Join PER® September 15th for the New York Advanced Practice Collaborative Meeting! Directed toward NP/PAs, this meeting blends presentations on cutting-edge information with panel discussions to enhance learning.

Colorectal Surgery

Tuesday, February 19, 2013
Patients routinely receive hospital discharge instructions that are usually developed by the staff of the particular hospital from which the patient is being discharged. Consequently, there is little standardization among discharge instructions and many times, these instructions are generic in their focus (e.g. all patients who have a surgical operation receive the same instructions).

To address this gap in knowledge and practice, an 11-member expert panel was convened to identify signs and symptoms that patients should report following colorectal surgery. The panel used a standardized Delphi process to reach a national consensus, which was defined as the point when at least 70% of the experts rated a symptom as 4 or more on a 5-point Likert scale (e.g. agree or strongly agree).

The expert panel members identified 10 signs and symptoms that patients should immediately report if they occur following colorectal surgery. They include wound drainage, wound opening, wound redness or changes in the skin around the wound, no bowel movement or lack of gas/stool from an ostomy for more than 24 hours, increasing abdominal pain, vomiting, abdominal swelling, high ostomy output and/or dark urine or no urine, fever greater than 101.5°F, and not being able to take anything by mouth for more than 24 hours. Two additional symptoms that require patients to seek emergency care shortness of breath or inability to breathe and chest pain. The expert panel hopes that this list will be used in clinical practice to guide discharge instructions for patients post colorectal surgery. This process also can be used to identify specific discharge instructions following other types of surgery.


Li LT, Mills WL, Gutierrez AM, et al. A patient-centered early warning system to prevent readmission after colorectal surgery: a national consensus using the Delphi method. Journal of the American College of Surgeons; 2012; 216(2): 210-216.

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
Lisa Schulmeister, MN, RN, ACNS-BC, FAAN
Blog Info
Lisa Schulmeister, MN, RN, ACNS-BC, FAAN is an oncology nursing consultant and editor-in-chief of Oncology Nursing News.
Author Bio
Lisa Schulmeister, MN, RN, ACNS-BC, FAAN, is the Editor-in-Chief for OncLive Nursing. She is an oncology nursing consultant and adjunct assistant professor of nursing at Louisiana State Health Sciences Center in New Orleans, LA. She provides continuing nursing education to nurses across the Unites States, is active in several professional nursing organizations, and is intrigued by the many ways nurses use technology to communicate.
External Resources

MJH Associates
American Journal of Managed Care
MD Magazine
Pharmacy Times
Physicians' Education Resource
Specialty Pharmacy Times
OncNurse Resources

Continuing Education
Web Exclusives

About Us
Advisory Board
Contact Us
Privacy Policy
Terms & Conditions
Intellisphere, LLC
2 Clarke Drive
Suite 100
Cranbury, NJ 08512
P: 609-716-7777
F: 609-716-4747

Copyright OncNursing 2006-2018
Intellisphere, LLC. All Rights Reserved.