MN
NACNS
Minnesota Affiliate of
National Association of Clinical
Nurse Specialists
Implementation of Pre-Operative Care Coordination to Reduce Anxiety Related to
Discharge for Patients Undergoing Head and Neck Cancer Surgery
Jessica Hus, BSN, CNS student
Winona State University
Winona, MN
Problem: Patients undergoing surgery for extensive cancer of the head and neck may
experience anxiety related to discharging with the possibility of a tracheostomy tube, a
feeding tube, surgical drain(s), and dressing changes. Thorough discharge teaching can
improve patient outcomes, reduce anxiety in patients, and decrease length of stay.
Changes in medical reimbursement and advances in medicine have shortened hospital
stays and patients with complex medical issues are discharging faster than they had two
decades ago. Time is limited for nurses to coordinate care and provide quality time for
educational needs at home.
Methods: Searches were conducted through CINAHL, OVID, PubMed, and Google
Scholar using the following terms: anxiety, head and neck cancer, coping, nursing, care
transitions, pre-operative teaching, discharge planning and preoperative teaching,
discharge planning and anxiety, informational needs and cancer, and preoperative
education and head and neck cancer.
CNS role description: A CNS with experience in care of an otorhinolaryngology patient
can provide insight to what their needs are at home and help patients/family plan for
home care needs prior to surgical interventions. The CNS will use a multidisciplinary
team approach to identify barriers patients may encounter during their transition to home.
Results: Studies were limited in terms of preoperative education in patients with head
and neck cancer. However, evidence suggests extensive preoperative teaching can
reduce anxiety and length of stay in patients experiencing joint replacement surgery,
radical prostatectomy, and cardiac surgery.
Implication for Practice: Extensive education and planning preoperatively can reduce
anxiety and length of stay for patients. Addressing barriers and having in place social
support networks for patients can also expedite discharge.