Optimising calcium monitoring post thyroid and parathyroid surgery.

2.50
Hdl Handle:
http://hdl.handle.net/11287/597037
Title:
Optimising calcium monitoring post thyroid and parathyroid surgery.
Authors:
Rayner, Eleanor; Williams, Nerida; Dunn, Julie
Abstract:
There is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Exeter (RD&E) Hospital over a ten month period in 2013. A retrospective audit was undertaken, identifying whether serum calcium was monitored according to guideline; ie measured within the first 24 hours of surgery and daily thereafter until the patient was normocalcaemic.[2-3] The audit showed an overall compliance in 79% (n = 34) of cases. Of the non-compliant cases (n=9), seven also suffered hypocalcaemia. The current process was mapped by a flow chart and used as a basis for discussing experiences and identifying areas for improvement. Interventions implemented included a patient leaflet, a process flow chart displayed in the team office and in the weekend handover book, standard text for use in discharge summaries describing the process to GPs, the issuing of prescriptions or actual supplements for patients felt to be at high risk of hypocalcaemia, and finally education to the wider surgical junior doctor team. Percentage compliance with guidelines was compared before and after intervention with a re-audit undertaken in April 2014. Significant improvement was shown, with 100% of re-audit cases compliant (n=41), and all seven cases of hypocalcaemia were managed in full compliance with guideline.
Citation:
Optimising calcium monitoring post thyroid and parathyroid surgery. 2014, 3 (1): BMJ Qual Improv Rep
Publisher:
BMJ
Journal:
BMJ quality improvement reports
Issue Date:
29-Oct-2014
URI:
http://hdl.handle.net/11287/597037
DOI:
10.1136/bmjquality.u204844.w2048
PubMed ID:
26732097
Additional Links:
http://dx.doi.org/10.1136/bmjquality.u204844.w2048
Note:
This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.
Type:
Journal Article; Report
Language:
en
ISSN:
2050-1315
Appears in Collections:
Breast Care Unit; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorRayner, Eleanoren
dc.contributor.authorWilliams, Neridaen
dc.contributor.authorDunn, Julieen
dc.date.accessioned2016-02-23T15:15:31Zen
dc.date.available2016-02-23T15:15:31Zen
dc.date.issued2014-10-29en
dc.identifier.citationOptimising calcium monitoring post thyroid and parathyroid surgery. 2014, 3 (1): BMJ Qual Improv Repen
dc.identifier.issn2050-1315en
dc.identifier.pmid26732097en
dc.identifier.doi10.1136/bmjquality.u204844.w2048en
dc.identifier.urihttp://hdl.handle.net/11287/597037en
dc.description.abstractThere is a risk of hypocalcaemia following total thyroidectomy and parathyroidectomy surgery, with the nadir being two to five days post operatively.[1] This project examined and improved the post-operative monitoring of serum calcium in patients undergoing these procedures at the Royal Devon and Exeter (RD&E) Hospital over a ten month period in 2013. A retrospective audit was undertaken, identifying whether serum calcium was monitored according to guideline; ie measured within the first 24 hours of surgery and daily thereafter until the patient was normocalcaemic.[2-3] The audit showed an overall compliance in 79% (n = 34) of cases. Of the non-compliant cases (n=9), seven also suffered hypocalcaemia. The current process was mapped by a flow chart and used as a basis for discussing experiences and identifying areas for improvement. Interventions implemented included a patient leaflet, a process flow chart displayed in the team office and in the weekend handover book, standard text for use in discharge summaries describing the process to GPs, the issuing of prescriptions or actual supplements for patients felt to be at high risk of hypocalcaemia, and finally education to the wider surgical junior doctor team. Percentage compliance with guidelines was compared before and after intervention with a re-audit undertaken in April 2014. Significant improvement was shown, with 100% of re-audit cases compliant (n=41), and all seven cases of hypocalcaemia were managed in full compliance with guideline.en
dc.language.isoenen
dc.publisherBMJen
dc.relation.urlhttp://dx.doi.org/10.1136/bmjquality.u204844.w2048en
dc.rightsArchived with thanks to BMJ Quality Improvement Reports. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcodeen
dc.subjectWessex Classification Subject Headings::Surgeryen
dc.titleOptimising calcium monitoring post thyroid and parathyroid surgery.en
dc.typeJournal Articleen
dc.typeReporten
dc.identifier.journalBMJ quality improvement reportsen
dc.description.noteThis article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text from the publisher's site.en
dc.type.versionPublisheden

Related articles on PubMed

All Items in RD&E Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.