Abstract:
ABSTRACT
INTRODUCTION: Preoperative evaluation of a patient is the fundamental component of
anaesthetic practice. Poor documentation and record keeping on the preoperative evaluation
(PEF) form is a big obstacle in attaining good practice and hence improving patient outcome
following operative procedures. The aim of the study was to conduct an audit of the
anaesthetic preoperative evaluation of general surgery patients at Dr George Mukhari hospital
(DGMH), Garankuwa.
METHODS: A sample size of 88 record files of general surgery patients who underwent
elective surgery during 2008 at DGMH was analysed. The proportion of completeness of
information recorded on the PEF used at DGMH was compared with a standardized PEF
which uses the global quality index (GQI).
RESULTS: Only 75 out of88 patients had PEF in their files. The Modified GQI scores for
the sample of75 patients ranged between 33.3% and 100%. The mean Modified GQI score
was 72.2 +/- SD 13.9%. The median was 73.3 %, while the lower quartile was 60% and the
upper quartile was 80%. The GQI scores were low for the following criteria; 'preoperative
diagnostic procedure' (46.7%), 'medications prescribed by surgeons' (46.7%), 'preoperative
fasting status' (32%), and deficiency in 'patient's weight' (34.7%) and 'allergies' (34.7%)
during the preoperative assessment. Only in 1.3% was the PEF filled completely in
accordance with the Modified GQI score.
CONCLUSION: The overall quality of the preoperative assessment was inadequate in a
number of the ModifiedGQI scores criteria suggesting the need for improvement in
preoperative assessment of patients by anaesthetists at this hospital to improve patient
outcome.
