EP.FRI.583 Re-Audit of the Quality of Operation Notes

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Orlaith McAuliffe ◽  
Ahmed Aboulela ◽  
Mohamed Mohamed
Keyword(s):  
Blood Loss ◽  
Surgical Patients ◽  
High Quality ◽  
Surgical Practice ◽  
Intraoperative Diagnosis ◽  
Retrospective Audit ◽  
Safe Management ◽  
Audit Data ◽  
Estimated Blood Loss

Abstract Aims High quality operation notes are crucial for the safe management of surgical patients. The Royal College of Surgeons Good Surgical Practice (2014) describes eighteen separate pieces of information that should be included in operation notes. Our aim was to determine whether the quality of operation notes have improved since the introduction in our hospital in 2015 of an electronic proforma to record these notes. Methods We conducted a retrospective audit of operation notes between 28th October and 19th November 2020 based on the RCS guidelines. These results were compared to those of our 2015 audit. Results Of the seventy eight operation notes analysed in this re-audit, twenty eight percent were produced using the electronic proforma compared to forty five percent in 2015. In our re-audit a significantly higher proportion of notes had records of whether operations were elective or emergency (p < 0.01), intraoperative diagnosis (p < 0.01) and estimated blood loss (p < 0.05).Compared to the 2015 audit data there was a significant improvement in recording whether or not the surgery was elective or emergency (p < 0.0001). Conclusion In this audit we noted a disappointing decrease in proportion of operation notes that were produced using the electronic proforma. We also noted that operation notes produced using the electronic proforma were of higher quality compared to those that were not. We need to increase awareness amongst surgeons in our hospital of the benefits of using the electronic proforma to improve the quality of operation notes.

scholarly journals 1434 An Audit of Surgical Consent Standards in Patients Undergoing Elective ENT Surgery

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T Shivabalendran ◽  
U Ahmed ◽  
A Eweiss ◽  
H Kaddour
Keyword(s):  
Patient Information ◽  
Additional Data ◽  
Sufficient Time ◽  
Surgical Practice ◽  
Face To Face ◽  
Patient Information Leaflets ◽  
Information Leaflets ◽  
Ent Surgery ◽  
Retrospective Audit

Abstract Aim Good Surgical Practice (RCS England) and GMC guidelines inform a surgeon’s practice in the consent process for an operation. Since the Covid-19 pandemic, many surgical departments have converted from face-to-face to telephonic consultations. The clinic letter is of increased importance given that it forms a key part of the medical record which the patient should receive to ensure sufficient time and information to make an informed decision. Method Clinic letters of patients undergoing elective ENT surgery at our trust over a four-week period were examined in this retrospective audit of compliance with RCSEng and GMC guidelines. Additional data was collected on clinician grade and proportion of letters sent to patients. Patients rated satisfaction with consultation on a five-point Likert scale. Results 135 eligible patients were included in our audit and the majority were listed by a consultant (57%). In all domains, consultant letters were more likely to be comprehensive as compared to registrars. Overall quality of clinic letters was highly variable regarding documentation of diagnosis (52%), surgical risks (50%), discussion of alternative or no treatment (30%) and registrar discussion with consultant (31%). There was also a stark difference between registrars and consultants sending patients copies of clinic letters (10% vs 47%). Only 10% of patients received a leaflet on their condition. 90% of patients were either satisfied or very satisfied with their clinic consultation. Conclusions Refresher sessions on consent, updated template letters and increased provision of patient information leaflets will be introduced to the ENT department, and improvements monitored with further re-audit.

Quality management in the prophylaxis of venous thrombembolism - Results of a survey including 464 medical and surgical patients

VASA ◽  
2011 ◽  
Vol 40 (2) ◽  
pp. 123-130
Author(s):  
Klein-Weigel ◽  
Richter ◽  
Arendt ◽  
Gerdsen ◽  
Härtwig ◽  
...  
Keyword(s):  
Renal Function ◽  
High Risk ◽  
Quality Management ◽  
High Risk Group ◽  
Surgical Patients ◽  
Medical Patients ◽  
Risk Status ◽  
Vte Prophylaxis ◽  
Safety Concerns

Background: We surveyed the quality of risk stratification politics and monitored the rate of entries to our company-wide protocol for venous thrombembolism (VTE) prophylaxis in order to identify safety concerns. Patients and methods: Audit in 464 medical and surgical patients to evaluate quality of VTE prophylaxis. Results: Patients were classified as low 146 (31 %), medium 101 (22 %), and high risk cases 217 (47 %). Of these 262 (56.5 %) were treated according to their risk status and in accordance with our protocol, while 9 more patients were treated according to their risk status but off-protocol. Overtreatment was identified in 73 (15.7 %), undertreatment in 120 (25,9 %) of all patients. The rate of incorrect prophylaxis was significantly different between the risk categories, with more patients of the high-risk group receiving inadequate medical prophylaxis (data not shown; p = 0.038). Renal function was analyzed in 392 (84.5 %) patients. In those patients with known renal function 26 (6.6 %) received improper medical prophylaxis. If cases were added in whom prophylaxis was started without previous creatinine control, renal function was not correctly taken into account in 49 (10.6 %) of all patients. Moreover, deterioration of renal function was not excluded within one week in 78 patients (16.8 %) and blood count was not re-checked in 45 (9.7 %) of all patients after one week. There were more overtreatments in surgical (n = 53/278) and more undertreatments in medical patients (n = 54/186) (p = 0.04). Surgeons neglected renal function and blood controls significantly more often than medical doctors (p-values for both < 0.05). Conclusions: We found a low adherence with our protocol and substantial over- and undertreatment in VTE prophylaxis. Besides, we identified disregarding of renal function and safety laboratory examinations as additional safety concerns. To identify safety problems associated with medical VTE prophylaxis and “hot spots” quality management-audits proved to be valuable instruments.

Influence of technology parameters of free-cutting steel continuous casting on the billet internal structure

2020 ◽  
Vol 76 (2) ◽  
pp. 139-142
Author(s):  
A. T. Kunakbaeva ◽  
A. M. Stolyarov ◽  
M. V. Potapova
Keyword(s):  
Regression Analysis ◽  
Continuous Casting ◽  
Internal Structure ◽  
Sulfur Content ◽  
Manganese Content ◽  
High Quality ◽  
Correlation And Regression Analysis ◽  
Cutting Steel ◽  
Continuously Cast

Free-cutting steel gains specific working properties thanks to the high content of sulfur and phosphorus. These elements, especially sulfur, have a rather high tendency to segregation. Therefore, segregation defects in free-cutting steel continuously cast billets can be significantly developed. The aim of the work was to study the influence of the chemical composition of freecutting steel and casting technological parameters on the quality of the macrostructure of continuously cast billets. A metallographic assessment of the internal structure of cast metal made of free-cutting steel and data processing by application of correlation and regression analysis were the research methods. The array of production data of 43 heats of free-cutting steel of grade A12 was studied. Steel casting on a five-strand radial type continuous casting machine was carried out by various methods of metal pouring from tundish into the molds. Metal of 19 heats was poured with an open stream, and 24 heats – by a closed stream through submerged nozzles with a vertical hole. High-quality billets had a cross-sectional size of 150×150 mm. The macrostructure of high-quality square billets made of free-cutting steel of A12 grade is characterized by the presence of central porosity, axial segregation and peripheral point contamination, the degree of development of which was in the range from 1.5 to 2.0 points, segregation cracks and strips – about 1.0 points. In the course of casting with an open stream, almost all of these defects are more developed comparing with the casting by a closed stream. As a result of correlation and regression analysis, linear dependences of the development degree of segregation cracks and strips both axial and angular on the sulfur content in steel and on the ratio of manganese content to sulfur content were established. The degree of these defects development increases with growing of sulfur content in steel of A12 grade. These defects had especially strong development when sulfur content in steel was of more than 0.10%. To improve the quality of cast metal, it is necessary to have the ratio of the manganese content to the sulfur content in the metal more than eight.

Experience of clinical testing of personal telemedicine system ‘Obereg’ for remote monitoring of patients in intensive care units

2020 ◽  
pp. 52-58 ◽  
Author(s):  
A. A. Eryomenko ◽  
N. V. Rostunova ◽  
S. A. Budagyan ◽  
V. V. Stets
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Remote Monitoring ◽  
Clinical Testing ◽  
Transportation Of Patients ◽  
High Quality ◽  
Telemedicine System ◽  
Accuracy Of Measurements ◽  
Hospital Equipment

The experience of clinical testing of the personal telemedicine system ‘Obereg’ for remote monitoring of patients at the intensive care units of leading Russian clinics is described. The high quality of communication with the remote receiving devices of doctors, the accuracy of measurements, resistance to interference from various hospital equipment and the absence of its own impact on such equipment were confirmed. There are significant advantages compared to stationary patient monitors, in particular, for intra and out-of-hospital transportation of patients.

METHODOLOGICAL ASPECTS OF VISUALIZATION OF CORONARY ARTERIES WITH TRANSTHORACIC ECHOCARDIOGRAPHY

2018 ◽  
pp. 26-35
Author(s):  
Z. A. Agaeva ◽  
K. B. Baghdasaryan
Keyword(s):  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Arteries ◽  
Transthoracic Echocardiography ◽  
Second Harmonic ◽  
Anatomic Reconstruction ◽  
High Quality ◽  
Acoustic Window ◽  
Methodological Aspects

The transthoracic echocardiography made by multifrequency probes with support of the mode of the second harmonic imaging, is a competitive method for visualization of the main coronary arteries and allows to estimate coronary blood flow with high quality. Of course, the method has considerable restrictions, most important of which is the low spatial resolution of a method, due to small acoustic window. Because of this the transthoracic visualization of coronary arteries perhaps will not become the leading method of anatomic reconstruction of separately taken coronary artery and especially all coronary arteries system. However uniqueness and indisputable advantage of this method is an opportunity to noninvasively estimate a coronary blood flow both once, and in dynamics.

Estimates on poverty in Russia and the additional measures to reduce it at the regional level

2020 ◽  
Vol 18 (4) ◽  
pp. 739-752 ◽  
Author(s):  
R.M. Sadykov
Keyword(s):  
Poverty Rate ◽  
Regional Level ◽  
Living Standards ◽  
Standard Of Living ◽  
High Quality ◽  
Social Standard ◽  
Republic Of Bashkortostan ◽  
The Republic ◽  
Sociological Studies

Subject. This article deals with the issues of social justice and a high quality of life, creating favorable economic and social conditions. Objectives. The article aims to assess the rate and changes in poverty in Russia and the Republic of Bashkortostan and develop complementary measures to reduce it. Methods. For the study, I used the methods of logical, comparative, economic and statistical analyses, the results of sociological studies, and official statistics. Results. The article highlights additional measures to reduce poverty in the region, including the establishment of a minimum social standard of living in each particular region that determines the poverty rate. Conclusions. Various factors, such as economic sanctions, economic slowdowns, territorial and regional imbalances, lead to living standards decline and poverty rise.

SCIENTIFIC BASIS OF POSTGRADUATE TRAINING FOR OFFICER WORKING ETHNIC AFFAIRS USING STATE BUDGET IN THE PERIOD OF 2018 – 2025

2017 ◽  
Author(s):  
La Duc Minh ◽  
Nguyen Thi Hao ◽  
Vu Thi Thuy
Keyword(s):  
Economic Development ◽  
Ethnic Groups ◽  
Human Resource ◽  
Postgraduate Training ◽  
Scientific Basis ◽  
National Defense ◽  
High Quality ◽  
State Budget ◽  
International Integration

Ethnic affairs play an important role in socio of ethnic groups’ solidarity, assurance of security and national defense stability. In -economic development, maintenanceorder to improve the quality of ethnic affairs, it is practical to carry out postgraduate training of officer implementing ethnic affairs using state budget with the aim of encouraging and enhancing officer quality to satisfy high-quality human resource in international integration.

Удобрение перца сладкого

2018 ◽  
Author(s):  
V.A. Borisov ◽  
A.M. Menshikh ◽  
V.S. Sosnov ◽  
G.F. Monakhos
Keyword(s):  
Drip Irrigation ◽  
Sweet Pepper ◽  
Water Soluble ◽  
Mineral Fertilizers ◽  
High Quality ◽  
Organic Mineral ◽  
Soluble Fertilizer

Показано действие минеральных удобрений, микрокристаллического комплексного водорастворимого удобрения «Мастер» и органоминерального наноудобрения с ростостимулирующей активностью «Арксойл» при капельном орошении на урожайность и качество сладкого перца нового гибрида F1 Темп. Сочетание основного удобрения с листовой и корневой подкормками позволяет получить до 65 т/га плодов перца высокого качества.The action of mineral fertilizers, microcrystalline complex water soluble fertilizer Master and organic mineral nano-fertilizer with growth-stimulating activity Arksoil under drip irrigation on the productivity and quality of sweet pepper of the new hybrid F1 Temp is shown. The combination of basic fertilizer with leaf and root fertilizing allows to obtain up to 65 t/ha of pepper fruits of high quality.

Child Diagnosis of Autism - How It Can Change the Family Life

2017 ◽  
Vol 5 (1) ◽  
pp. 498
Author(s):  
Maria Stănescu
Keyword(s):  
Early Intervention ◽  
Family Life ◽  
Social Life ◽  
Decisive Role ◽  
Autistic Children ◽  
Child Behaviors ◽  
High Quality ◽  
Child Diagnosis ◽  
The Family

The article is about the role of the family in the education and formation of children and, especially, in the life and development of autistic children. It describes the problems their family is facing and the need for counseling to parents with autistic children. The reaction to finding the diagnosis of autism varies from one family to another and may encounter a large variety: from disbelief, anger, guilt, helplessness, devastation, surprise, or even rejection of the child, to understanding and relief when finally the parents have an explanation for their child behaviors. Early intervention is important in psychological sustaining of the parent, as parent involvement in the recovery of the child with autism has a determinant role in his development and in ensuring a high quality of life of the child and the life of the hole family. The response to a child's autism diagnosis varies from one family to another. The family goes through a variety of disbelief, anger, guilt, helplessness, devastation, surprise, or even rejection of the child, to understanding and relief. Early intervention is very important in the psychological support of the parent. Because any change disturbs the family equilibrium. A diagnosis of autism changes not only the life of the diagnosed child, but also the life of family members. All the resources are focused on the need of the child. Although each parent is different, after diagnosing the child with autism, all parents are overwhelmed by confusion, shock and denial. Parents' feelings can be influenced by how their children's situation affects different aspects of life - it has an impact on service, on social life and all their personal life. If we look at the family as a system and when a disturbing factor appears, all parts of the system are affected. The involvement of parents in the recovery of the child with autism has a decisive role in its development and in ensuring a high quality of child's life and family life.

REORGANIZATION OF A MULTI-SPECIALTY HOSPITAL IN AN UNFAVORABLE EPIDEMIOLOGICAL SITUATION

2020 ◽  
pp. 43-46
Author(s):  
Nikitin A.E. ◽  
Znamenskiy I.А ◽  
Shikhova Yu.A. ◽  
Kuzmina I.V. ◽  
Melchenko D.S. ◽  
...  
Keyword(s):  
Contact Time ◽  
Laboratory Diagnostics ◽  
Protective Equipment ◽  
Timely Manner ◽  
High Quality ◽  
Institu Tions ◽  
Quality Of Medical Care ◽  
Spread Of Infection ◽  
Epidemiological Situation

This study provides a retrospective analysis of work to ensure high quality of medical care in an unfavorable epidemic situation. The consequence of COVID-19 was the implementation of a program to prevent the spread of infection, the re-profiling of medical institu-tions, and the introduction of restrictive and anti-epidemic measures. The experience of our work has shown the effectiveness of changing the order of med-ical care, the organization of the functioning of de-partments and patient routing. The study reflects the measures implemented in the hospital departments, the Department of clinical and laboratory diagnostics, radiation diagnostics and pathology Department. To ensure the safety of patients, it was decided to place patients on a single bed according to the type of infec-tious boxes. The safety of employees was ensured by the use of personal protective equipment, minimiza-tion of contact time with patients, and preventive weekly examination of staff for SARS-CoV-2 infection. The organized and well-coordinated work of the en-tire staff of the institution made it possible to prevent the spread of COVID-19 among employees, to detect cases of infection in a timely manner, and to carry out appropriate isolation and monitoring measures. At the time of completion of infectious diseases departments, the mortality rate among patients was less than 9%. Our experience in reorganizing a multi-specialty facil-ity can be used in the future when working with pa-tients who have undergone COVID-19, as well as in the context of a worsening epidemic situation.

Sign in / Sign up

Export Citation Format

Share Document