scholarly journals 239 An Audit on The Consenting Process For Orthopaedic Surgery During The COVID Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Manoharan ◽  
J Edakalathur ◽  
P Akhbari ◽  
R Potter
Keyword(s):  
Length Of Stay ◽  
Royal College ◽  
Potential Risk ◽  
Orthopaedic Surgery ◽  
Prospective Audit ◽  
Consent Forms ◽  
Elective Surgical Procedures ◽  
Orthopaedic Patients ◽  
Compliance Level ◽  
Hygiene Measures

Abstract Aim The Royal College of Surgeons have published guidelines on consenting for treatment of patients when COVID-19 is present in society. Patients should be made aware that attending hospital for elective surgical procedures exposes them to the risk of contracting COVID-19, despite the stringent health and hygiene measures employed by hospitals and their staff. Our aim is to investigate whether orthopaedic patients are being appropriately consented for surgery during the COVID pandemic. Method A prospective audit of 100 consent forms was performed. The forms were examined to identify whether COVID-19 risk was documented as a potential risk of surgery. Data was also collected on consented grade, patient length of stay and any complications post-operatively. Results 56% of consent forms reviewed did not contain the risk of COVID documented in them. 34% of forms that did not state COVID risk were completed by consultants, 18% by fellows and 48% were by registrars. 24% of these patients had an in-patient length of stay of 3 or more days. 6% patients were suspected of COVID post-operatively and tested. 0% patients contracted COVID in this cohort. Conclusions The Royal College of Surgeons COVID-19 Toolkit states that the risk of contracting COVID while in hospital is 0.45%. All patients should be made aware of this risk prior to proceeding with surgery. Only 44% of patients in our hospital have had this risk discussed and documented. This compliance level has to be significantly improved.

scholarly journals Assessing the adequacy of procedure-specific consent forms in orthopaedic surgery against current methods of operative consent

2010 ◽  
Vol 92 (3) ◽  
pp. 246-249 ◽  
Author(s):  
Andrew W Barritt ◽  
Laura Clark ◽  
Victoria Teoh ◽  
Adam MM Cohen ◽  
Paul A Gibb
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Orthopaedic Surgery ◽  
Knee Arthroscopy ◽  
Information Provision ◽  
Prospective Audit ◽  
Consent Forms ◽  
Total Knee ◽  
Audit Cycle ◽  
British Orthopaedic Association

INTRODUCTION This is an audit of patient understanding following their consent for orthopaedic procedures and uses information on new Orthoconsent forms endorsed by the British Orthopaedic Association as the set standard. The objectives were to: (i) assess whether patients& understanding of knee arthroscopy (KA) and total knee replacement (TKR) at the point of confirming their consent reaches the set standard; and (ii) to ascertain whether issuing procedure-specific Orthoconsent forms to patients can improve this understanding. SUBJECTS AND METHODS This was a prospective audit using questionnaires consisting of 26 (for KA) or 35 (for TKR) questions based on the appropriate Orthoconsent form in a department of orthopaedic surgery within a UK hospital. Participants were 100 patients undergoing KA and 60 patients undergoing TKR between February and July 2008. Participants were identified from sequential operating lists and all had capacity to give consent. During the first audit cycle, consent was discussed with the patient and documented on standard yellow NHS Trust approved generic consent forms. During the second audit cycle, patients were additionally supplied with the appropriate procedure-specific consent form downloaded from < www.orthoconsent.com > which they were required to read at home and sign on the morning of surgery. RESULTS Knee arthroscopy patients consented with only the standard yellow forms scored an average of 56.7%, rising to 80.5% with use of Orthoconsent forms. Similarly, total knee replacement patients& averages rose from 57.6% to 81.6%. CONCLUSIONS Providing patients with an Orthoconsent form significantly improves knowledge of their planned procedure as well as constituting a more robust means of information provision and consent documentation.

scholarly journals EP.WE.568Compliance with the Royal College of Surgeons of England Guidelines on the Surgical Consenting Process in the Era of the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Boluwatife Ayantunde ◽  
Danielle Clyde ◽  
Gregory Ekatah
Keyword(s):  
Informed Consent ◽  
General Hospital ◽  
Surgical Procedures ◽  
Royal College ◽  
District General Hospital ◽  
Informed Consent Process ◽  
Consent Process ◽  
Prospective Audit ◽  
Consent Forms

Abstract Aims Due to the current COVID-19 pandemic, The Royal College of Surgeons of England released guidelines advising on additional considerations which should be discussed with patients as part of the informed consent process prior to surgery. We conducted a prospective audit on whether COVID-19 infection was mentioned as a possible complication during the consenting process for patients undergoing emergency and elective general surgical procedures at a District General Hospital. Methodology We prospectively collected data on the patients admitted for surgical procedures over a 2-week period. Consent forms were reviewed noting whether COVID-19 infection was listed as a possible complication. Results 35 patients were audited with a median age of 54 (12-94) years including 17 males and 18 females. Patients presented with varying surgical diagnoses, with 16 and 19 undergoing emergency and elective operations, respectively. 77.1% (27) of patients had COVID-19 infection mentioned as a possible complication on their consent forms. Five out of six consent forms completed by Clinical Fellows or CT trainees, 10 out of 13 by Registrars, 12 out of 16 by Consultants mentioned COVID-19 infection. We found no significant correlation between the grade of the consent taker and COVID-19 infection being mentioned as a possible complication. Conclusion Most of the consent takers were aware of the guidelines and mentioned COVID-19 infection as a possible complication during consenting. However, this awareness could be expanded. The results will be presented to the department before a plan to re-audit and close the loop in a few weeks.

The impact of the novel coronavirus on trauma and orthopaedics in the UK

2020 ◽  
Vol 81 (4) ◽  
pp. 1-6 ◽  
Author(s):  
Catrin Morgan ◽  
Aashish K Ahluwalia ◽  
Arash Aframian ◽  
Lily Li ◽  
Stephen Ng Man Sun
Keyword(s):  
Orthopaedic Surgery ◽  
Musculoskeletal Injury ◽  
The Novel ◽  
Front Line ◽  
Orthopaedic Patients ◽  
Novel Coronavirus ◽  
Injury Burden ◽  
The Uk ◽  
The Impact ◽  
British Orthopaedic Association

At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.

scholarly journals Perioperative Prophylactic Antibiotics in Orthopaedic Surgery

2013 ◽  
Vol 3 (1) ◽  
pp. 5-10
Author(s):  
Bikram Prasad Shrestha ◽  
Surya Raj Niraula ◽  
Parvin Nepal ◽  
Guru Prasad Khanal ◽  
Navin Karn ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Drug Resistant ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Randomized Controlled ◽  
Orthopaedic Patients ◽  
Significant Difference

Introduction: In our country, various institutes have different protocols for postoperative antibiotics. Many western literature have mentioned that administration of prophylactic antibiotics for longer than 24 hours has no advantage and may actually lead to superinfection with drug-resistant organisms. Because of environmental and theater condition most of the surgeon here are very reluctant to use prophylactic antibiotics for only 24 hours. The objective of the study was to find out the effect of duration of prophylactic antibiotics on the rate of surgical site infection in clean elective orthopaedic surgeries. Methods: This was a randomized controlled trial involving 207 clean elective orthopaedic patients undergoing surgery. The patients were divided into three groups which received intravenous prophylactic antibiotics for 24 hours, 48 hours and 48 hours followed by 7 days of oral antibiotics respectively. The patients were followed up for three months postoperatively. Result: There was no significant difference in the rate of surgical site infection among the three groups. Conclusion: We conclude that there is no benefit in prolonging prophylactic antibiotics beyond 24 hours. DOI: http://dx.doi.org/10.3126/noaj.v3i1.9318   Nepal Orthopedic Association Journal 2013 Vol.3(1): 5-10

Consenting patients for orthopaedic surgery: Is there need for change?

2018 ◽  
Vol 29 (9) ◽  
pp. 300-305
Author(s):  
Epaminondas M Valsamis ◽  
Christopher Thornhill ◽  
Jay Watson ◽  
Shivun Khosla ◽  
Benedict Rogers ◽  
...  
Keyword(s):  
United Kingdom ◽  
Surgical Procedure ◽  
Orthopaedic Surgery ◽  
Major Trauma ◽  
Trauma Centre ◽  
Consent Forms ◽  
Mandatory Training ◽  
The United Kingdom ◽  
Major Trauma Centre ◽  
Level Of Understanding

An adequate consent form must be completed prior to a planned surgical procedure. Consent forms are mandatory, but the form itself does not reflect or quantify the adequacy of the discussion between surgeon and patient or the patient’s level of understanding. This study audited the adequate completion of consent forms for orthopaedic operations at a Major Trauma Centre in the United Kingdom. We also suggested recommendations regarding the completion of consent forms and proposed that tuition concerning the consent process be included as part of mandatory training for surgeons.

Sepsis in orthopaedic surgery: epidemiology, microbiology, treatment, consequences

2012 ◽  
Vol 19 (3) ◽  
pp. 163-165
Author(s):  
Iveta Golubovska ◽  
Elena Solovjova ◽  
Dace Vigante ◽  
Aleksejs Miscuks ◽  
Vitolds Jurkevics
Keyword(s):  
Orthopaedic Surgery ◽  
Microbial Culture ◽  
Source Of Infection ◽  
Orthopaedic Patients ◽  
Septic Inflammation ◽  
History Of ◽  
History Of Pain ◽  
Picco Monitoring ◽  
Overall Mortality ◽  
Severe Septic Shock

Background. Musculoskeletal sepsis is a region of orthopaedic surgery focused on the diagnosis and treatment of infections involving the bones, joints, muscles, and skin. The objective of our study was to point out things that should be taken into account by physicians faced with probable musculoskeletal sepsis. Materials and methods. A retrospective study was carried out and included all of the orthopaedic patients with positive blood culture between January 1, 2009 and March 31, 2012 who were admitted to the Hospital of Traumatology and Orthopaedics. Results. In total, thirty five patients were hospitalized. Thirty one patients met the criteria for admission to the ICU. The median time spent in the ICU was 8 days with a range from 1 to 70. The source of infection was recognized in twenty five patients, it was not obvious for six patients. Moderate or severe septic shock developed in nineteen (61.3%) patients, twenty four (77.4%) required invasive monitoring, five PICCO monitoring, three of them required continuous haemodialysis. Overall mortality was 19.4% (six patients). 58.1% were artificially ventilated from 1 to 46 days. The main microbial culture was Staphylococcus aureus (45.2%), the second one was Clebsiella pneumoniae (12.9%), the third microbial cultures were Escherichia coli and Enterobacter cloacae (6.5%). More prevalent risk factors were diabetes mellitus, oncologic disease, ischemic heart disease and adipositas. Conclusions. Patients with a history of pain, swollen and tender joints, extremities or back with restriction of movement should be regarded as having septic inflammation until proven otherwise. We should always take into account orthopaedic sepsis if any other source is not obvious.

scholarly journals Recognising and dealing with complications in orthopaedic surgery

2017 ◽  
Vol 99 (3) ◽  
pp. 185-188 ◽  
Author(s):  
D Ricketts ◽  
RA Rogers ◽  
T Roper ◽  
X Ge
Keyword(s):  
Royal College ◽  
Orthopaedic Surgery ◽  
Data Interpretation ◽  
Accurate Data ◽  
Orthopaedic Surgeons

Orthopaedic surgeons need information about the complications they are likely to encounter. The literature on complications is difficult to interpret owing to a lack of agreed definitions, problems with collecting accurate data and with data interpretation. We suggest a role for the Royal College of Surgeons and specialist societies in collecting and interpreting complications data.

Informed consent for orthopaedic surgery: a prospective audit

2003 ◽  
Vol 8 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Pankaj Sharma ◽  
Anand Arya ◽  
Samrendu Singh
Keyword(s):  
Informed Consent ◽  
Orthopaedic Surgery ◽  
Prospective Audit
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