1094 Pre-Operative Prescribing Practices for Patients Undergoing Emergency General Surgical Operations
K Nair, M Gill, C Sri-Pathmanathan, D Balasubramaniam- Surgery
Abstract
Aim
To identify if pre-operative prescribing has improved over time within the general surgery department as identified within the NCEPOD 2002 report on pre-operative drug treatment. This multi-cycle audit aims to achieve 100% compliance when administering essential drugs and omitting certain drug classes.
Method
Data for the current cycle of this audit was collected retrospectively. The drug charts of 131 patients who had an emergency general surgical operation in CEPOD theatre between August and October 2022 were analysed. The drug classes to be collected were based on the NCEPOD 2002 report, local trust and European anaesthesiology/cardiology guidelines. The data was compared to previous cycles collected over multiple years.
Results
For a total of 236 essential drug classes prescribed, 181 were given pre-operatively (76.7%). Compared with previous cycles, results have improved (67% in 2021, 68% in 2018 and 56% in 2015). A frequent reason charted for holding essential medications was “nil by mouth”. Of the 9 medications that should have been withheld on the day of surgery, 7 were held appropriately (77.8%), which was similar to previous results (78% in 2021, 50% in 2018, 75% in 2015).
Conclusions
Although the results have shown improvement over time, there is still a significant proportion of patients who are not receiving essential medications pre-operatively. There also remains ongoing misconceptions about what “nil by mouth” means and how this impacts medication administration. More education is required for both doctors and nursing teams with information on which drug classes should still be given pre-operatively and which should be omitted.