Clinical audit (closed loop)-Day 1 postoperative bloods in NOF

8^th International Conference on Surgeons

October 28, 2022 | Webinar

Hafiz Muhammad Nuheel Iqbal

Nottingham University Hospital-Queen Medical Centre, England

Scientific Tracks Abstracts: J Surg

Abstract :

Introduction: Many hospitals undertake post-operative blood tests routinely to identify common post-op complications. Day 1 post-operative bloods in NOF are required as per NUH Trust guidelines. The aim of this study was to identify whether blood tests (FBC and Urea & Electrolytes) are routinely requested as per hospital guidelines and performed in a timely fashion. Method: Retrospective data was collected from patients admitted through orthopedics ward of QMC with an isolated neck of femur fracture which was operated in QMC. Two cycles, each of sample size of 50 were carried out, based on a 5 months data. For the first cycle, around 10-15 random patients were selected from the month of January, February, March and April making a total sample of 50. For the second cycle, first 50 patients from the month of May were selected chronologically. Post-operative blood tests and medical records were reviewed to identify derangement in hemoglobin level and renal function requiring clinical intervention. Results: Over the span of 5 months, in both cycles, it was found that bloods were requested by the surgeons in 92% of post-operative patients. Data of first cycle revealed that Day 1 post-operative bloods were ordered in 86% patients in total of which 50% were sent timely i.e. before 7 am. In contrast, bloods were ordered and timely sent before 7 am in 94% patients, in the second cycle of audit. Among the samples obtained, they were sent before 12 pm in 50% of patients in the first cycle and in 90% patients in the second cycle. For most patients, the results were obtained before 5 pm on the same day; 64% in 1st cycle and 96% in 2nd cycle. Meanwhile, 22% of the results in 1st cycle and 4% in the second cycle were not available. A 6% sample error rate was also found in cycle 1. Looking at blood results, 22% patients showed AKI in cycle 1 and 4% in cycle 2. 8% patients required blood transfusion after 1st Day post-operative bloods in cycle 1 and 4% in cycle 2. Conclusion: Adherence to hospital guidelines is of paramount importance. Results depicted that if bloods are requested and taken timely, incidence of AKI can be reduced. Similarly, if blood components are required for transfusion, it can be done without any delays. Thus, post-operative complications can be minimized significantly..

Biography :

Hafiz Muhammad Nuheel Iqbal (Consultant Surgeon) Studied in Nottingham University Hospital-Queen Medical Centre, England.