National multicentre audit of pregnancy status in general surgery admissions in Scotland

Abstract

Background Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery. Methods A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years. Results There were 2743 admissions, with 612 (22.3%) women of reproductive age. After 82 exclusions, the final total was 530: 169 (31.9%) elective and 361 (68.1%) emergency. Documentation of PS was achieved in 274 (51.7%) cases: 52 (30.8%) elective and 222 (61.5%) emergency. In 318 (88.1%) of the emergency admissions, the patient had abdominal pain. Of these, 211 (65.1%) had a documented PS. The possibility of pregnancy was established in 237 (44.7%) cases. Discussion Establishing the possibility of pregnancy before surgery is poor, particularly in the elective setting. Objective documentation of PS in the emergency setting in those with abdominal pain is also poor. Our study highlights an important safety issue in the management of female patients. We advocate electronic storage of pregnancy test results and new guidelines to cover both elective and emergency surgery. PS should form part of the pre-theatre safety brief and checklist.

Checklist in colorectal surgery – proposal of experts of the Polish Club of Coloproctology and National Consultant in general surgery

“…Although certain checklist points might not be obvious, they should be kept in mind when preparing the patient for surgery. For instance, the surgeon should make sure whether women of childbearing age are pregnant, which still is not routine practice [32]. This issue might be important in young female patients with menstrual cycle abnormalities, such as patients with inflammatory bowel disease.…”

A multispecialty study of determining the possibility of pregnancy and the documentation of pregnancy status in surgical patients: a cause for concern?

“…The simultaneous study conducted across Scottish general surgical centres included our general surgery results in the subsequent publications. 3,4 Determining PoP and documentation of PS was performed in three ways. Firstly, we looked for evidence that the question 'Is there any possibility of pregnancy?'…”

“…Using the same protocols as the original pilot study 2 and subsequent multi-centre general surgery study, 3,4 we collected data prospectively across three sites: Perth Royal Infirmary, Stracathro and Ninewells Hospital between 10 May 2015 and 24 May 2015 to include elective and emergency admissions. Caldicott approval was obtained.…”

“…2 A Scottish multi-centre study of the documentation of PS and gynaecological history in general surgery patients was proposed and carried out. 3,4 We hypothesised that poor documentation would not be limited to general surgery and undertook a study of all surgical specialties in our trust at the same time as the multi-centre general surgery study. The data for general surgery in this manuscript were also included in the findings of the general surgery multi-centre study.…”

Results of a national multicenter audit assessment of gynecologic history in surgical patients

“…A detailed description of the protocol for the study has been reported previously, having been modified from the original pilot study . A full description of the study protocol is available (Supplementary File ).…”