Patient Education at Dismissal After Surgical Procedure

Study Overview
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Brief Summary
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Can improvements in patient dismissal education materials reduce incidence of wound non-healing and infection.

Detailed Description
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The investigators seek to address the specific educational needs of patients and caregivers with low-literacy, dyslexia and related learning disabilities in the context of properly performing wound care for patients with surgical wounds. Specific aims include both improving care by decreasing wound complications and improving patient satisfaction by using techniques designed for this population. Objectives include utilizing surveys to determine the incidence of dyslexia among the patients' and caregivers' within the general surgery service as well as the perception of our current educational offerings, to design a new dismissal package with enhanced educational offerings, to re-measure this effect on the patient experience with survey data, and to compare wound infection rates before and after implementing the new curriculum. Dyslexia and associated learning disabilities are common and likely impact the health literacy among this population due to the ubiquitous literacy-based documentation of hospital course and dismissal instructions. Adults with dyslexia may be reluctant to disclose any inability to understand written instructions. There is currently no mechanism within the dismissal system to specifically identify and address the unique needs of this population. The impact on clinical outcomes of proper wound packing is substantial, and if performed incorrectly can lead to slow wound healing and infections that often require readmission, multiple courses of antibiotics, and reoperation. In severe cases, improper wound care can lead to severe infection, sepsis, and death. By enhancing the educational offerings of proper wound care to this population, the investigators hope to reduce these complications.

Official Title
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Patient Education at Dismissal After Surgical Procedure: Clinical Outcome Implications and Improvement Strategies

Conditions
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Wound Open, Wound Infection Post-Traumatic, Wound Infection, Wound Complication, Wound Breakdown

Intervention / Treatment
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* Behavioral: Enhanced Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients on the general surgery service with open wounds requiring packing Exclusion Criteria: Patients with wound vacs Patients receiving exclusively professional wound care or home health services

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with open surgical wounds<br>Patients with open surgical wounds will undergo enhanced packing education with curriculum designed for learners with low literacy, dyslexia or associated learning disorders. | Behavioral: Enhanced Education<br>* Enhanced educational curriculum will involve learning modalities including 3D modeling, video, and visual-aid enhanced text for references to improve caregiver and patient understanding of wound packing techniques.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Utilization of education curriculum designed for learners with low literacy, dyslexia and associate learning disorders | Nursing surveys answering the question, Have you been trained to teach wound care to patients with dyslexia or learning disabilities? Were answered No, by 43/46 (93%) respondents. We seek to have a 90% rate of affirmative (Yes) answers to this survey after implementation of our curriculum. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient satisfaction with wound education | Survey of patients' wound education experiences should indicate that they are being offered curriculum suitable for learners with low literacy, dyslexia and associated learning disorders. We will utilize a scale of Definitely satisfied, somewhat satisfied, somewhat dissatisfied, definitely dissatisfied as our measure. | 6 months | 
| shorter time to wound healing | After implementation of new curriculum, it is anticipated that wound complication rates and time to wound healing would decrease. We will calculate the time based on the date of wound creation to their final clinic appointment indicated the wound is satisfactorily healed with days as our unit of measure. | 1 year |