Elective surgery cancellations due to suboptimal medicine management: a retrospective single site study

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research Pub Date : 2023-08-21 DOI:10.1002/jppr.1876

Kate Elizabeth Doreen Ziser BPharm, GradDdpEd APP[II], MClinPharm, Jessica Barbara King BPharm, Natasha Alkass BPharm, Jane Elizabeth Dunsdon BPharm, BNursing APP[II]

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引用次数: 0

Abstract

Background

Elective surgery cancellations and delays are associated with negative financial and staffing ramifications, adverse clinical outcomes, and poor patient outcomes. The Princess Alexandra Hospital in Brisbane, Australia, performs approximately 15 000 elective surgeries per year and medication optimisation is pivotal in preparing a patient for surgery to avoid same day of surgery theatre cancellations. Ideally, patients are seen in a multidisciplinary pre-admission clinic for optimisation of their health and medicines, and to provide education regarding their surgery.

Aim

To calculate the incidence of elective surgery cancellations due to medication misadventure over a 12-month period.

Method

A retrospective audit at a tertiary Queensland Hospital was conducted over a 12-month period (April 2021–March 2022), including patients who had their elective surgeries cancelled. The medical records from the hospital's digital databases for patients who were identified by the hospital coding service as ‘unfit for surgery’ were screened to see if the reason for the surgery cancellation was due to medication misadventure. The project was reviewed by the Metro South Human Research Ethics Committee and deemed exempt from further review (Ref No: CM20221651).

Results

The surgery cancellation rate was 50% (n = 6626 cancelled surgeries from 13 255 total surgeries booked). The same day of surgery cancellation rate was 5.5% (n = 734). Medication misadventure resulting from suboptimal medicine management was responsible for 1% (n = 66 out of 6626 surgery cancellations). A total of 41% (n = 27) of patients had their surgery cancelled ahead of time by the pharmacist due to a medication not being withheld for long enough, which prevented a same-day cancellation.

Conclusion

Having a pre-admission clinic pharmacist improves preoperative medication optimisation and has been proven to avoid same-day cancellations.

查看原文本刊更多论文

由于药物管理不理想而取消择期手术:一项回顾性单点研究

选择性手术的取消和延误与负面的财务和人员影响、不良的临床结果和不良的患者结果有关。澳大利亚布里斯班的亚历山德拉公主医院演出约15场 000例择期手术，药物优化对于为患者做好手术准备以避免手术当天取消至关重要。理想情况下，患者可以在多学科的入院前诊所就诊，以优化他们的健康和药物，并提供有关他们手术的教育。计算12个月内因药物意外事故而取消择期手术的发生率。昆士兰一家三级医院进行了为期12个月（2021年4月至2022年3月）的回顾性审计，包括取消择期手术的患者。对医院数字数据库中被医院编码服务部门认定为“不适合手术”的患者的医疗记录进行了筛查，以确定取消手术的原因是否是药物意外。该项目由Metro South人类研究伦理委员会审查，并被视为免于进一步审查（参考号：CM20221651）。手术取消率为50%（n = 6626例手术从13例取消总共预约了255个手术）。当天手术取消率为5.5%（n = 734）。不良药物管理导致的药物意外事故占1%（n = 6626例手术取消中有66例）。总共41%（n = 27）的患者由于药物扣留时间不够长而被药剂师提前取消了手术，这阻止了当天的取消。有一位入院前的诊所药剂师可以改善术前的药物优化，并已被证明可以避免当天取消。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pharmacy Practice and Research Health Professions-Pharmacy

CiteScore

1.60

自引率

9.50%

发文量

期刊介绍： The purpose of this document is to describe the structure, function and operations of the Journal of Pharmacy Practice and Research, the official journal of the Society of Hospital Pharmacists of Australia (SHPA). It is owned, published by and copyrighted to SHPA. However, the Journal is to some extent unique within SHPA in that it ‘…has complete editorial freedom in terms of content and is not under the direction of the Society or its Council in such matters…’. This statement, originally based on a Role Statement for the Editor-in-Chief 1993, is also based on the definition of ‘editorial independence’ from the World Association of Medical Editors and adopted by the International Committee of Medical Journal Editors.