David Bunting
Introduction
Target daycase rates for all suitable procedures in the UK are set by the British Association of Day Surgery. Daycase surgery is associated with improved patient outcomes, reduced hospital bed use, lower healthcare costs and less environmental impact. Day case performance is monitored locally, regionally nationally
Aim
This audit aimed to identify reasons for planned and unplanned overnight stay in patients undergoing inguinal hernia repair.
Methods
All patients undergoing inguinal hernia repair surgery between May 2024 and April 2025 in a single UK NHS Trust were identified. Data were collected on patient demographics, diagnosis, procedure, operative approach (open, laparoscopic or robotic), reasons for planned overnight stay and reasons for unplanned overnight stay.
Results
917 patients were identified. 863 patients were planned daycase and 54 patients were planned overnight stay. 818 patients (89.2%) were discharged on the same day as surgery and 99 patients (10.8%) stayed at least one night. Of the latter, 40 were planned admissions and 59 were unplanned admissions. Most common reasons for planned admissions were patient co-morbidity, social reasons, procedure complexity, and frailty. Most common reasons for unplanned overnight stay were pain, peri-operative complexity/complication, social reasons, urinary retention, and medical reasons.
Conclusions
Day case rates for inguinal hernia surgery were in line with national benchmark standards. The reasons for overnight stay were evaluated and strategies for reducing these developed including a discharge with catheter protocol for urinary retention, a default to daycase booking policy and a protocol for managing patients with no carer at home.
Authors
David Bunting, Abdul-Rahman Suleman, Lauren Ramage, Caoimhe Peregrine, Lily Ridehalgh, North Devon District Hospital, Barnstaple, United Kingdom