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9. The relatives are also informed and updated regarding the nature and
complications of the procedure. 10.
Informed written consent is taken from the patient prior to surgery. 11.
All cases are seen by anaesthetist prior to surgery. 12.
All investigations are taken and reviewed by the attending doctor and if necessary, blood is grouped and cross matched.
13. Selected complicated patients will be required to undergo bowel preparation.
14. Pre operative assessment is done by the operating surgeon prior to the
operation.
Measurable elements of 13.1
1. Waiting time from diagnosis to operation.
2. Preoperative decision made by specialist.
3. Written high risk consent from patients.
4. Number of high risk cases seen by anaesthetist.
5. Number of cases cancelled by anaesthetist.
6. Operative complications, ureteric, bladder and bowel injury and unplanned
return of patient to operation theatre- incident report
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
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14.0 GYNAECOLOGY DAY CARE PROCEDURES
Standard
14.1 Day care hysteroscopy 14.1.1 Patients undergoing hysteroscopy procedures must fully satisfy all
requirements and is decided by specialist. 14.2 Day Care Tubal Ligations
14.2.1 Patients undergoing laparoscopic Tubal Ligations must fully satisfy all requirements and is decided by specialist.
14.1 DAY CARE HYSTEROSCOPY 14.1.1 Standard
Patients undergoing hysteroscopy procedures must fully satisfy all requirements and is decided by specialist.
Intent of 14.1.1
1. All patients are seen at the Gynae Clinic by Specialists Medical Officers.
2. Only specialists can order for a hysteroscopy after explaining to the patient
regarding the procedure. 3.
The Clinic Nurse will inform the Day Care Nurse regarding the case and an appointment is given within 3 to 4 weeks.
4. On appointment day , patient arrives half an hour prior to the procedure and
the vital signs are taken. 5.
The doctor will review the patient and the procedure will be re-explained and consent taken.
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6. After the procedure and if a specimen is sent for histopathology, the patient
will be re-counselled regarding the findings any complications and discharged once well. The review clinic appointment is given within 2 weeks in urgent
cases or 6weeks for normal cases.
Measurable elements of 14.1.1
1. Time taken from consultation to time procedure being done.
2. All cases should be managed by specialist or privileged medical officer.
3. Waiting time at hysteroscopy clinic
4. Time taken for HPE report to be ready.
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
14.2 DAY CARE TUBAL LIGATIONS 14.2.1 Standard
Patients undergoing laparoscopic Tubal Ligations must fully satisfy all requirements and is decided by specialist.
Intent of 14.2.1
1. All patients for tubal ligation are seen at the gynaecology clinic.
2. They are given an appointment during the first 2 weeks of their LMP.
3. On the morning of the procedure, a UPT and an Ultrasound scan is done for
the patient.
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