Document Type
DNP Project
Publication Date
2026
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Dr. Constance Glenn, DNP, MSN, APRN, FNP-BC, CNE: DNP
Practice Mentor
Kasey Hindinger, APRN
Abstract
Title
Enhancing Postoperative Outcomes with Preoperative Education for Esophagectomy Patients
Background/Significance
Esophageal cancer is an aggressive disease and the fourth most common gastrointestinal cancer. A surgical treatment for a patient with esophageal cancer who is a surgical candidate is an esophagectomy. Immediate postoperative complications may include pneumonia, arrhythmias or anastomotic leaks, all of which can potentially increase the patient’s length of stay. Delayed discharges can lead to a backup throughout the hospital, limiting the amount of available inpatient beds for patient care.
Purpose
The DNP project purpose was to implement an additional preoperative telehealth visit in order to provide patient education prior to surgery. Additional patient education prior to surgery would be expected to enhance patient recovery outcomes.
Methods
This project was created based on an evidence review. Seventy-nine articles were reviewed using the Melnyk and Fineout‑Overholt rapid critical appraisal tool (Melnyk & Fineout-Overholt, 2015). Twelve articles were selected to be used in this project. Practice change included implementing an additional patient education telehealth appointment. Education covered included use of incentive spirometers, physical activity, nutrition optimization, and substance use cessation. Nutritional risk referral was evaluated through albumin and prealbumin measures with a nutrition referral planned for suboptimal results or documented weight loss. Referral was planned for patient request as well. Outcome measures included patient surveys as well as incidence of pneumonia and length of stay.
Results
One hundred percent of esophagectomy candidates between September 20th, 2025 to February 13th, 2026, were screened for this project. Three patients consented and participated. Patients were given three surveys during their participation period which consisted of Likert-scale questions. Average scores for the first and second survey were as follows: 4.6 for understanding the use of an incentive spirometer, 3.4 on increasing exercise, 1.2 regarding alcohol intake, 1.4 regarding smoking status, and a score of 4.4 regarding preparedness for surgery. There were no instances of weight loss prior to surgery, and no referrals to a registered dietician were made. The post intervention survey had an average score of 3.33 on feeling more prepared after the telehealth visit. There were no diagnoses of pneumonia. The average length of stay in the intervention group was 11.33 days compared with 10.79 days in the pre-intervention group.
Conclusions
While the number of patients was small and this was a low-powered project, subjective patient survey results revealed that there was increased preparedness for surgery. There were no incidences of pneumonia complications during this project implementation period. The additional preoperative appointment is now standard practice at the DNP project site; however, this project would need to run for a longer period to gain more patients to achieve statistically significant results.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Kattman, G. (2026). Enhancing postoperative esophagectomy outcomes with preoperative education: A quality improvement project [Unpublished DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.