Joellene Mitchell, Marianne Boden, Lynsay Lawless, Aileen Clyde, Chris Johnstone, Ross Junkin
NHS Ayrshire & Arran, Ayr, United Kingdom
Abstract
Introduction: Discharge information to primary care after day surgery (DS) may be delayed as it has been provided by letter from surgeons, along with written information given to the patient. This did not include prescribing information. A local audit showed up to 25% of patients contacted their GP within 2 weeks of surgery for additional analgesia.
FPM guidance recommendations include; providing up to 7 days of pain relief, avoiding compound drugs (co-codamol), weaning analgesia after surgery. More complex surgery is being performed as DS and may require strong opioids for postoperative analgesia.
HEPMA (Hospital Electronic Prescribing & Medicines Administration) is utilised in our health board. Immediate Discharge Letters (IDLS) can be generated including medication and provides communication with primary care within 24 hours of discharge.
Methods: HEPMA bundles were created to comply with recommendations, replacing co-codamol with paracetamol and dihydrocodeine, and ensuring appropriate quantity for up to 7 days.
The use of HEPMA IDLs for DS patients was introduced, education sessions provided to the anaesthetic department and further support from the HEPMA team given as required.
Results: A six month period was analysed using HEPMA. Two hospital sites were included. Engagement in one site was already well established, and the second site showed significant improvement over this period.
Supplementary medications at discharge included antibiotics and venous thromboembolism prophylaxis. Information on dressing changes and follow-up was also provided.
Discussion: HEPMA provides an effective platform to provide timely communication to primary care and standardised prescribing bundles for discharge analgesia after DS.