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Derks LSM, Smit AL, Thomeer HGXM, Topsakal V, Grolman W, Stokroos RJ, Wegner I. Quality of life, hearing results, patient satisfaction and postoperative complications of day-case versus inpatient unilateral cochlear implantation in adults: a randomized controlled, equivalence trial. Eur Arch Otorhinolaryngol 2024; 281:2313-2325. [PMID: 38180606 PMCID: PMC11023990 DOI: 10.1007/s00405-023-08352-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To investigate the hypothesis that day-case cochlear implantation is associated with equal quality of life, hearing benefits and complications rates, compared to inpatient cochlear implantation. STUDY DESIGN A single-center, non-blinded, randomized controlled, equivalence trial in a tertiary referral center. METHODS Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on general quality of life, patient satisfaction, (subjective) hearing improvement, postoperative complications and causes of crossover and/or readmission were assessed using questionnaires, auditory evaluations and patients' charts over a follow-up period of 1 year. RESULTS Overall quality of life measured by the HUI3 was equal between the day-case (n = 14) and inpatient group (n = 14). The overall patients' satisfaction showed a slight favor towards an inpatient approach. There was no significant difference in the subjective and objective hearing improvement between both treatment groups. During the 1-year follow-up period no major complications occurred. Minor complications occurred intraoperatively in three day-case patients resulting in three out of nine admissions of day-case patients. Other causes of admission of day-case patients were nausea and vomiting (n = 1), drowsiness (n = 1), late scheduled surgery (n = 2), social reasons (n = 1), or due to an unclear reason (n = 1). No patients required readmission. CONCLUSION We found equal outcomes of QoL, patient satisfaction, objective, and subjective hearing outcomes between day-case and inpatient unilateral cochlear implantation. Nine out of 14 day-case patients were admitted for at least one night postoperatively (crossover). No major complications occurred in both groups. A day-case approach seems feasible when using specific patient selection, surgical planning and the preoperative provision of patient information into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team can increase the feasibility of day-case surgery. LEVEL OF EVIDENCE: 1
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Affiliation(s)
- Laura S M Derks
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Adriana L Smit
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans G X M Thomeer
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Vedat Topsakal
- University Department Otorhinolaryngology, Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
| | - Wilko Grolman
- Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France
| | - Robert J Stokroos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands
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Micaletti F, Boullaud L, Amelot A, Schleich M, Pondaven-Letourmy S, Lescanne E. Day-case otology: Special attention to the pediatric cochlear implantation procedure. Int J Pediatr Otorhinolaryngol 2024; 179:111932. [PMID: 38537448 DOI: 10.1016/j.ijporl.2024.111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Assess the feasibility of cochlear implantation as day-surgery in children and identify variables influencing admission, readmission, and unplanned postoperative consultation. METHODS This retrospective observational monocentric study was conducted according to the STROBE recommendations. Between January 2017 and July 2022, all medical records of children who underwent cochlear implantation were analyzed. Eligible children were admitted for the first time to the pediatric day-surgery unit. Exclusion criteria were children planned for inpatient procedure, bilateralization or explantation-reimplantation. Sex assigned at birth, analgesic medication, anesthesia and complications were related to categorical variables. Age, duration of anesthesia, length of stay and ASA score were related to continuous variables. RESULTS We included 66 children from a total of 106. Mean age was 53 months [SD: 46 months, range 8-184 months]. Successful day-surgery management was observed in 86% of cases. In 14% of cases, children were admitted to the pediatric ENT unit for the following reasons: late awakening in 6%, non-controlled pain in 4.5%, postoperative nausea and vomiting in 3.5% of cases. Univariate analysis did not observe any factor promoting success of day-surgery regarding anesthetic agents. Age was not statistically significant as a factor of ambulatory failure. Time spent in the operating room was not a determining factor (p = 0.559). None of the children were rehospitalized. Early unplanned consultations were observed in 3% of cases for vertex edema in 1 case and uncomplicated otorrhea in 1 case. CONCLUSION This study adds to the knowledge on pediatric cochlear implantation and suggests that this procedure is suitable for day-surgery at any age.
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Affiliation(s)
- Fabrice Micaletti
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France.
| | - Luc Boullaud
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France
| | - Aymeric Amelot
- Neurosurgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; INSERM U1253, IBrain, University of Tours, Tours, France
| | - Marianne Schleich
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France
| | - Soizick Pondaven-Letourmy
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; Pediatric Head and Neck Surgery Department, University Hospital Center of Tours, 49 Boulevard Béranger, 37000, Tours, France
| | - Emmanuel Lescanne
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044, Tours, France; Pediatric Head and Neck Surgery Department, University Hospital Center of Tours, 49 Boulevard Béranger, 37000, Tours, France; Faculty of Medicine, Université de Tours, 10 Boulevard Tonnellé, 37044, Tours, France
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Boullaud L, Amelot A, Aussedat C, Pondaven S, Lescanne E. Safety of middle-ear day-surgery in children: A STROBE observational study. Eur Ann Otorhinolaryngol Head Neck Dis 2022. [DOI: 10.1016/j.anorl.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Derks LSM, Borgstein ILA, Lammers MJW, Kamalski DMA, Thomeer HGXM, Grolman W, Stokroos RJ, Wegner I. Admission Rates Following Day-Case Major Otologic Surgery: A Systematic Review. Otol Neurotol 2021; 42:1291-1299. [PMID: 34267096 DOI: 10.1097/mao.0000000000003265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess whether day-case major otologic ear surgery is a safe and feasible alternative to inpatient surgery, while maintaining equal complication rates, and to identify causes of admission after day-case surgery. DATA SOURCES PubMed, Embase, and Cochrane. REVIEW METHODS A systematic search was conducted. Studies reporting original data on the effect of day-case ear surgery on admission rate, patient satisfaction, and/or postoperative complications were included. Risk of bias of the selected articles was assessed using criteria based on the Cochrane Collaboration's tool for assessing risk of bias. RESULTS A total of 1,734 unique studies were retrieved of which 35 articles discussing 34 studies were eligible for data extraction. The admission rates ranged from 0% to 88% following day-case endaural surgery, 0% to 13% following day-case stapes surgery, 0% to 82% following day-case mastoid surgery, and 0% to 15% following day-case cochlear implant surgery. Patient and parent satisfaction regarding day-case surgery ranged from 67% to 99%. Five studies comparing day-case and inpatient otologic surgery showed no difference in hearing outcome, postoperative complications, or patient satisfaction. CONCLUSION The highest pooled admission rate was seen following day-case mastoid surgery. Studies comparing day-case and inpatient care suggest hearing results and postoperative complication rates in day-case otologic surgery are similar to inpatient otologic surgery in both children and adults. Therefore, day-case major otologic surgery seems to be a safe and feasible alternative to inpatient surgery for both children and adults.
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Affiliation(s)
- Laura S M Derks
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Isabelle L A Borgstein
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
| | - Marc J W Lammers
- Division of Otolaryngology, BC Rotary Hearing and Balance Centre at St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Digna M A Kamalski
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Hans G X M Thomeer
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
| | - Wilko Grolman
- Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France
| | - Robert J Stokroos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
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Abstract
AIMS To study the evolution of middle-ear surgery in 2019 in relation to the French Health Authority target of 66% day-surgery by 2020. MATERIAL AND METHODS A single-center retrospective observational study included all patients undergoing otologic surgery between January 2014 and December 2018 in a university hospital center. 1064 of the 1368 patients were scheduled for outpatient surgery: 309 for otosclerosis, 355 for tympanoplasty with or without ossiculoplasty, 376 for cholesteatoma and 24 for other procedures. Two groups were constituted: day-surgery and conventional, according to hospital stay. Surgery time, follow-up duration, number of crossovers to conventional admission, number of emergency postoperative consultations, number of readmissions and data from the phone-call systematically made the day after surgery were analyzed. The main objective was to evaluate the safety of outpatient surgery for major middle-ear interventions compared to a control group managed under conventional admission during the same period. RESULTS 27 patients (2.5%) required crossover, mainly due to disabling vertigo (57.7%). 53 patients (4.9%) consulted before the scheduled 8th day consultation, because of severe pain (23.5%) or dizziness (34.0%). Only 10 patients required emergency readmission. CONCLUSION Provided that the inclusion criteria are met, all major middle-ear surgery procedures can be performed as day-surgery under satisfactory safety conditions.
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Lazard D, Donné F, Lecanu J. Day-surgery in otology: Impact study of a dedicated organizational model. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:465-468. [DOI: 10.1016/j.anorl.2019.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Heilbronn C, Lin H, Bhattacharyya N. Adult ambulatory otologic surgery: Unplanned revisits and complications. Laryngoscope 2019; 130:1788-1791. [DOI: 10.1002/lary.28346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Cameron Heilbronn
- University of California Irvine Medical Center Department of OtolaryngologyOrange California U.S.A
| | - Harrison Lin
- University of California Irvine Medical Center Department of OtolaryngologyOrange California U.S.A
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Ralli G, Nola G, Taglioni A, Grasso M, Ralli M. Day-case management of chronic suppurative otitis media with cholesteatoma with canal wall down technique surgery: long-term follow-up. Audiol Res 2017; 7:187. [PMID: 29071059 PMCID: PMC5641836 DOI: 10.4081/audiores.2017.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/02/2017] [Indexed: 11/23/2022] Open
Affiliation(s)
- Giovanni Ralli
- Department of Sense Organs, La Sapienza University, Rome
| | | | | | - Michele Grasso
- Department of Sense Organs, La Sapienza University, Rome
| | - Massimo Ralli
- Department of Oral and Maxillofacial Sciences, La Sapienza University, Rome, Italy
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Kaleva AI, Hone RWA, Tikka T, Al-Lami A, Balfour A, Nixon IJ. Predicting hypocalcaemia post-thyroidectomy: a retrospective audit of results compared to a previously published nomogram in 64 patients treated at a district general hospital. Clin Otolaryngol 2016; 42:442-446. [PMID: 26682531 DOI: 10.1111/coa.12610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2015] [Indexed: 12/30/2022]
Affiliation(s)
- A I Kaleva
- Ear Nose & Throat Department, Head & Neck Directorate, William Harvey Hospital, Willesborough, Ashford, Kent, UK
| | - R W A Hone
- Ear Nose & Throat Department, Head & Neck Directorate, William Harvey Hospital, Willesborough, Ashford, Kent, UK
| | - T Tikka
- Birmingham Heartlands Hospital, Birmingham, UK
| | - A Al-Lami
- Ear Nose & Throat Department, Head & Neck Directorate, William Harvey Hospital, Willesborough, Ashford, Kent, UK
| | - A Balfour
- Ear Nose & Throat Department, Head & Neck Directorate, William Harvey Hospital, Willesborough, Ashford, Kent, UK
| | - I J Nixon
- Ear Nose & Throat Department, Head & Neck Directorate, William Harvey Hospital, Willesborough, Ashford, Kent, UK
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Affiliation(s)
- Mark Mitchell
- Faculty of Health and Social Care; University of Salford; Salford UK
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Abstract
OBJECTIVES This study aims to assess the safety of daycase cochlear implant surgery. METHODS A retrospective review was conducted on all patients who underwent cochlear implant surgery at a teaching hospital in Oxford, UK between September 2008 and February 2012. RESULTS One hundred and sixteen patients underwent cochlear implant surgery. This included 73 adults and 43 children. Twenty-six patients underwent the procedure as a daycase procedure. There were no readmissions. DISCUSSION The demand 'to do more with less' has led to increasing drives for efficiency and cost-effectiveness. Therefore, the role of daycase surgery is becoming increasingly widespread. Daycase surgery has been shown to be advantageous for both patients and hospitals. CONCLUSION Daycase cochlear implant surgery is feasible and can be safely conducted in a select group of patients.
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Younis J, Salerno G, Chaudhary A, Trickett JP, Bearn PE, Scott HJ, Galbraith KA. Reduction in Hospital Reattendance due to Improved Preoperative Patient Education Following Hemorrhoidectomy. J Healthc Qual 2013; 35:24-9. [DOI: 10.1111/j.1945-1474.2012.00201.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Younis J, Salerno G, Chaudhary A, Trickett JP, Bearn PE, Scott HJ, Galbraith KA. Reduction in Hospital Reattendance due to Improved Preoperative Patient Education Following Hemorrhoidectomy. J Healthc Qual 2012. [DOI: 10.1111/j.1945-1474.2012.00133.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
CONCLUSIONS Stapedotomy is, in our opinion, the technique of choice in stapes surgery. The precision of this technique allows clinicians to perform the surgical procedure in day surgery under local anesthesia. OBJECTIVES There is a strong emphasis on increasing the number of elective day surgery cases, especially in the patients' best interest, as it decreases the likelihood of late cancellation and hospital-acquired morbidity. A prospective study was performed to determine whether stapes surgery for otosclerosis could be performed safely in an outpatient setting. METHODS We present a series of stapes surgery cases for otosclerosis performed on a day-case basis. We performed a classic stapedotomy in 9 patients, a reverse classic step stapedotomy in 2 patients, a partial reverse classic step stapedotomy in 11 patients, and a hemi-stapedectomy in two patients. RESULTS Three of 24 patients (12.5%) treated with classic stapedotomy, 1 patient with partial reverse classic step stapedotomy, and 1 patient with hemi-stapedectomy were formally admitted to the hospital after surgery (length of stay, 23 h). The indications were vertigo (two patients) and asthenia (one patient). These patients were treated under general anesthesia. Two of these patients resided more than 250 km away from the hospital.
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O’Neill JP, Young O, Conlon B. Major otology day case surgery: viable, cost efficient and safe. Ir J Med Sci 2011; 180:841-4. [DOI: 10.1007/s11845-011-0739-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 07/09/2011] [Indexed: 10/17/2022]
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Rosén HI, Bergh IH, Odén A, Mårtensson LB. Patients´ experiences of pain following day surgery - at 48 hours, seven days and three months. Open Nurs J 2011; 5:52-9. [PMID: 21769308 PMCID: PMC3137156 DOI: 10.2174/1874434601105010052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 05/11/2011] [Accepted: 05/12/2011] [Indexed: 11/22/2022] Open
Abstract
Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased.
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Affiliation(s)
- Helena Inger Rosén
- School of Life Sciences, University of Skövde, Box 408, Skövde, (SE-541 28), Sweden
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Mottram A. "Like a trip to McDonalds": a grounded theory study of patient experiences of day surgery. Int J Nurs Stud 2010; 48:165-74. [PMID: 20678770 DOI: 10.1016/j.ijnurstu.2010.07.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Revised: 07/05/2010] [Accepted: 07/07/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The amount and complexity of (ambulatory) day surgery is rapidly expanding internationally. Nurses have a responsibility to provide quality care for day surgery patients. To do this they must understand all aspects of the patient experience. There is dearth of research into day surgery using a sociological frame of reference. OBJECTIVE The study investigated patients' experiences of day surgery using a sociological frame of reference. DESIGN A qualitative study using the grounded theory approach was used. SETTING The study was based in two day surgery units in two urban public hospitals in the United Kingdom. PARTICIPANTS 145 patients aged 18-70 years and 100 carers were purposely selected from the orthopaedic, ear nose and throat and general surgical lists. They were all English speaking and were of varied socio-economic background. METHODS The data was collected from 2004 to 2006. Semi-structured interviews were conducted on three occasions: before surgery, 48 h following surgery and one month following discharge. Permission was received from the Local Research Ethics Committee. Analysis of the data involved line-by-line analysis, compilation of key words and phrases (codes) and constant comparison of the codes until categories emerged. FINDINGS Patients liked day surgery and placed it within the wider societal context of efficiency and speed. Time was a major issue for them. They wished surgery, like all other aspects of their life to be a speedy process. They likened it to a McDonald's experience with its emphasis on speed, predictability and control. CONCLUSION This study throws new light on patient experiences and offers an understanding of day surgery against a western culture which emphasises the importance of speed and efficiency. It is a popular choice for patients but at times it can be seen to be a mechanistic way of providing care. The implications for nurses to provide education and information to add to the quality of the patient experience are discussed.
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Affiliation(s)
- Anne Mottram
- School of Nursing and Health Visiting, Mary Seacole Building, University of Salford, Frederick Road, Salford M6 6PU, United Kingdom.
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Abstract
INTRODUCTION In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. PATIENTS AND METHODS Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. RESULTS Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. DISCUSSION ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.
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Affiliation(s)
- T Pézier
- Ear, Nose and Throat Department, University Hospital Lewisham, Lewisham, UK
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