How Can a Nurse Practitioner Improve Patient Compliance and Patient Education in a Perioperative Setting?

Jane C. Rothrock, DNSc, RN, CNOR, FAAN


January 07, 2008

Preoperative and Postoperative Patient Education

During the 1960s, as nursing research grew, structured preoperative patient education was introduced and became an integral part of the nurse's role. By the early 1970s, the link between preoperative preparation and postoperative recovery was validated by nursing research. Since that time, a large body of research has been published about the type of information offered to patients preoperatively and postoperatively. The ultimate goal of patient education is to enable patients to be responsible for their own healthcare. Patient education is a planned experience designed to change or improve health behaviors and health status, and in evidence-based practice, is based on the best information available. Patient education is a systematic way of introducing new information, events, skills, or objects into the patient's environment. When viewed as an interpersonal interaction between the patient and nurse, teaching is a distinctive form of communication that is uniquely structured and sequenced to produce learning.[8]

Preoperatively, perioperative nurses often focus on 2 areas: sensory (what the patient will feel, hear, see, and smell during the surgical procedure) and procedural (sequence of perioperative events, what the procedure involves). Encompassing a broad array of topics, this education may start in the surgeon's office. Information about all preoperative events can be complicated and confusing; in addition to written instructions using language easily understood by the layperson, educational encounters should include "repeat back" or "teach back" opportunities for patients to describe, in their own words, their understanding of what they are to do, when they will do it, and how to make appointments or complete required tasks (such as a bowel prep or continuation or cessation of a medication regimen). Because there is an enormous amount of information given at each preparatory step, patients must be able to comprehend the information and repeat it back as they understand it. As the preoperative and then postoperative experience progresses, time for the patient to organize the input must be assured, with opportunities and encouragement to ask questions.

Preoperative and postoperative educational materials may be provided in the form of preprinted written instructions or designed as colorful pamphlets. Video-based materials may complement written or verbal information. Regardless of the form the educational materials take, they should be free of medical or nursing jargon. Educational materials should also:

  • Be written at the 6th grade level or lower;

  • Use basic, familiar terms of 1 or 2 syllables;

  • Emphasize key information;

  • Be free of distracting fonts and computerized enhancements;

  • Include pictures or illustrations where they are important to the information being provided; and

  • Provide a resource person or phone number to call for clarification.


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