AB174. 44. Piloting outpatient surgery—minor operations in Wexford

Background: With increasing medical tourism and international healthcare, emerging multidrug resistant organisms (MDROs) or “superbugs” are becoming more prevalent. These MDROs are unique because they are resistant to antibiotics and can carry special resistance mechanisms. In April 2019, our hospital was notified that a superbug, New Delhi Metallo-β-lactamase(NDM)–producing carbapenem-resistant Enterobacteriaceae (CRE), was identified in a patient who had been transferred to another hospital after being at our hospital for 3 weeks. Our facility had a CRE admission screening protocol in place since 2013, but this patient did not meet the criteria to be screened on admission. Methods: The infection prevention (IP) team consulted with the Minnesota Department of Health (MDH) and gathered stakeholders to discuss containment strategies using the updated 2019 CDC Interim Guidance for Public Health Response to Contain Novel or Targeted Multidrug-resistant Organisms (MDROs) to determine whether transmission to other patients had occurred. NDM CRE was classified under tier 2 organisms, meaning those primarily associated with healthcare settings and not commonly identified in the region, and we used this framework to conduct an investigation. A point-prevalence study was done in an intensive care unit that consisted of rectal screening of 7 patients for both CRE and Candida auris, another emerging MDRO. These swabs were sent to the Antibiotic Resistance Laboratory Network (ARLN) Central Regional Lab at MDH for testing. An on-site infection control risk assessment was done by the MDH Infection Control Assessment and Response (ICAR) team. Results: All 7 patients were negative for both CRE and C. auris, and no further screening was done. During the investigation, it was discovered that the patient had had elective ambulatory surgery outside the United States in March 2019. The ICAR team assessment provided overall positive feedback to the nursing unit about isolation procedures, cleaning products, and hand hygiene product accessibility. Opportunities included set-up of soiled utility room and updating our process to the 2019 MDH recommendation to screen patients for CRE and C. auris on admission who have been hospitalized, had outpatient surgery, or hemodialysis outside the United States in the previous year. Conclusions: Point-prevalence study results showed no transmission of CRE and highlighted the importance of standard precautions. This event supports the MDH recommendation to screen for CRE any patients who have been hospitalized, had outpatient surgery, or had hemodialysis outside the United States in the previous year.Funding: NoneDisclosures: None

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Day stay, ambulatory or outpatient surgery

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1994.tb126545.x ◽

1994 ◽

Vol 160 (3) ◽

pp. 99-100 ◽

Cited By ~ 3

Author(s):

Frederick O Stephens

Keyword(s):

Outpatient Surgery

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Patient satisfaction of minor outpatient surgery in an academic hospital in Argentina

Enfermería Clínica (English Edition) ◽

10.1016/j.enfcle.2020.05.003 ◽

2021 ◽

Author(s):

Natalia Veronica Giorgi ◽

Estefania Nahir Pintos ◽

Pablo Rosón Rodríguez ◽

Luis Ignacio Garegnani ◽

Juan Víctor Ariel Franco

Keyword(s):

Patient Satisfaction ◽

Outpatient Surgery ◽

Academic Hospital

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494 Streamlining the Minor Operations Process - The Effect of Better Documentation

British Journal of Surgery ◽

10.1093/bjs/znab134.436 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

T Schrire ◽

C Estela

Keyword(s):

Patient Care ◽

Plastic Surgery ◽

Patient Experience ◽

Patient Flow ◽

Vital Part ◽

Rapid Turnover ◽

Quality Of Patient Care ◽

New Form ◽

Minor Operations

Abstract Introduction Plastic Surgery Minor Operations is a fast paced, rapid turnover operative environment. It is reliant on effective communication, accurate surgery, and time efficiency. It was noticed in our department that there was confusion regarding booking and operative intentions leading to delays in surgery and over-running lists. This was worsening patient experience and leading to delays in patient care. Method In response to the delays and confusion in booking, a new booking form was created, so all patients have a standardised booking containing the necessary information. This form was disseminated across all the booking clinics and formed a vital part of the pre-operative check in process. Results The audit was carried out at the time of introduction, and then re-audited a year later to see if the form has improved care for patients. Results showed that with the new booking form, people were not having to cancel or rearrange patients. Patient booking forms were sufficient, and a copy of the clinic letter no longer required for the operation to proceed or for clarity. It was noted that more senior advice was sought. Conclusions The new form has improved patient flow and quality of patient care, whilst streamlining the booking process.

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