A service evaluation on the use of digital chest drains following thoracic surgery on postoperative mobilisation and time on physiotherapy caseload
Chloe Tait, Leanne McCarthy, Simon Hayward
Abstract
Introduction Chest drains are required following thoracic surgery but their presence can cause people pain, limit postoperative mobility and increase hospital length of stay (LOS). The use of portable digital chest drains can promote early postoperative mobilisation, reduce drain duration and hospital LOS. In our hospital, digital chest drains were introduced in February 2017 for use with patients following thoracic surgery performed by one thoracic surgeon. Other surgeons continued to use under water seal (UWS) drains. Aims To explore whether the use of digital chest drains allowed earlier postoperative mobilisation, compared with UWS drains. To explore whether the use of digital chest drains reduced time on physiotherapy caseload, chest drain duration and hospital LOS. Method A retrospective service evaluation was conducted in a UK teaching hospital. Data were collected for a six month period for all patients following thoracic surgery referred to physiotherapy. Data were analysed using descriptive statistics and statistical tests. Results Median day first mobilised postoperatively was statistically significantly shorter for the digital drain group (day 1) compared to the UWS drain group (day 3) (observed median difference 1, 95% CI 1 to 2 p = 0.0001). Time on physiotherapy caseload was statistically significantly shorter for the digital drain group (4 days) compared to the UWS drain group (5 days) (Observed median difference 1, 95% CI 1 to 2 p = 0.02). There was no statistically significant difference in median chest drain duration between the digital drain group (2 days) and the UWS group (3 days) (observed median difference 1, 95% CI 0 to 0 p = 0.91). Median hospital LOS was shorter for the digital drain group (5 days) compared to the UWS group (6 days) however this difference did not reach statistical significance (observed median difference 1, 95% CI 0 to 1 p = 0.06). Conclusion The use of digital chest drains with inbuilt suction enabled individuals to mobilise on the first day following thoracic surgery, thereby facilitating earlier liberation from the bed space and reducing the potential for known effects of immobilisation. The use of digital chest drains also facilitated earlier discharge from physiotherapy. In this service evaluation there was no significant difference in chest drain duration or hospital LOS between individuals with digital drains and those with UWS drains.