Do they do as they are instructed? A review of out‐patient anaesthesia

Abstract

Forumfor example, has been demonstrated by several yet only 65% of the patients in this survey were extended this simple courtesy. This figure is probably no worse than the national mean, yet if the anaesthetist seriously wishes to be thought of as a medical specialist rather than a technician, can he regard this as a satisfactory measure of his professional diligence ? Some practising anaesthetists are perhaps not doing full justice to the job that they were trained for, and, if their excuse is that they d o not have time, then perhaps their efforts should be directed less towards sacrificing their standards for the sake of convenience, and more towards insisting that they are given enough time for routine ward assessment. SummaryDuring a single 5 day working week a series of adult National Health patients uiidergoing general anaesthesia for routine surgery a t a District General Hospital were interviewed on the day following the anaesthetic. Their experiences of anaesthesia, and their opinions of their anaesthetists are discussed. Key words

Patient noncompliance before surgery

“…This finding is in keeping with other studies, in which up to 40% of patients deny having received either written or verbal perioperative instructions [5]. Other studies showed that verbal instruction alone is misinterpreted, forgotten, or altogether ignored in 4–12.5% of cases [6].…”

“…However, written instructions can provide a reproducible communication tool to which patients can repeatedly refer. This means of communication has been shown to significantly improve patient compliance when compared to verbal instructions alone [6,7]. However, as our study shows, even written communication is fallible.…”

An audit of preoperative fasting compliance at a major tertiary referral hospital in Singapore

“…This is an established combination that is known to be very effective in improving understanding and compliance to perioperative instructions in patients undergoing ambulatory surgery. (10) Although we cannot be completely certain that every clinic nurse followed the standard operating procedure and explained the reasons for fasting to all the patients we surveyed, we are certain that the patients were told the reason for the fasting requirement during their preoperative telephone call reminder, as those calls were made by the same clerk. Adding to patient education using further education techniques (e.g.…”

Anaesthesia for Day-care Surgery: A Review

“…Not only are there many potential hazards to an incompletely recovered patient who obeys instructions, but others have been known to disobey. Ogg (1975) found that 31 of 100 patients went home unaccompanied and that 9 drove themselves; Malins (1978) found that patients who were merely told about the dangers forgot more easily than those with written instructions, although both groups contained individuals who disobeyed. He also advised that ethnic minorities may need printed instructions in their own language, or interpreters.…”