Abstract

Introduction and Background

Breast cancer is a disease characterized by abnormal cell growth that develops from interactions including genetics, environment, and cellular functions (Taurin & Alkhalifa, 2020). Breast cancer is common in women, and breast reconstruction is a main course of treatment (Taha et al, 2023). One in eight women may have breast cancer in their lifetime (Tedesco & Loerzel, 2020). In the United States, 151,641 breast reconstruction surgeries were reported in 2022 by the American Society of Plastic Surgery (Perez et al., 2024). The infection rate after breast reconstructive surgery can be as high as 25% and occurs within 90 days after surgery. The consequences of breast implant infections can be an implant removal, and if the patient requires chemotherapy or radiation, it may be delayed, resulting in increased health care costs or hospital readmission (Meglaa et al., 2024).

Methodology

Several Tools used include the pre-assessment survey, nursing demographic survey, lesson plan PPT education, CDC post-course evaluation, CDC delayed evaluation patient education bundle, patient satisfaction survey, surgical wound assessment, patient participation questionnaire, chronic disease self-efficacy scales assessment, pre-assessment chronic disease self-efficacy scales assessment, and post-assessment. The tools collected information from the nurse about the current discharge workflow, patient education, certifications, training, years of experience, and pre- and post-education knowledge of the PPT presentation and its relevance to patients. Patients had a questionnaire before and after receiving the nurse's discharge education and answered questions about their age, education, self-efficacy, and overall satisfaction. The nursing staff received education regarding the bundle and were equipped with the necessary discharge information. The patients discussed their self-efficacy with the nurse and articulated their understanding of their discharge instructions before leaving the hospital. Once the patient received their discharge instructions, they had the necessary knowledge to care for themselves and the Jackson-Pratt drain, including recognizing signs of infection, drain failure, and knowing when to contact the practitioner. They also understood the importance of attending their postoperative appointment and bringing their drain measurement chart to the clinic appointment. Data for both nurses and patients were collected via Qualtrics, using a hyperlink or QR code to open the questionnaires.

Results

The nurses' survey showed an improvement in nurses' knowledge after the educational presentation. The nurses also revealed that the educational content was highly relevant to their clinical practice and had practical value. In addition, the nurses stated their intention to incorporate their new knowledge into their care of postoperative patients, and that the education enhanced understanding and will influence patient outcomes and future clinical practice. The patient demonstrated strong self-efficacy throughout the project, as evidenced by interactions with the nurse at discharge, showing confidence in managing their care after discharge. The patients also revealed a strong understanding and engagement with the discharge material provided, reporting feeling supported by the provider and nurses, and being prepared for their recovery. Notably, no patients developed surgical site infections during the project period, suggesting a positive impact of the education and support on patient outcomes.

Conclusion

The objective of the project was to provide education, resources, and clear pathways for assistance to prevent patient harm, readmission, and unnecessary hospital costs. The nurses’ surveys showed that their knowledge improved, that the education was relevant to practice, and that the nurses plan to continue applying what they learned when caring for post‑operative patients. The patients demonstrated strong self‑efficacy, that they received education well, and they felt supported and prepared. Notably, no patients developed surgical site infections during the project period.

Keywords: Breast Reconstruction, Infection Prevention, Standardized Care, Self-Efficacy

LLU Discipline

Nursing

School

School of Nursing

First Advisor

Robin Dudley Pueschel

Second Advisor

Salem Dehom

Degree Name

Doctor of Nursing Practice (DNP)

Year Degree Awarded

2026

Date (Title Page)

5-23-2026

Language

English

Type

Doctoral Project

Page Count

108 p., 1 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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