RESUMO
Background and objective Missing information or mistakes in patients' medical records, including those related to intraoperative and postoperative information, in an operative note can have profound clinical, ethical, and medicolegal implications. Operative notes should be informative, clear, and inclusive of the necessary data and should be collated immediately following surgery. In this study, we aimed to determine the ways to improve the quality of operative notes in the field of vascular surgery. Methods In this retrospective analysis, we compared the operative notes of 32 patients in the Department of Vascular and Endovascular Surgery, University Hospital Galway, against the standard set by the Royal College of Surgeons in Ireland (RCSI) (Code of Practice for Surgeons RCSI, 2018) and presented the results to our departmental staff. To facilitate an improvement in the quality of operative notes, a structured poster checklist was designed and displayed in the operating theatre. Furthermore, a scanner was set up in the operating theatre with clear and easy-to-follow instructions for uploading the operative notes into our hospital's online and digital patient record system (EVOLVE). An explanatory video was circulated among the staff. Three months after the first cycle, two further retrospective cycles were performed. Results A total of 96 patients' operative notes were analysed. Following the intervention, a significant improvement in documentation was noted concerning the dates; procedures followed; as well as the details of surgeons, assistants, anesthetists, incisions, surgery types, operative diagnoses, complications, additional procedures, tissue details, prostheses involved, closure techniques, postoperative plans, and surgeons' signatures. We also observed a significant increase in the uploading of the operative notes in the EVOLVE system. Conclusions The quality of the operative notes improved considerably after staff education, poster display, and scanner installment in the operating theatre. It is important to have an efficient and well-structured plan to improve the process of operative note-keeping, thereby ultimately enhancing overall patient care.
RESUMO
1.In this work we tried to study the effect of the regular use of potent mouthwash in COVID19 cases, on the premise that it may speedup the recovery, through the repeated reduction of microbial load, of both, the 2019-nCOV and oral microbiota; thus slowing the disease progression and lowering the incidence of superinfections. Through a randomized controlled trial, a mixed solution of Hydrogen peroxide 2% and chlorhexidine gluconate, to be used for oral rinsing and gargling three times daily, was tested in cases admitted to COVID treatment facility, versus the standard (only) COVID19-treatment protocol, starting with 46 cases in each group, matched in terms of disease severity, of symptoms, and average cycle threshold value (CT-value) for the COVID PCR test on diagnosis. Our findings showed statistically significant improvement in terms of a higher conversion rate to "COVID19-negative PCR" by five days of treatment (6/46 Vs 0/46), improvement in "symptoms severity" after two days of treatment, and less intubation and mortality (0/46 Vs 3/46) with all P-value < 0.05. There was also a trend of improvement in other outcome variables, though with no statistically significant difference; namely "shorter hospital stays," "less progression in Oxygen requirements", "less rate of plasma transfusion", and better "gross extent of improvement". Our findings support a beneficial role in treating active cases (Disease) and anticipates better outcome should implemented earlier in course of the disease; thus, suggest a role in limiting the spread (Pandemic), as an additional preventive method. Additionally, we think the repeated reduction in the microbial load might have been sufficient to induce a strain in a possible viral-microbial interaction, resulting in slowing down of the disease progress.
