EP.FRI.454 National Emergency Laparotomy Audit: are we compliant with pre-operative mortality risk documentation?. (28th October 2021)

• Record Type: Journal Article
• Authors: Lam, Mark; Ng, Sherwin
• Is Part Of: British journal of surgery. Volume 108:Supplement 7(2021)
• Publication Date: 2021-10-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab312.071
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: The National Emergency Laparotomy Audit (NELA) set out key performance indicators in patients undergoing emergency laparotomy, one of which is the assessment of individuals pre-operative risk of mortality. This should be made explicit to the patient and recorded clearly on the consent form and in the medical record. 1 Pre-operative mortality risk can be calculated through clinical assessment or using the NELA risk scoring tool. Omission of a this can lead to patients missing out on accepted standards of care and belies gaining informed consent. A snapshot audit of patients added to the NELA database was performed between 01/08/2020 and 31/10/2020. Data collected included the pre-operative mortality risk percentage (if calculated) and whether the patient was taken to theatre. This figure was correlated against the patient's physical notes or scanned copies on Medway. A target level of ≥ 85% of patients having their pre-operative mortality risk calculated and the this figure being documented appropriately. 49 patients were uploaded to the NELA database and 80% (n = 39) had a calculated risk. 55% of these patients (n = 27) proceeded to theatre, however correlation with physical notes and scanned documents on Medway revealed none had the correct documentation as per NELA standards. A questionnaire circulated to trainees and consultants exploring their understanding of pre-operative mortality risk documentation. Of the 7 respondents, 4 stated they rarely or never documented the pre-operative mortality risk as per NELA guidance. Ideas for improving the documentation process included a NELA pathway document, visual aids (e.g. poster) and a pre-operative mortality risk sticker.