Sue Woodward Chair PLG RCS Eng

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Peter Toby Henderson
8 years ago
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1 Sue Woodward Chair PLG RCS Eng

2 Day / Short Stay Surgery Patient Perceptions Patient Responsibilities Patient Concerns Patient Benefits Surgeon and the teams Responsibilities Hospital Benefits

4 Patient Perception of Day / Short Stay surgery Straightforward Does not carry the same risks Recovery simple and quicker Less risk of hospital infection Operation performed by suitably qualified person

5 Surgeons Perception Patients prefer to be at home Patients like to avoid hospital Patients want to be responsible for their health Patients want to understand what is to happen

6 Patient Selection When patients are referred for day surgery/short stay it is essential to ensure that: the procedure is suitable the risk of complications (from surgery and anaesthetic) are minimised patients are adequately supported after discharge home. Patients understand what is to happen and what they need to do before and after surgery

7 Surgical Teams The procedure to be carried out has been fully explained Set expectations for likely outcome Informed Consent taken Correct Tests completed and available to ensure no cancellation Assessment of the care of this patient post operation Communication with relevant parties to ensure that this is available

8 Groups for Special Consideration Children Elderly Mums with families Working Patients Young People

9 Patient Actions Get Organised Get Fit for anaesthetic Arrange Transport Organise Care post operatively Plan for Restrictions Organise Equipment Research ask Questions about Treatment/recovery So Know what to expect is the Normal plan but also plan that this may not be the case

10 Information Given on Discharge medication wound care arrangements for dressing renewal and suture removal resuming normal activities what normal symptoms may be expected and their duration what would be abnormal symptoms and what to do if they occur contact telephone numbers for information or in an emergency arrangements for follow up (telephone and out patients)

11 ? That need addressing When is it safe to get a wound wet i.e. have a shower? Who can I contact when I have a query once I have left the ward? What sort of pain should I expect? What symptoms should prompt me to go for help and should that be the GP or the Hospital? How do I spot a possible wound infection how fast should I react? What sort of rehabilitation do I need and how do I go about getting it?

12 Patient Benefits Less time in Hospital Less Risk Hospital Acquired infections Easier to rest and sleep Psychologically Patients feel responsible for their own recovery at home

13 Hospital Benefits Reduced time Spent in Hospital saves money Reduced Infection Rates Reduction in Waiting Times for operations More Patients Treated

14 Hospital Challenges Suitable Facilities are available Patient Care needs to be joined up and rethought This environment does not reduce opportunities for surgical training

15 Unplanned admissions for day surgery orthopaedics 2005 comparing patients managed through day and in patient theatres and those managed through a dedicated day surgery unit ref Fehrmann et al Journal of one Day day Unit surgery Vol 19 No 2p39 47 Number of Patients Number of unplanned admissions Dedicated Day Unit Inpatient day beds 13 (2.1%) 108(16.8%)

16 Day / Short Stay Surgery Patient Perceptions Patient Responsibilities Patient Benefits Patient Concerns Surgeon and the teams Responsibilities Hospital Benefits

17 Warning Day Surgery or short stay surgery and the early discharge should not be considered in the blind assumption that it is better for the patient to be out of hospital,

Keyhole (Laparoscopic) Surgery

Patient Information leaflet Keyhole (Laparoscopic) Surgery Produced by: Department of Obstetrics & Gynaecology December 2002 Reviewed April 2010 1 What is keyhole (laparoscopic) surgery? Laparoscopic surgery