Suji Ann John

Graduation Semester and Year




Document Type


Degree Name

Doctor of Nursing Practice



First Advisor

Mary Schira

Second Advisor

Richard E Gilder


Same day cancellations on the day of the procedure are associated with poor quality of care, lower patient satisfaction, and higher healthcare costs. Cancellations are often the result of NPO (nil per os or nothing by mouth) violations, missed preoperative instructions, and patient illness. This quality improvement project explored email preoperative instructions as a means to decrease surgical cancellations on the day of the procedure. Methods Design and Setting This quality improvement project was implemented in a large pediatric facility using convenience sampling to evaluate the effectiveness of emailed preoperative instructions along with preoperative phone calls to decrease same day surgery cancellations. The project was implemented in four outpatient surgical services. Implementation and Data Analysis Retrospective and prospective data were gathered from the electronic medical records. Pre-intervention data was gathered from 6/12/2017 to 9/15/2017. The emailed preoperative instructions were implemented in four surgical services over a 13-week period. Implementation and post-intervention data were gathered from 10/15/2017 to 1/12/2018. Data collected was analyzed using SPSS. The chi-square and Mann-Whitney U test were used to measure the statistical significance of emailed preoperative instructions to decrease surgical cancellations. Results Although not statistically significant, results yielded clinical significance. In most instances, there were fewer same day cancellations when parents/guardians received emailed preoperative instructions. Conclusion Emailed preoperative instructions enhances medical communication and provides parents and guardians a retrievable reference of NPO (nil per os or nothing by mouth) guidelines, patient illness considerations, medication recommendations, and arrival times.


Preoperative instructions -- email, Surgery cancellations, Medical communication -- surgery -- patients


Medicine and Health Sciences | Nursing


Degree granted by The University of Texas at Arlington

Included in

Nursing Commons