ObjectiveTo analyze the reasons for operation cancellation, in order to improve the efficiency and quality of work in Day-surgery (DS) ward. MethodsRetrospective study and related factor analysis were carried out for 985 cases of canceled DS operations from October 2012 to October 2013. ResultsThe main factors for canceling DS operations included diseases, patients and relatives refusing operation, incomplete preoperative preparation and accidental events. ConclusionDS medical staff of each department should enhance the sense of responsibility and cooperation. Preoperative treatment of patients with chronic diseases and preoperative health education and psychological aids should be strengthened to reduce temporary cancellation of DS operations.
ObjectiveTo evaluate the safety and quality of patients in day surgery. MethodsThe clinical data of patients in day surgery from March to December 2014 in this hospital were collected. The incidence of complications, delayed discharge rate, rate of readmission to hospital, satisfaction, and so on, were analyzed. ResultsOf 5 520 patients were in day surgery, including laporoscopic cholecystectomy, hernia repair surgery, vocal cord polyps resection, breast minimally invasive surgery, varicose vein of lower limb, choledochoscopy, gastrointestinal polyposis, and so on. No patient was loss of follow-up, unplanned reoperation or death after day surgery. There were 39.95%(2 205/5 520) of wound pain and 0.51%(28/5 520) of postoperative nausea and vomiting in the complications. The delayed discharge rate was 0.62%(34/5 520), the rate of unplanned readmission to hospital was 0.49%(27/5 520), and the satisfaction rate was 98.99%(5 464/5 520). ConclusionFor the above surgery types in this study, the day surgery mode is safe and effective.
ObjectiveTo analysis the reasons of delayed discharge in day surgery ward, so as to provide the basis for discharged quality monitoring of ambulatory surgery management. MethodsA retrospective survey was conducted on patients admitted in Department of Day Surgery Center of West China Hospital of Sichuan University from April 2012 to August 2014 after day surgery. The characteristics of patients classified as "delayed discharge patients" were described and the factors associated with delayed discharges were analyzed by using SPSS 19.0 software. ResultsA total of 14 560 patients were included, of which 81 patients were classified as "delayed discharge", and the rate of delayed discharge was 0.56% (81/14 560). Single disease delayed discharge rates were as follows: gallstone 2.13% (37/1 737), operation for varicose veins of lower limbs 1.91% (11/576), gastrointestinal polyps resection 0.33% (11/3 325), inguinal herniorrhaphy 0.63% (9/1 424), polyp of vocal cord resection 0.21% (4/1 879), breast package block minimally invasive resection 0.11% (2/1 761), choledochoscopy 0.06% (1/1 563) and other surgical 0.26% (6/2 295). No significant differences were found between the delayed discharge patients and normal discharge patients in age and gender (P>0.05). Compared with the normal discharge patients, there were significant differences in the four aspects of operation mode changes, postoperative complications, anesthesia factors and patient's own factors of delayed discharge patients (P<0.05). ConclusionThe changes of operation mode, postoperative complications, anesthesia factors and patient's own factors are related to the delay of hospital discharge. Strictly grasping the indications for ambulatory surgery and anesthesia patients, strengthening the admission education, letting the patients accept day surgery fully in psychological and preventing the possible complications and ensure the quality and safety after day surgery.
ObjectiveTo assess the efficacy and safety of pediatric day surgery (PDS) program. MethodsWe retrospectively analyzed 148 pediatric surgeries between June 2012 and June 2013, including 31 for cryptorchidism, 53 for concealed penis, and 64 for hernia. According to the operation mode, these children were divided into PDS group and in-patient group. Analysis of the postoperative complications and hospital stay, and hospitalization expenses was carried out. ResultsThere was no statistical differences on success rate of operation, re-admission rate, postoperative fever, and postoperation nausea and vomiting between the two groups (P>0.05). But compared with the in-patient group, hospitalization expenses, medical cost, therapeutic treatment fee and hospital stay were significantly lower or shorter in the PDS group (P<0.05). ConclusionPDS is a safe and cost-effective program that reduces the average hospitalization days, reduces the per capita hospitalization cost, increases the turnover of beds, and benefits the child and the family.
ObjectiveTo explore the role of fast-track surgery (FTS) in day-case laparoscopic cholecystectomy (DLC) pain management. MethodsWe used bidirectional cohort study to investigate the patients undergoing day surgery of laparoscopic cholecystectomy admitted into our department. A total of 143 patients between April and September 2014 receiving routine pain management were chosen to be the control group, and 78 patients between October 2014 and January 2015 receiving FTS pain management were regarded as the FTS group. Postoperative pain, early ambulation, influence of pain on the sleep, patients' satisfaction and prolonged hospital stay rate were compared between the two groups. ResultsPain scores of patients in the FTS group 0-0.5, 0.5-6, 6-12, and 12-24 hours after surgery were significantly lower than those in the control group (P<0.05). The proportion of patients with early postoperative ambulation and patients' satisfaction rate in the FTS group were significantly higher than the control group (P<0.05). ConclusionThe FTS pain management model can effectively reduce patients' pain after DLC, accelerate patients' postoperative rehabilitation and increase patients' satisfaction.