ABSTRACT PURPOSE This project aimed to implement a new advanced practice provider (APP) protocol to reduce 30-day postoperative dehydration rates for patients with new ileostomies. PARTICIPANTS AND SETTING Adult patients (n = 21) with new ileostomies from a large academic urban medical center within the colorectal surgery clinic in eastern North Carolina. APPROACH Using a pre/post-test quality improvement approach, new ileostomy patients were scheduled for a follow-up visit with an APP within 7 business days of hospital discharge from May to July 2023. Postoperative complication rates were collected and compared with the American College of Surgeons (ASC) National Surgical Quality Improvement Program (NSQIP) data that provide benchmarks to other medical facilities to determine postintervention complication rates. OUTCOMES The comparison period (January-March 2023) complication rate was 10.3%; the implementation period rate was 2.8%. The relative reduction was 72.8%, thus exceeding the goal of 10%. IMPLICATIONS FOR PRACTICE Project findings support the importance of a protocol with the follow-up period being conducted earlier (within 1-week postoperative) for new ileostomy patients to identify those patients at a risk of dehydration and postoperative complications. More patient education on monitoring their intake and output should be incorporated into preoperative teaching.
Eltz et al. (Fri,) studied this question.