A team of nurses and doctors at Dorset County Hospital have developed a comprehensive pre–assessment service to ensure patients are properly prepared for surgery.The Anaesthetic Pre–assessment Unit aims to ensure that patients are fit enough and adequately prepared for an operation prior to hospital admission, with a principal focus on the provision of safe anaesthesia.
The unit has streamlined the administrative process from the patient having an operation booked, through to admission to hospital. This involves the collation of results and information relating to anaesthesia, surgery and nursing issues so that all relevant details are available for the admission day.
The unit comprises both nursing and anaesthetic medical staff who together assess patients booked for surgery. There is a close liaison with consultant anaesthetists, who assess the medically more complex patients in greater detail. There is a close working relationship, enhanced by improved communication, with surgeons and other departments including haematology, biochemistry and cardiology. The overall effect of the assessment unit is to ensure that patients’ needs are better served during and after an operation.
If problems are indentified early on patients can be treated so when they come in for their surgery, an appropriate, individualised plan of care is in place. Problems regularly dealt with are previously undiagnosed or poorly treated high blood pressure, heart murmurs, leg ulcers, diabetes and obesity. The team liaises with other departments in the hospital as well as GPs and community nurses to ensure all these problems are dealt with in partnership with the patient and colleagues. Optimising the patient for surgery also means they will recover much more quickly afterwards.
There have been many other additional benefits to both patients and the hospital. Patients receive a more holistic and better organised approach to their individual needs prior to admission. Medical conditions are reviewed and if appropriate further investigated prior to an operation.
The incidences of late cancellations, with the inconvenience to patients, has decreased. This has also enabled more efficient utilisation of inpatient beds and operating suites. Patients receive better information concerning the operation, anaesthetic and recovery period after surgery, which supports informed consent. Social aspects of care are also discussed so that patients are able to plan individual needs during recuperation after an operation.
The Pre–Assessment Unit has also supported the development of the Surgical Admissions Lounge where patients are frequently admitted to on the day of surgery. The strengths of these two units are based on a focus of improved and efficient patient care. The link between preoperative assessment and the admission units will strengthen in the future to provide better care for patients booked for elective surgery.
Pre-assessment Unit 01305 254222
Surgical Admissions Lounge 01305 255836