Total laryngectomy discharge planning in an acute hospital setting in China: a best practice implementation project

Executive Summary Background Total laryngectomy patients will meet various kinds of physical and psychosocial problems after the surgery. And the adjustment and rehabilitation of total laryngectomy require the input of skilled members of a multidisciplinary team, especially the specialized nurses. To provide the patients a comprehensive and evidence-based discharge plan is recommended. Objectives The aim of this project was to integrate the available evidence of discharge plan for total laryngectomy into practice, and implement strategies to improve compliance with acceptable practice. Methods The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the available best-evidence on the discharge plan for total laryngectomy. The program was divided into three phases and conducted over five months in the ear, nose and throat ward, ward 7, Eye and Ear Nose and Throat (ENT) Hospital, Fudan University, Shanghai. 8 nurses and 15 patients were involved in baseline audit. 6 nurses and 15 patients were audited in the post-implementation audit. Results The post-implementation audit findings revealed a significant improvement in education on discharge for total laryngectomy, as well as in supplying patients with post-laryngectomy care products, and ongoing nursing support after discharge. Conclusion The project provided nurses with a good opportunity to receive evidence-based training about total laryngectomy patient education on discharge, and highlighted that providing the patients with evidence-based education after total laryngectomy should be the responsibility of an ear, nose and throat specialist nurse.