Effectiveness of clinical practice guidelines for preoperative patient preparation on postponement and cancellation of elective case in Phrae hospital - ประสิทธิผลการใช้แนวปฏิบัติทางคลินิกในการเตรียมผู้ป่วยก่อนผ่าตัดกรณีผ่าตัดไม่เร่งด่วน ต่อการเลื่อนและงดผ่าตัดในโรงพยาบาลแพร่

Abstract

Background: Patients surgery in elective case preparation is a readiness process that involves multiple parties, both physician and hospital services. Surgical cancellation made a waste times, a waste of resources and Affect the minds, patients and relatives. Previous research has shown the cause of surgical abstinence from patients not ready. And since there are no guidelines for preparing patients in the same direction within the hospital. As a result, there are still surgical cancellation elective case. The use of prepare guidelines in elective patients will reduce the risk of cancellation surgery.

Objective: Study on the results of using clinical guidelines in elective surgery patients at Phrae Hospital for reduction postponement and cancellation surgery cause of the patient.

Methods: This study is clinical efficacy research study with prospective interrupted time design was conducted at Phrae Hospital in all elective patients undergoing surgery at Phrae Hospital. Between September 2016 - January 2017 (1,727 elective patients September 2016 – November 2016 non-use guideline, 1,205 elective patients December 2016 – January 2017 use guideline). Prepare guidelines for preoperative patients. More indications recommendations for patients, specific diseases, and consultations with anesthesiologists. Data is collected by recording the Prevent Cancellation Surgery , HOSxP Program and Patient assessment record form before and after anesthesia. Compare groups used and not using guidelines. Describe the data using percentage, mean, standard deviation. Data were analyzed by using t-test and exact probability test.

Results:  The use of clinical practice guidelines for elective patients in Phrae Hospital. It was found that cancellation surgery and postponement surgery was not significantly different between use guideline and non- use guideline patients in two periods. However when analyzing the cause, the elective patient is not ready. The group used the guidelines can reduce the incidence of surgery caused by patients with abnormal vital signs,  laboratory tests, ECG, CXR and abstain from morning sickness surgery compared to non-practice groups statistically significant (P-value 0.001, 0.013, 0.002, 0.029, 0.023) 

Keywords: Clinical Practice Guideline, Elective case, Cancellation surgery, Postponement surgery