A survey of Canadian surgeons on the indications for home care nursing following vascular surgery

Abstract

Background: Recent evidence suggests that home care nursing is variably prescribed after vascular surgery, and may reduce emergency department visits and hospital readmissions. We therefore sought to characterize the indications for home care nursing following vascular surgery from the surgeon’s perspective. Methods: An online survey was distributed to the 141 members of the Canadian Society for Vascular Surgery with questions related to home care nursing after carotid endarterectomy (CEA), endovascular aortic aneurysm repair (EVAR), open abdominal aortic aneurysm (AAA) repair and open or hybrid revascularization for peripheral arterial disease (PAD). We included all questionnaires in our analysis; the frequency denominator changes according to the number of respondents who completed each survey item. Results: There were 46 survey respondents (33% of 141) from across the country. A total of 28 (62% of 45) worked in a teaching hospital. Home care nursing was routinely prescribed by 5%, 10%, 31% and 41% of respondents following CEA, EVAR, open AAA repair and open or hybrid revascularization for PAD, respectively. Across all procedure types, the same procedure-related criteria were most often deemed to warrant a prescription for home care nursing: surgical site infection, wound complications (e.g., open wound, lymphatic leak) and use of negative-pressure wound therapy. Across all procedure types, lack of social support, physical frailty and cognitive impairment were most frequently identified as patient-specific considerations for prescribing home care nursing. Few respondents reported restrictions or standards that informed their prescribing practice. Conclusion: Most surgeon respondents agreed on the indications for home care nursing after vascular surgery. However, evidence-based standards to guide patient selection for home care nursing after vascular surgery are needed.

Perceptions of Canadian vascular surgeons toward artificial intelligence and machine learning

“…In other fields of medicine, clinician surveys on AI/ML have response rates that vary widely from 1.3% to 72% 23,[53][54][55] . Our response rate is consistent with those reported in other published surveys of Canadian vascular surgeons 56,57 . Second, most of the respondents were white males practicing in academic settings, which may not adequately represent the perspectives of women and non-white populations working in non-academic settings.…”

“…These demographics reflect the current vascular surgery workforce, 57 as demonstrated in previously reported surveys of Canadian vascular surgeons. 55 , 56 , 58 Similar demographic distributions are present in the U.S. vascular surgery workforce. 59 We would recommend conducting an updated survey in the future as increasing efforts are underway to improve workforce diversity.…”

“…Second, most of the respondents were white males practicing in academic settings, which may not adequately represent the perspectives of women and non-white populations working in non-academic settings. These demographics reflect the current vascular surgery workforce 58 , as demonstrated in previously published surveys of Canadian vascular surgeons 56,57,59 . Similar demographic distributions are seen in the US vascular surgery workforce 60 .…”

“… 23 , 52 , 53 , 54 Our response rate is consistent with those reported for other surveys of Canadian vascular surgeons. 55 , 56 Second, most of the respondents were White men practicing in academic settings, which might not adequately represent the perspectives of women and non-White populations working in nonacademic settings. These demographics reflect the current vascular surgery workforce, 57 as demonstrated in previously reported surveys of Canadian vascular surgeons.…”

The experiences of patients with COVID-19 and their relatives from receiving professional home care nursing: a qualitative content analysis

“…The research findings related to home care nursing can provide primary data for the use and policy-making of home care nursing [ 15 , 18 ]. COVID-19 has made a wide range of changes in all aspects of healthcare systems.…”