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Perioperative nurse hopes pioneer ‘surgery school’ for patients will expand further

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A ground-breaking “surgery school” designed to boost the fitness and wellbeing of patients before they go under the knife is helping reduce the time people spend in hospital, shows an evaluation.

The initiative, developed by clinicians at Southampton University Hospital NHS Foundation Trusts, sees groups of patients about to undergo bowl, urological or gastrointestinal surgery attend weekly sessions with a nurse, dietician and therapist.

“We hope the project continues to grow both within the trust and further afield”

Imogen Fecher-Jones

Topics covered include exercise, nutrition, alcohol education and smoking cessation – with the aim of reducing patients’ risk of complications post-surgery and the length of time they spend in hospital.

Results of a two-year audit of the programme found it had helped boost patients’ activity levels and cut length of stay.

Nearly half – 48% – of patients who were physically inactive before attending “surgery school” said they had increased their activity levels and made lifestyle improvements.

Overall, the findings, presented at the Evidence Based Perioperative Medicine conference in Ireland, show 46% of patients who took part in the scheme increased their activity compared with 25% who did not go to sessions.

Crucially, those who attended spent one day less in hospital on average with fewer post-surgery complications, said the trust.

The audit shows 450 out of 848 patients invited to attend sessions went on to take part.

“What these initial results show us is that we are making huge strides in that area”

Denny Levett

In all, 63% said they were likely to make a lifestyle change as a result with 98% saying they would recommend the programme to a friend having surgery.

The scheme was launched by Professor Mike Grocott, a consultant in critical care at the trust, and his team in 2016.

Groups of 10 patients attend the weekly two-hour sessions. As part of the project, patients can be referred to specialist advisers at Southampton Healthy Living for advice on quitting smoking, as well as a dedicated alcohol support team.

Imogen Fecher-Jones, lead nurse for perioperative medicine at the trust, said she was keen to see the project expand further

“We are really pleased with the results we have seen so far, and we hope the project continues to grow both within the trust and further afield,” she said.

She added: “It is already well-established that patients who are in good physical shape prior to surgery have fewer complications and enjoy a quicker recovery, so the key is to engage more patients to take action – particularly in the hard to reach groups.”

University Hospital Southampton NHS Foundation Trust

Imogen Fecher-Jones

Imogen Fecher-Jones

Professor Denny Levett, clinical lead for the perioperative medicine service, said: “What these initial results show us is that we are making huge strides in that area, with almost half of patients who were inactive reportedly increasing their physical activity and making lifestyle improvements as a result of the school.”

The surgery school is one of a number of such initiatives, known as Fit-4-Surgery, introduced by the perioperative medicine team at Southampton University Hospital.

These include pre-surgery exercise sessions – known as “prehabilitation” – for cancer patients, which are being trialled across the region as part of a £2.3m study.

The team has also received a £1.8m National Institute for Health Research grant with University Hospitals Bristol Foundation Trust to evaluate the effectiveness of muscle training before major operations to reduce pneumonia after surgery.

University Hospital Southampton NHS Foundation Trust

Southampton surgery school perioperative

Exercise lab at University Hospital Southampton NHS Foundation Trust

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