scholarly journals 275 Feasibility and Patient Satisfaction of Intra-Detrusor Botulinum Toxin (Botox) Injections Under Local Anaesthetic (LA) In the Outpatient Setting

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Y C Tan ◽  
T Tien ◽  
N L Ow ◽  
S l Chowdhury
Keyword(s):  
Patient Satisfaction ◽  
Local Anaesthetic ◽  
Cost Savings ◽  
Outpatient Setting ◽  
General Anaesthetic ◽  
High Patient Satisfaction ◽  
Satisfaction Rate ◽  
Patient Pain ◽  
Improve Cost ◽  
Patient Satisfaction Rate

Abstract Introduction Intra-detrusor Botox injections for overactive bladder has shifted to being performed under local anaesthetic rather than general anaesthetic to improve cost and efficiency. However, it may cause the patient pain and discomfort. We aim to assess the feasibility of LA Botox injections in the outpatient setting and to evaluate patient satisfaction. Method Our first cycle assessed whether patients would consider intra-detrusor Botox injections under local anaesthetic in the outpatient setting. Our services were then restructured to run LA Botox clinics. Our second cycle then assessed the patient satisfaction of these clinics using the client satisfaction questionnaire (CSQ-8) template. Results The first cycle showed that 70% (14/20) of patients would consider having outpatient Botox injections under LA. A potential annual saving of £88,434 was estimated. The second cycle showed a high patient satisfaction rate with an average CSQ-8 score of 30/32 in 16 patients who had Botox injections in the outpatient setting. 9 patients reported being “very satisfied” with our service and the remainder reported being “mostly satisfied” Conclusions LA Botox injections in the clinic setting has a high patient satisfaction rate and can provide considerable cost savings. Suitable patients should have LA intra-detrusor Botox injections in the outpatient setting where possible.

SAFETY OF INTRAOSSEOUS ANESTHESIA IN DENTISTRY.

2020 ◽  
pp. 98-99
Author(s):  
Bogaevskaya O.Yu.
Keyword(s):  
Patient Satisfaction ◽  
Local Anesthetic ◽  
High Patient Satisfaction ◽  
Satisfaction Rate ◽  
Patient Satisfaction Rate

The aim is to increase safety and efficiency of intraosseous anesthesia by automated injectors. Duration of intraosseous anesthesia depends on the concentration of epinephrine in the local anesthetic. Intraosseous analgesia has a high patient satisfaction rate in terms of efficiency and comfort – more than 97%.

scholarly journals 907 Reduction of Nasal Fractures During COVID-19: A Single-Centre Experience

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Crotty ◽  
M Corbett ◽  
T Hussain ◽  
A Diaconescu ◽  
N Patil
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Local Anaesthetic ◽  
Regional Anaesthesia ◽  
Effective Alternative ◽  
General Anaesthetic ◽  
Single Centre ◽  
Pain Scores ◽  
Single Centre Experience ◽  
Nasal Fractures

Abstract Introduction The utilization of local or regional anaesthesia for manipulation of nasal fractures (MNF) avoids the need for general anaesthetic (GA), and the risk associated with instrumentation of the airway during the COVID-19 pandemic. Furthermore, MNF under local anaesthetic (LA) provides similar results with regards to cosmesis and patient satisfaction. We present our experience of performing MNF under LA during the COVID-19 pandemic. Method A single-centre, prospective study of all patients undergoing MNF under LA was conducted (13th July/20–11thSeptember/20). Following reduction, pain scores and patient satisfaction surveys were administered. Results A total of 25 patients (M/F:16/9, median age, 25.6yr (14-52yr)) were enrolled. The majority of patients received either one or two instillations of LA (n = 19, 76%). Pain reported during the MNF procedure was 4.4/10, whilst pain during LA administration was reported as 3.2/10. 80% of patients felt instillation of LA was less painful than expected. 88% of respondents tolerated the LA well, and only 8% would have opted for general anaesthetic. 24 (96%) participants were happy with the cosmetic result. Discussion MNF under LA is a safe and effective alternative to MNF under GA. More literature is needed to define the best method of administering LA prior to performing MNF.

scholarly journals Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Operative Time ◽  
Surgical Techniques ◽  
Satisfaction Rate ◽  
Areola Complex ◽  
Different Types ◽  
Aesthetic Results ◽  
The Mean ◽  
Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

Volar Plate Arthroplasty for Closed Proximal Interphalangeal Joint Injuries

1992 ◽  
Vol 17 (4) ◽  
pp. 422-428 ◽  
Author(s):  
G. DURHAM-SMITH ◽  
G. M. MCCARTEN
Keyword(s):  
Patient Satisfaction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plate ◽  
Middle Phalanx ◽  
Satisfaction Rate ◽  
Joint Injuries ◽  
Original Procedure ◽  
Patient Satisfaction Rate

The anatomy and histology of the volar plate at the proximal interphalangeal joint and the mechanism of fracture/subluxation of the base of the middle phalanx in closed proximal interphalangeal joint injuries is reviewed. Our current technique of repair for these injuries and its evolution from Eaton’s original procedure is described. The results of 71 cases of volar plate arthroplasty performed over a five-year period for fracture/subluxations of the proximal interphalangeal joints are presented with follow-up ranging from six months to four years. 62 (87%) patients achieved a stable pain-free joint with a range of motion from 5° to 95° within two months. Complications were uncommon and correctable with an overall eventual patient satisfaction rate of 94%.

Keller Arthroplasty: A Prospective Review

Foot & Ankle ◽  
1987 ◽  
Vol 8 (1) ◽  
pp. 46-54 ◽  
Author(s):  
T. R. Love ◽  
A. S. Whynot ◽  
I. Farine ◽  
M. Lavoie ◽  
L. Hunt ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Prospective Study ◽  
Hallux Valgus ◽  
Joint Pain ◽  
Female Patients ◽  
Satisfaction Rate ◽  
Level Of Activity ◽  
A Prospective Study ◽  
Patient Satisfaction Rate

A prospective study of the Keller procedure for hallux valgus was carried out on 44 female patients (75 feet) with an average age of 66 years. The average follow-up was 31 months (range, 12–64 months). The operation was effective in improving symptoms (joint pain and bunion tenderness), cosmesis, function (footwear and level of activity) and in decreasing the deformity. The operation did not have an influence on metatarsal calluses. Cock-up deformity was common postoperatively but did not affect the results. The overall patient satisfaction rate was 77%.

scholarly journals 1212 A Novel Approach to Alleviating Surgical Anxiety: QI Study in a Primary Care Government Centre

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Peri
Keyword(s):  
Patient Satisfaction ◽  
Support Groups ◽  
Elective Surgery ◽  
Treatment Modalities ◽  
Satisfaction Rate ◽  
Adequate Knowledge ◽  
Operative Care ◽  
Novel Approach ◽  
Pdsa Cycle ◽  
Patient Satisfaction Rate

Abstract Aim Surgical Anxiety is a challenging problem in the peri-operative care of a patient often leading to poor surgical outcomes and repeated visits by the patient to the hospital. Despite being well documented, in practice, it still remains the most neglected and haphazardly adopted part of patient care. This study aimed to make the overall experience of surgery, safer and pleasant to the patient by instituting a novel, multimodal and easy to follow protocol. Method A self-made questionnaire formed the source for data collection from 43 patients listed for elective surgery in a government setup, throughout the duration of their admission and review period. Patient satisfaction rate was assessed by re-audits, post implementation of changes via a Plan-Do-Study-Act (PDSA) cycle. The ease of protocol administration and sustainability were assessed from staff via an audit and it was further simplified to ensure adoption was easy and patient satisfaction rate remained high as well. Results Initial audit showed only 49% (n = 21) of patient satisfaction rate at the time of admission. Significant variations of > 90% (n = 39) patient satisfaction rate was noted post implementation of changes after the first PDSA cycle. A second PDSA cycle was instituted to simplify the protocol and post audit >90% acceptance rate from staff were noted. Conclusions Shared Decision Making, Peer Support Groups, Adequate knowledge of the treating surgeon, the disease, treatment modalities and complications instituted via a proper protocol helped to alleviate surgical anxiety and prepare a positive patient for surgery.

scholarly journals Clinical results of arthroscopic tight fibrous band release for adult moderate-to-severe gluteal fibrosis using anterior and posterior portals: a retrospective analysis of 118 consecutive cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shu-guang Gao ◽  
Wei-jie Liu ◽  
Ming Yang ◽  
Jing-ping Li ◽  
Chao Su ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Operation Time ◽  
Radiofrequency Energy ◽  
Fatty Tissue ◽  
Fibrous Band ◽  
Gluteal Muscle ◽  
Satisfaction Rate ◽  
Gluteal Fibrosis ◽  
Patient Satisfaction Rate

Abstract Background To evaluate the clinical outcomes of arthroscopic tight fibrous band release in the treatment of adult moderate-to-severe gluteal fibrosis using anterior and posterior portals during mid-term follow-up. Methods The data of 138 patients (58 males, 80 females) aged between 18 and 42 years (mean, 28.6 years), presenting with bilateral moderate-to-severe gluteal fibrosis (GF) from October 2013 to August 2019, was retrospectively analyzed. All patients underwent arthroscopic tight fibrous band release using anterior and posterior portals with radiofrequency energy. Under arthroscopic guidance through the posterior portal, we debrided the fatty tissue overlying the contracted band of the gluteal muscle and excised the contracted bands using a radiofrequency device introduced through the anterior portal. The pre- and post-operative gluteal muscle contracture disability (GD) scale and the patient satisfaction rate were compared to evaluate the curative effect of the operation. Results The average operation time was 18 min (range, 10–30 min) and the average blood loss was 4 ml (range, 2–10 ml) for unilateral arthroscopic release. Two cases of post-operative minimal hematomas, 2 cases of bruising and 2 cases of local subcutaneous edema were observed as early complications and were cured by conservative treatment. After surgery, all incisions healed in stage I, and no other complications such as wound infection, nerve and blood vessel injury were detected. One hundred eighteen patients were followed up for 6 to 72 months (mean, 36 months). No lateral instability of the hip was observed and all patients returned to normal gait. The degree of adduction of the hip joint in all these 118 patients was significantly improved relative to their pre-operative conditions. One hundred fifteen patients (97.5%) were able to crouch with knees close to each other after surgery. One hundred fourteen patients (96.6%) were able to cross the affected leg completely without any support. The GD scale was improved from 55.5 ± 10.6 before operation to 90.1 ± 5.2 at the last follow-up (p < 0.05). The patient satisfaction rate was 95.8%. Conclusion Arthroscopic tight fibrous band release using anterior and posterior portals is minimally invasive for adult moderate-to-severe gluteal fibrosis, with a high success rate, quick recovery after surgery and reliable medium-term effect.

scholarly journals Reducing Hospitalizations: Institution of Outpatient Infusional EPOCH-Based Chemotherapy at a Safety Net Hospital

2019 ◽  
Vol 15 (8) ◽  
pp. e644-e651 ◽  
Author(s):  
Neil Keshvani ◽  
Mary Hon ◽  
Arjun Gupta ◽  
Timothy J. Brown ◽  
Lonnie Roy ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Acquisition Cost ◽  
Drug Acquisition ◽  
Drug Acquisition Cost ◽  
Cost Savings ◽  
Safety Net ◽  
Patient Survey ◽  
Outpatient Setting ◽  
Chemotherapy Administration ◽  
Safety Net Hospital

PURPOSE: EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) -based chemotherapy is traditionally administered inpatient because of its complex 96-hour protocol and number of involved medications. These routine admissions are costly, disruptive, and isolating to patients. Here, we describe our experience transitioning from inpatient to outpatient ambulatory EPOCH-based chemotherapy in a safety-net hospital, associated cost savings, and patient perceptions. METHODS AND MATERIALS: Guidelines for chemotherapy administration and educational materials were developed by a multidisciplinary team of physicians, nurses, and pharmacists. Data were collected via chart review and costs via the finance department. Patient satisfaction with chemotherapy at home compared with hospitalization was measured on a Likert-type scale via direct-to-patient survey. RESULTS: From January 30, 2017, through January 30, 2018, 87 cycles of EPOCH-based chemotherapy were administered to 23 patients. Sixty-one ambulatory cycles (70%) were administered to 18 patients. Of 26 cycles administered in the hospital, 18 (69%) were the first cycle of treatment. Rates of inappropriate prophylactic antimicrobial prescription and laboratory testing were lower in the outpatient setting. Eight of nine patients surveyed preferred home chemotherapy to inpatient chemotherapy. Per-cycle drug costs were 57.6% lower in outpatients as a result of differences in the acquisition cost in the outpatient setting. In total, the transition to ambulatory EPOCH-based chemotherapy yielded 1-year savings of $502,030 and an estimated 336 days of avoided hospital confinement. CONCLUSION: Multiday ambulatory EPOCH-based regimens were successfully and safely administered in our safety-net hospital. Outpatient therapy was associated with significant savings through avoided hospitalizations and reductions in drug acquisition cost and improved patient satisfaction.

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