An Audit of preoperative evaluation of general surgery patients at Dr George Mukhari Hospital (DGMH), Ga-Rankuwa

Thesis (Anaesthesiology)) -- University of Limpopo, 2010.

ABSTRACT INTRODUCTION: Preoperative evaluation of a patient is the fundamental component of anaesthetic practice. Poor documentation and record keeping on the preoperative evaluation (PEF) form is a big obstacle in attaining good practice and hence improving patient outcome following operative procedures. The aim of the study was to conduct an audit of the anaesthetic preoperative evaluation of general surgery patients at Dr George Mukhari hospital (DGMH), Garankuwa. METHODS: A sample size of 88 record files of general surgery patients who underwent elective surgery during 2008 at DGMH was analysed. The proportion of completeness of information recorded on the PEF used at DGMH was compared with a standardized PEF which uses the global quality index (GQI). RESULTS: Only 75 out of88 patients had PEF in their files. The Modified GQI scores for the sample of75 patients ranged between 33.3% and 100%. The mean Modified GQI score was 72.2 +/- SD 13.9%. The median was 73.3 %, while the lower quartile was 60% and the upper quartile was 80%. The GQI scores were low for the following criteria; 'preoperative diagnostic procedure' (46.7%), 'medications prescribed by surgeons' (46.7%), 'preoperative fasting status' (32%), and deficiency in 'patient's weight' (34.7%) and 'allergies' (34.7%) during the preoperative assessment. Only in 1.3% was the PEF filled completely in accordance with the Modified GQI score. CONCLUSION: The overall quality of the preoperative assessment was inadequate in a number of the ModifiedGQI scores criteria suggesting the need for improvement in preoperative assessment of patients by anaesthetists at this hospital to improve patient outcome.