Journal of Patient Care

An audit on pregnancy testing in acute surgical admissions

2^nd World Congress on Patient Safety & Quality Healthcare

June 21-22, 2018 | Dublin, Ireland

Egemen Tezcan

Luton and Dunstable University Hospital, UK

Scientific Tracks Abstracts: J Pat Care

Abstract:

Introduction: Pregnancy testing is important for women admitted to hospital under the care of the surgical team. It is essential for two reasons: diagnosis of ectopic pregnancy in patients presenting with abdominal pain and the discovery of pregnancy impacting further management and avoiding unnecessary harm. Ectopic pregnancy caused 18 deaths in the UK between 2009-2013. The rate of unrecognised and incidentally discovered pregnancies in pre-operative pregnancy testing is quoted as 0.34%-2.4%. NICE guidelines on preoperative testing have outlined the need for all women with childbearing potential to undergo pregnancy testing. Aims & Methodology: An audit was designed to assess the rate of pregnancy testing documented in clinical notes and raise local awareness. Retrospective patient lists were used to identify women under 50 admitted to adult wards as an acute surgical admission over 1 week. Patients with documented reasons for not performing pregnancy testing were excluded e.g. menopause, bilateral oophorectomy/hysterectomy. Results were shared with surgical unit staff, awareness posters were placed and re-audit was performed after 4 weeks. Results: The first audit (01/12/17-08/12/17) identified 44 admissions, mean age 32.5. Pregnancy test was documented in 27 of 44 admissions (61%). An operation was performed in 14 admissions (32%); 1 in 14 of those patients did not have a documented pregnancy test. Second cycle of the audit (11/01/18-18/01/18) identified 42 patients; mean age 32.1. Pregnancy test was documented in 31 admissions (74%); 11 operations performed, all having had documented pregnancy testing. Conclusion: The audit revealed an important proportion of patients who did not undergo routine pregnancy testing. One patient who underwent surgery was identified as not having had a pregnancy test during their admission, revealing a risk to patient safety. The increased awareness and safety posters produced a modest improvement of 13% in rate of pregnancy testing on re-audit.

Biography :

Egemen Tezcan is a Junior Doctor currently working at Luton and Dunstable University Hospital. He graduated with an MBBS degree in 2015 from Newcastle University and completed his foundation training in the North Central Thames Foundation School in 2017. He is working towards a career in surgery and has an interest in healthcare innovation and medical education.