Although preoperative planning for pediatric oncology surgery often involves a well-developed multidisciplinary process, postoperative discharge planning after surgery is also an important aspect that requires forethought and planning and can involve multiple disciplines in putting an agreed plan into action. It can be informal where time, availability, and other constraints do not lend to a formal meeting. But in whatever form it takes, the multifaceted care of the patient should be addressed. The social and physical environment into which the child will be discharged is an important factor to consider, and home visits and assessments may be needed. The discharge planning for the pediatric oncology patient should begin with the preoperative preparation, assessment, and planning. Many issues may be predicted and prepared for at this stage, to avoid last-minute surprises and difficulties. With implementation of enhanced recovery after surgery, earlier discharge from hospital can be encouraged and expected. The surgical specific aspects of discharge planning that should be planned for include wound care, removal of drains or tubes, pain relief, and mobility adjustment, among others. There should also be a plan for psychosocial assessment and input at home if identified. The medical follow-up required is made in consultation with the oncology team, including the final staging discussion, plan, and communication to parents. In advanced cases there needs to be a palliation plan. Several frameworks that exist already can be consulted and local adaptations made to improve the patient experience.

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Postoperative Discharge Plan

  • Merrill McHoney,
  • Emma Johnson

摘要

Although preoperative planning for pediatric oncology surgery often involves a well-developed multidisciplinary process, postoperative discharge planning after surgery is also an important aspect that requires forethought and planning and can involve multiple disciplines in putting an agreed plan into action. It can be informal where time, availability, and other constraints do not lend to a formal meeting. But in whatever form it takes, the multifaceted care of the patient should be addressed. The social and physical environment into which the child will be discharged is an important factor to consider, and home visits and assessments may be needed. The discharge planning for the pediatric oncology patient should begin with the preoperative preparation, assessment, and planning. Many issues may be predicted and prepared for at this stage, to avoid last-minute surprises and difficulties. With implementation of enhanced recovery after surgery, earlier discharge from hospital can be encouraged and expected. The surgical specific aspects of discharge planning that should be planned for include wound care, removal of drains or tubes, pain relief, and mobility adjustment, among others. There should also be a plan for psychosocial assessment and input at home if identified. The medical follow-up required is made in consultation with the oncology team, including the final staging discussion, plan, and communication to parents. In advanced cases there needs to be a palliation plan. Several frameworks that exist already can be consulted and local adaptations made to improve the patient experience.