Cargando…

Optimising calcium monitoring post thyroid and parathyroid surgery

There is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Ex...

Descripción completa

Detalles Bibliográficos
Autores principales: Rayner, Eleanor, Williams, Nerida, Dunn, Julie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645811/
https://www.ncbi.nlm.nih.gov/pubmed/26732097
http://dx.doi.org/10.1136/bmjquality.u204844.w2048
_version_ 1782400870617448448
author Rayner, Eleanor
Williams, Nerida
Dunn, Julie
author_facet Rayner, Eleanor
Williams, Nerida
Dunn, Julie
author_sort Rayner, Eleanor
collection PubMed
description There is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Exeter (RD&E) Hospital over a ten month period in 2013. A retrospective audit was undertaken, identifying whether serum calcium was monitored according to guideline; ie measured within the first 24 hours of surgery and daily thereafter until the patient was normocalcaemic.[2–3] The audit showed an overall compliance in 79% (n = 34) of cases. Of the non-compliant cases (n=9), seven also suffered hypocalcaemia. The current process was mapped by a flow chart and used as a basis for discussing experiences and identifying areas for improvement. Interventions implemented included a patient leaflet, a process flow chart displayed in the team office and in the weekend handover book, standard text for use in discharge summaries describing the process to GPs, the issuing of prescriptions or actual supplements for patients felt to be at high risk of hypocalcaemia, and finally education to the wider surgical junior doctor team. Percentage compliance with guidelines was compared before and after intervention with a re-audit undertaken in April 2014. Significant improvement was shown, with 100% of re-audit cases compliant (n=41), and all seven cases of hypocalcaemia were managed in full compliance with guideline.
format Online
Article
Text
id pubmed-4645811
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher British Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-46458112016-01-05 Optimising calcium monitoring post thyroid and parathyroid surgery Rayner, Eleanor Williams, Nerida Dunn, Julie BMJ Qual Improv Rep BMJ Quality Improvement Programme There is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Exeter (RD&E) Hospital over a ten month period in 2013. A retrospective audit was undertaken, identifying whether serum calcium was monitored according to guideline; ie measured within the first 24 hours of surgery and daily thereafter until the patient was normocalcaemic.[2–3] The audit showed an overall compliance in 79% (n = 34) of cases. Of the non-compliant cases (n=9), seven also suffered hypocalcaemia. The current process was mapped by a flow chart and used as a basis for discussing experiences and identifying areas for improvement. Interventions implemented included a patient leaflet, a process flow chart displayed in the team office and in the weekend handover book, standard text for use in discharge summaries describing the process to GPs, the issuing of prescriptions or actual supplements for patients felt to be at high risk of hypocalcaemia, and finally education to the wider surgical junior doctor team. Percentage compliance with guidelines was compared before and after intervention with a re-audit undertaken in April 2014. Significant improvement was shown, with 100% of re-audit cases compliant (n=41), and all seven cases of hypocalcaemia were managed in full compliance with guideline. British Publishing Group 2014-10-29 /pmc/articles/PMC4645811/ /pubmed/26732097 http://dx.doi.org/10.1136/bmjquality.u204844.w2048 Text en © 2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode
spellingShingle BMJ Quality Improvement Programme
Rayner, Eleanor
Williams, Nerida
Dunn, Julie
Optimising calcium monitoring post thyroid and parathyroid surgery
title Optimising calcium monitoring post thyroid and parathyroid surgery
title_full Optimising calcium monitoring post thyroid and parathyroid surgery
title_fullStr Optimising calcium monitoring post thyroid and parathyroid surgery
title_full_unstemmed Optimising calcium monitoring post thyroid and parathyroid surgery
title_short Optimising calcium monitoring post thyroid and parathyroid surgery
title_sort optimising calcium monitoring post thyroid and parathyroid surgery
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645811/
https://www.ncbi.nlm.nih.gov/pubmed/26732097
http://dx.doi.org/10.1136/bmjquality.u204844.w2048
work_keys_str_mv AT raynereleanor optimisingcalciummonitoringpostthyroidandparathyroidsurgery
AT williamsnerida optimisingcalciummonitoringpostthyroidandparathyroidsurgery
AT dunnjulie optimisingcalciummonitoringpostthyroidandparathyroidsurgery