Elsiddig Mohammed, Hassan Mohammed
Urology, Military Hospital, Khartoum, SDN.
Cureus. 2024 Oct 19;16(10):e71845. doi: 10.7759/cureus.71845. eCollection 2024 Oct.
Objective This study aimed to assess the practices of documenting operative notes in the urology department at a tertiary care facility in Sudan. Materials and methods This cross-sectional, retrospective study evaluated the practices of documenting surgical notes for patients who required urological procedures at a tertiary hospital in Sudan. The study included all patients who underwent emergency or elective urological surgery between March 1, 2023, and April 1, 2023, under general or spinal anesthesia, regardless of age. The medical records were accessed to analyze the operative notes' standards. Sixty-two operative notes were included and analyzed. We used the Royal College of Surgeons of England (RCS) guidance as the standard for our study. The Royal College of Surgeons of England has provided comprehensive and standardized guidelines for writing an operative note, including patient identification, date and time of the procedure, type of procedure (elective/emergency procedure), name of surgeon and assistant, name of anesthetist, name of the procedure, type of incision, operative diagnosis, operative findings, complications encountered, any extra procedure performed with reason, details of tissue removed, added or altered details of closure technique, anticipated blood loss, prosthesis details, antibiotic prophylaxis, deep vein thrombosis prophylaxis, detailed post-op instructions, signature. Results A total of 62 consent forms were included. Patient identification, name of the surgeon and assistant, and name of the procedure were mentioned in 61 (98.4%). The operative diagnosis and details of tissue removed were written in 41 (66%). Antibiotic prophylaxis and deep vein thrombosis prophylaxis were given in 28 (45.2%) and 25 (40%), respectively. The type of anesthesia was mentioned in 56 (90.3%) of cases. The name of the anesthetist and anticipated blood loss: recorded completion rates of 12 (19.3%) and 18 (29%), respectively. The date and time of the procedure were completely documented in 59 (95.2%). Senior doctors wrote six (9.7%) of the operative notes with a completeness of four (66.7%). Junior doctors wrote 56 (90.3%) operative notes, and only 12 (21.4%) completed the essential components of the notes. Conclusions The current practices of documenting operating notes were shown to be imprecise. Handwritten operative notes do not follow standard practice. Using a pre-designed operating note that may be customized according to the circumstances of the operation is the preferred option. An educational session should be planned for junior doctors to focus on correct documentation and promote adherence to best clinical practices.
目的 本研究旨在评估苏丹一家三级医疗机构泌尿外科手术记录的书写情况。
材料与方法 本横断面回顾性研究评估了苏丹一家三级医院中需要接受泌尿外科手术的患者的手术记录书写情况。该研究纳入了2023年3月1日至2023年4月1日期间在全身麻醉或脊髓麻醉下接受急诊或择期泌尿外科手术的所有患者,不分年龄。查阅病历以分析手术记录的标准。纳入并分析了62份手术记录。我们将英国皇家外科医学院(RCS)的指南作为本研究的标准。英国皇家外科医学院提供了书写手术记录的全面且标准化的指南,包括患者识别、手术日期和时间、手术类型(择期/急诊手术)、外科医生和助手姓名、麻醉医生姓名、手术名称、切口类型、手术诊断、手术发现、遇到的并发症、任何额外进行的手术及原因、切除组织的细节、缝合技术的补充或更改细节、预计失血量、假体细节、抗生素预防、深静脉血栓形成预防、详细的术后医嘱、签名。
结果 共纳入62份同意书。61份(98.4%)记录了患者识别、外科医生和助手姓名以及手术名称。41份(66%)记录了手术诊断和切除组织的细节。分别有28份(45.2%)和25份(40%)给予了抗生素预防和深静脉血栓形成预防。56份(90.3%)病例提到了麻醉类型。麻醉医生姓名和预计失血量的记录完成率分别为12份(19.3%)和18份(29%)。59份(95.2%)完整记录了手术日期和时间。高级医生书写了6份(9.7%)手术记录,其中4份(66.7%)完整。初级医生书写了56份(90.3%)手术记录,只有12份(21.4%)完成了记录的基本内容。
结论 目前手术记录的书写情况显示不精确。手写手术记录未遵循标准做法。使用可根据手术情况定制的预先设计的手术记录是首选方案。应为初级医生安排一次教育课程,重点关注正确记录并促进遵循最佳临床实践。