Clinical Application of Ambulatory Ward Nursing for Patients Undergoing Glaucoma Filtration Surgery

Abstract

Aims and objectives: To evaluate the efficacy and safety of out-patient“day surgery”nursing mode forglaucoma filtration surgery.

Background: While out-patient“day surgery”is already the preferred practice in 99% of ophthalmicsurgeries in USA, until quite recently, patients being hospitalized for several days was still the standard in most eye hospitals in China. Because of the overwhelming clinical responsibilities relative to quite limited medical resources, the Chinese government is undergoing a comprehensive medical reform attempting to reconcile this conflict. As to ophthalmology, transition to out-patient surgery at a tertiary eye hospital is proactively encouraged.

Design: Retrospective case study.

Methods: Clinical data of 134 patients received glaucoma filtration surgery in Zhongshan OphthalmicCenter between November 2014 and November 2015. All participants were followed up for 6 months to 1 year. Surgery success rate, efficiency and safety profile of nursing mode adjusted to this out-patient setting was retrospectively analyzed.

Results: Among 134 glaucoma patients, 131 cases (97.8%) were with a successful outcome using out-patient surgerysetting and nursing mode. Among those 3 with complications, one was hospitalized due to intraoperative transient blurry vision and 2 other cases were shifted to hospitalization because of postoperative shallow anterior chamber and severe inflammatory response. Compared with conventional hospitalization, the waiting time for hospital bed was shortened from 5-6 days to 0.5-1 day, and the mean length of hospital stay was reduced from 4.5 days to 1 day. The average hospitalization expense of filtrating surgery, including trabeculectomy and drainage device implantation, were decreased from 6295 to 5175 and 12658 to 10757 RMB Yuan respectively, when the numbers were compared with conventional hospitalization.

Conclusion: While improving the efficiency of glaucoma filtration surgery using out-patient setting and nursingmode, it is also successful and practical in term of surgery outcomes.

Relevance to clinical practice: High-efficiency out-patient surgery setting and nursing mode can be apreferred protocol of practice in China’s major eye hospitals.