PATIENT EDUCATION MAY IMPROVE PERIOPERATIVE SAFETY

Importance: There is a growing interest in enabling ways for patients to participate in their own care to improve perioperative safety, but little is known about the effectiveness of interventions enhancing an active patient role. Objective: To evaluate the effect of patient participation on perioperative safety. Evidence review: We conducted a systematic review by searching the Cochrane, PubMed and EMBASE databases without a time limit for publications on the effect of patient-related interventions on perioperative safety. We included randomized controlled trials, quasi-experimental studies and cohort studies. The included studies were analyzed for type of intervention, safety outcomes, effects and quality. Results: Thirteen studies were included: eight RCT's, four cohort studies and one quasi-experimental study. All studies concerned a preoperative structured educational intervention on postoperative self-management activities of patients, such as everyday movements, coughing, getting out of bed or exercising. Safety outcomes were complications, in-hospital falls and mortality. Results from eleven studies indicate positive effects of such patient-related interventions. Conclusion and relevance: Patients appear able to improve their perioperative safety by participating in preoperative structured educational programs about postoperative regimes. Educational programs on self-management activities should be integrated in the preoperative trajectory. Further research should address the most effective components and timing of education, explore other kinds of patient involvement and link the robustness of the intervention, e.g. in terms of behavior change, to perioperative patient safety outcomes.