Impact of a Designed Nursing Intervention Protocol about Preoperative Liver transplantation Care on Patients’ Outcomes at A University Hospital in Egypt

Abstract

Background: Literature review cited that, Liver transplantation is now considered as the gold standard for treatment of patients with end-stage liver diseases and early liver tumors in cirrhotic livers. Patient education is vital to the safety and success of a transplant. Aim: the aim is to assess the impact of a designed nursing intervention protocol about preoperative liver transplantation care on patient’s outcomes as indicated by: patients` knowledge & practice mean scores, and complications developed. To fulfill the aim of this study, the following hypothesis was formulated: patients undergoing liver transplantation who will be exposed to the designed nursing intervention protocol about preoperative liver transplantation care will show better outcomes. Material and Methods: A convenient sample of 14 adult male and female patients admitted to Liver Transplant Unit at El Manial University Hospital were included, three of them were died with an attrition rate of 21.4%. Four tools were formulated to collect data pertinent to the study. 1- Sociodemographic and medical data sheet; 2- Pre/Post knowledge assessment questionnaire sheet, 3- Observational checklists, & 4- Complications assessment sheet. Structured interview, reviewing medical records, direct observation and physical examination were utilized for data collection. Results: a  significant statistical difference was found in relation to the total and subtotal mean knowledge and practice scores during different assessment periods  with P values (0.00 for both); as well, 45.5 %  of patients developed respiratory complications (pleural effusion) compared to 53.8 % of their correspondence who developed respiratory complications (pleural effusion, chest infection, and others), in addition, 9.1% of the studied subjects developed  rejection, and ascites as compared to (1.9 %, 5.7%) of their correspondence over the last consecutive three years respectively. Conclusion: Liver transplantation patients showed a positive improvement in their knowledge and practice in relation to breathing, coughing, & using respirometer exercises and range of motion. Replication of this study on a larger sample selected from different geographical areas is highly recommended.

Key wards: liver transplantation, designed nursing intervention protocol, preoperative liver transplantation care, knowledge, complications, and patient`s outcome.