The use of standardized order sets to improve adherence to evidence-based postoperative management in major head and neck surgery - 19/09/18
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Abstract |
Background |
Standardized order sets (SOSs) are clinical tools derived from clinical care pathways that have shown improved patient-recovery and economic benefits. The primary objective was to examine the effect of SOSs on adherence to evidence-based postoperative guidelines for laryngectomy patients.
Methods |
A retrospective chart review comparing handwritten and SOS-based postoperative physician orders was conducted for consecutive laryngectomies performed (n=70) within a 3-year time period. Orders were analyzed for errors and deviations from evidence-based guidelines. Secondary outcome included complications such as thromboembolic disease, return to operating room, fistula formation, salivary bypass tube, length of hospital stay and death.
Results |
Approximately 81% of cases utilizing handwritten orders had at least one error (n=36) compared to 38% in the group that used an SOS (n=34) (P<0.0001). Subgroup analyses demonstrated that errors in mechanical deep vein thrombosis prophylaxis (P<0.0001) and antibiotic prophylaxis (P=0.0173) orders were significantly reduced in the SOS group compared to the handwritten group. No significant differences were observed between the two groups for measured postoperative complications (P>0.05) and length of hospital stay (18.6 days in both SOS and handwritten orders groups).
Conclusions |
SOSs are associated with reduced errors in postoperative orders. They are important tools to improve adherence to standardized guidelines for surgeries requiring complex postoperative management. Clinical care pathways and Enhanced Recovery After Surgery protocols can use SOSs to ensure appropriate orders are being made.
Le texte complet de cet article est disponible en PDF.Keywords : Standardized order sets, Head and neck surgery, Laryngectomy, Patient safety, Postoperative orders
Abreviations : SOS:, TED:, SCD:, DVT:, ERAS:
Plan
☆ | Podium presentation at the Canadian Society of Otolaryngology-Head and Neck Surgery. Annual General Meeting in Ottawa, Ontario, Canada in May 2014.. |
Vol 135 - N° 5S
P. S107-S111 - septembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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