymously.
Results: Two hundred fifty-nine (57 percent) responded to the survey. The range of ages for children whose parents responded to the survey was from 15 months to 17 years, with a mean age of 6.5 years. The reasons for surgery were infection (101 patients), obstructive breathing (106), infection and obstructive breathing (38), and peritonsillar abscess (12) and other reasons in two patients.
In scheduling the surgery without a post-operative office visit preoperative anxiety decreased in 25 parents, increased in 53 parents, and had no change in 181 parents. Other results from the survey included:
--Of the 197 children who went home the same day as their surgery, 165 parents stated they would again plan for an outpatient tonsillectomy if they had to accommodate surgery again.
--Forty-three percent (112 parents) of the 259 respondents found it necessary to contact a health care provider after leaving the hospital. The reasons were usually multiple and included postoperative bleeding questions (82), pain (51), not eating/drinking (45), and nausea/vomiting (23). Of the 112 parents, 34 sought a physician's care.
--Of the 259 parents, 249 believed their concerns were met in a telephone interview with an otolaryngology nurse. Of that group, 187 stated that a physician visit was not necessary; 62 still desired a physician visit.
--Of the ten parents who were not satisfied with the telephone survey, seven could not be reached by telephone, one had an antibiotic prescription discrepancy; one believed that inadequate pain control was prescribed; and one sought additional clarification regarding voice changes.
Conclusions: Patient satisfaction with the outpatient, or day-surgery, tonsillectomy remains high. This study believes that a telephone call by a trained nurse is a safe and economical means of following patients postoperatively.
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