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- W4313142511 abstract "Background: The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) Highs and Lows (2018) report1 highlighted a lack of clinical continuity of diabetes management across the different specialties in the perioperative pathway, resulting in diabetes management of patients falling between gaps in the surgical pathway. We sought to review our hospital’s performance against several recommendations made in the report. Methods: We reviewed the electronic healthcare records (Epic™) of 50 patients with diabetes who had surgery in September 2021, of which 34 were elective cases and 16 were non-elective cases. Results: Our current preoperative assessment workflow for diabetic patients attending for elective surgery was effective for monitoring HbA1c levels and identifying high-risk patients. The majority of elective patients were listed first in the morning and afternoon list. This was less consistent for non-elective surgery, which resulted in prolonged fasting times >12 h. Compliance was poor for intraoperative blood glucose monitoring compared with other time points (Fig. 5). There were 42% of patients who had a written plan for their diabetic medications, and there is scope to improve this by flagging up patients with poorly controlled diabetes at surgical ‘sign-out’ so that the surgical team could be made aware. This is particularly important if the patient is expected to have a delay in resuming regular oral intake. Conclusions: This audit provided an excellent opportunity to improve anaesthetic workflows on the newly implemented electronic patient record, MyCare (by Epic™). Through this audit, we have highlighted the use of messaging systems where high-risk patients can be brought to the attention of the anaesthetists by the preoperative team and included an automatic prompt on the anaesthetic chart to monitor the patient’s blood sugars. We hope to devise an anaesthetic ‘Dashboard’ for more efficient data collection in the future. 1.The National Confidential Enquiry into Patient Outcome and Death. Highs and Lows. 2018. London" @default.
- W4313142511 created "2023-01-06" @default.
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- W4313142511 date "2022-10-01" @default.
- W4313142511 modified "2023-09-27" @default.
- W4313142511 title "The Epic™ diabetes audit" @default.
- W4313142511 doi "https://doi.org/10.1016/j.bjao.2022.100043" @default.
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