Download Assessing the Degree of Implementation of SIGN 77:

Assessing the Degree of
Implementation of SIGN 77:
77
Postoperative Management in Adults Using an Audit Tool
Based on Recommendations from the Guideline
MR G.A. NICHOLSON (STR4), MRS K. BASCOMBE (PHYSICIAN ASSISTANT – R)
& MISS R. LIVERMORE (PHYSICIAN ASSISTANT - R) HAIRMYRES HOSPITAL, LANARKSHIRE
Background:
SIGN 77 was published in August 2004 to offer
guidance on the best practice for postoperative
care. Audit tools are available on the SIGN
website for ease of local audit and to allow
aggregation with other hospitals to create a
national audit database.
Results:
Re-audit in June 2012 demonstrated
improvements in 6 of the 12 variables impacting
on clinical outcome. The degree of improvement
ranged from 3% to 61% compared with baseline
in these 6 variables (see Fig. 1).
Objectives:
To assess current practice in a single
institution with regard to implementation
of the SIGN postoperative management
guideline, by employing an audit tool based
on recommendations from the guideline.
To report on the findings and make
recommendations for change in practice
To complete the audit cycle and comment
on differences
Method:
The degree to which documentation followed
recommended guidelines was audited using the
SIGN audit tool. Twelve criteria recommended
by SIGN were measured; ASA grade, time of
arrival on HDU, Dr informed of arrival, time
of review on HDU, grade of Dr reviewing the
patient, operation note present in notes, intraoperative complications stated, contact details
recorded, post-op instructions documented, past
medical history noted, medications and allergies
documented.
Patients presenting as either emergency or
elective admissions and requiring ITU/HDU postoperative care were audited between October
and December 2011. Results were fed back to the
medical staff involved highlighting any deviation
from recommended practice. Practice was then
re-audited between April and June 2012. Results
were uploaded to SIGN to add to the nationally
collected dataset.
Conclusions:
The SIGN audit tool for postoperative
management of patients is useful for assessing
the implementation of SIGN 77 locally. It can also
assist in the improvement of documentation inline with SIGN 77. The SIGN data upload facility
allows data to be aggregated from individual
hospitals to inform degree of implementation and
change in practice at a national level. It is hoped
that the improvements noted here will impact
positively on patient outcome.
CTP.SIGN77.93883