Background: Biliary obstruction often occurs with hepatobiliary cancers. Treatment consists of internal biliary stents or external biliary drains. Patient education regarding signs and symptoms of cholangitis, change of stents, or care of biliary drains is both critical and challenging. The Nursing Advisory Board of the Cholangiocarcinoma Foundation (CCF) found patient questions regarding stents and drains posted on the CCF website. Quality of life is impacted by treatment complications as well as lack of knowledge regarding living with stents or drains. Aim: To compare stent and biliary drain patient education practices of NCCN Member Institutions across the United States. Methods: A 40 item information survey was sent to the NCCN Member Institutions by email. Intended respondents were nursing or health professionals who provided patient instruction regarding biliary stents drains. The survey was sent to interventional radiology and endoscopy departments. It included questions regarding demographics of respondents, patient education and instructions, supplies provided, signs and symptoms to be reported, and follow-up appointments. Results: There were 26 survey responses. Of the 26 responses, 23 responses were complete. Patient education regarding stents or drains was predominantly completed by registered nurses (74%), or nurse practitioners (26%). The largest number of respondents practiced in interventional radiology (52%), endoscopy (13%), and other (30%), which included gastroenterology, or surgery. Verbal and written instructions were provided by 87% of NCCN centers. There was variation in survey responses regarding biliary drains. Survey responses regarding biliary stents were more cohesive. A schedule for stent change was provided by 75% of NCCN Member Institutions, although there was variation on length of time between stent exchanges. The majority of patients at these institutions receive education regarding signs and symptoms to report (95%). Conclusion: Discharge instructions to patients with external drains are inconsistent. Although there is some agreement among NCCN Member Institutions, the schedules for stent change vary. Patient education and instruction is predominantly provided by nurses and NPs. The importance of teaching signs and symptoms to report is evident in this sample. Standardized patient instructions post stents or external biliary drains may enable patients to care for drains and will help nurses and NPs reinforce consistent education.
Corresponding Author: Lorraine C. Drapek, DNP, FNP-BC, AOCNP