Abstract
BACKGROUND: Ensuring standardized competencies in T-tube management is pivotal for optimizing recovery and minimizing postoperative morbidity. Despite its growing use in clinical training, the impact of structured video-based skill assessments on nursing practice has not been clearly defined. METHODS: We conducted a retrospective comparative analysis at Xingtai People's Hospital, enrolling adult inpatients who underwent T-tube placement between January 2019 and December 2023. Participants were stratified according to whether their primary nurse had completed a formal video-based assessment of T-tube care. Primary endpoints were T-tube retention time distribution and length of postoperative hospital stay. Tube-related complications were analyzed as secondary/exploratory outcomes. Secondary endpoints included patient satisfaction, internal nursing quality indicators, and nurse-reported confidence. Intergroup comparisons were performed using independent-sample t tests and chi-square tests, with significance set at P < 0.05. RESULTS: Among 200 eligible patients, 80 were retrospectively classified into the video-based assessment (VBA) group and 120 into the traditional clinical assessment (TCA) group according to the credentialing status of the primary nurse responsible for T-tube care at the time care was delivered. The VBA group exhibited a more concentrated retention time distribution (42.1 ± 3.6 vs 44.8 ± 6.2 days; P < 0.001) and a shorter postoperative hospital stay (5.8 ± 1.2 vs 6.2 ± 1.5 days; P = 0.02). Tube-related complications were numerically fewer in the VBA group (6.3% vs 10.8%), with significantly lower infection rate (2/80 [2.5%] vs 8/120 [6.7%]; Fisher's exact test, P = 0.04), while rates of accidental dislodgement and blockage did not differ significantly. Patient satisfaction scores and internal nursing quality ratings were consistently superior in the VBA group across all assessed domains (all P < 0.01). CONCLUSION: Implementation of structured video-based nursing assessments was associated with more standardized T-tube retention time, shorter hospitalization, a lower observed rate of local infection and enhanced patient-reported and nursing quality outcomes. Given the retrospective observational design and routine staffing-based (non-random) nurse assignment, these findings should be interpreted as associations rather than causal effects. Complication endpoints were infrequent, and safety-related differences require confirmation in larger prospective studies. Integrating video-based evaluation into routine nursing competency frameworks may represent a scalable quality-assurance strategy for postoperative T-tube management and warrants confirmation in prospective, preferably randomized or mixed-method, studies.