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Reducing returns to theatre for neck of femur fracture patients

The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased length...

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Autores principales: Graham, Selina, Dahill, Mark, Robinson, Derek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411718/
https://www.ncbi.nlm.nih.gov/pubmed/28469902
http://dx.doi.org/10.1136/bmjquality.u215756.w6261
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author Graham, Selina
Dahill, Mark
Robinson, Derek
author_facet Graham, Selina
Dahill, Mark
Robinson, Derek
author_sort Graham, Selina
collection PubMed
description The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians. The plan-do-study-act model for improvement was used to reduce rates of returns to theatre for wound ooze. Interventions included cyclical teaching during each trainee rotation, updated inductions, posters, email reminders and scrub team involvement to open the protocol sutures unprompted. The primary outcome measure was returns to theatre for wound complications. Baseline data showed 4 returns to theatre over a two month period (4.40% of patients). Length of stay for each patient affected by wound ooze was also compared to the departmental mean. In the 6 month intervention period there was one return to theatre (0.36% of patients). The observed reduction saved the department an estimated £13,831 in length of stay alone. The standardisation of wound closure protocol, with continued reinforcement to all members of the multidisciplinary team, improves patient outcome in this group. Mobilising a group of clinicians across a variety of specialities, with one common goal, is highly effective for patients, improves multidisciplinary working and reduces cost.
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spelling pubmed-54117182017-05-03 Reducing returns to theatre for neck of femur fracture patients Graham, Selina Dahill, Mark Robinson, Derek BMJ Qual Improv Rep BMJ Quality Improvement Programme The Royal United Hospital, Bath, admits approximately 550 patients with neck of femur fractures per year. The risks from returning to theatre for this patient group are often life-threatening. Post-operative wound ooze was noted to cause a significant rate of return to theatre, with increased lengths of stay and patient morbidity. A wound closure protocol was agreed by the consultant body. This information was disseminated by email and teaching sessions to all members of the multidisciplinary team, including surgeons, theatre staff and ortho-geriatricians. The plan-do-study-act model for improvement was used to reduce rates of returns to theatre for wound ooze. Interventions included cyclical teaching during each trainee rotation, updated inductions, posters, email reminders and scrub team involvement to open the protocol sutures unprompted. The primary outcome measure was returns to theatre for wound complications. Baseline data showed 4 returns to theatre over a two month period (4.40% of patients). Length of stay for each patient affected by wound ooze was also compared to the departmental mean. In the 6 month intervention period there was one return to theatre (0.36% of patients). The observed reduction saved the department an estimated £13,831 in length of stay alone. The standardisation of wound closure protocol, with continued reinforcement to all members of the multidisciplinary team, improves patient outcome in this group. Mobilising a group of clinicians across a variety of specialities, with one common goal, is highly effective for patients, improves multidisciplinary working and reduces cost. British Publishing Group 2017-04-27 /pmc/articles/PMC5411718/ /pubmed/28469902 http://dx.doi.org/10.1136/bmjquality.u215756.w6261 Text en © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 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
Graham, Selina
Dahill, Mark
Robinson, Derek
Reducing returns to theatre for neck of femur fracture patients
title Reducing returns to theatre for neck of femur fracture patients
title_full Reducing returns to theatre for neck of femur fracture patients
title_fullStr Reducing returns to theatre for neck of femur fracture patients
title_full_unstemmed Reducing returns to theatre for neck of femur fracture patients
title_short Reducing returns to theatre for neck of femur fracture patients
title_sort reducing returns to theatre for neck of femur fracture patients
topic BMJ Quality Improvement Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411718/
https://www.ncbi.nlm.nih.gov/pubmed/28469902
http://dx.doi.org/10.1136/bmjquality.u215756.w6261
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