Introduction of a specialized consultation prior to insertion of totally implantable access venous devices: Impact on cancellation rate and patient satisfaction

Vascular. 2020 Dec;28(6):816-820. doi: 10.1177/1708538120930470. Epub 2020 Jun 6.

Abstract

Objectives: Preoperative consultation is usually not performed before insertion of a totally implantable venous access device (TIVAD). In our experience, an incomplete preoperative assessment, a predictable medical condition contraindicating surgery, or no-show patients the day of surgery led to several surgery cancellations. Therefore, we introduced a specific preoperative surgical consultation for TIVAD that took place shortly before surgery. The aim of the present study is to evaluate the patients' satisfaction and to establish the rate of cancellation after the adoption of this strategy.

Methods: Two-hundred and four patients who benefited from the preoperative consultation before TIVAD insertion from August 2014 to August 2016 were included. Satisfaction of patients and cancellation rate were documented.

Results: With that strategy, no TIVAD insertion was either delayed or cancelled. The overall level of satisfaction was high (91.8%); 184 patients (90.2%) judged the consultation useful in preparation for the surgery. The surgical procedure met their expectations in 92.2% of cases. Patients known for a psychiatric comorbidity were more likely to express dissatisfaction.

Conclusions: The introduction of a specific preoperative surgical consultation for TIVAD insertion led to a high level of patients' satisfaction. After the preoperative consultation, no cancellation was recorded. Special approaches have to be considered for patients with a psychiatric comorbidity.

Keywords: Vascular access devices; consultation; patient satisfaction; preoperative period; referral; surgery cancellation rate.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Appointments and Schedules*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation*
  • Catheters, Indwelling*
  • Central Venous Catheters*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Planning Techniques
  • Prospective Studies
  • Referral and Consultation*
  • Treatment Outcome
  • Young Adult