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Emergency Laparotomy Forum

 

NELA up and running!

Up to Emergency Laparotomy Forum
January 29. 2014
david saunders

It's 3 weeks since we started to enter patient detail. How are you finding it? Any particular issues? Any tips? What's going well and what is proving more problematic?

It would be helpful to share experiences perhaps. No point reinventing the wheel etc.....

Challenges for me have included

Encouraging engagement from colleagues: there are a lot of people to get up to speed with obtaining accounts and login passwords; remembering to enroll patients; sharing the burden of data entry.

Some quesitons about eligability (eg jejunostomy surgery post-oesophagectomy; colostomy for a patient with fourniers gangrene). I've made my best judgement.

A bug in the question about peritoneal contamination (if no contamination, next question still demands to know if this is widespread or localised non-contamination). Reported to NELA who are aware of issue.

Follow up process. I'm still trying to work this through. Decided that tracking individual patients on the wards until discharge is not feasible, so then very difficult to know whether or not elderly care have been involved. Histology reports will lag long behind patient discharge. An issue with critical care data: our patient management software can track those who were admitted to critical care and the levels of support needed and for how long, but level 2 care might be delivered at the ICU end of the ward, and vice versa. Difficult thus to know how to answer the length of stay in ICU and HDU questions. We do not have 2 separate units; rather a 20 bedded critical care unit, flexibly staffed and run with varying levels of organ support.

 

Good:

no objections to the collection of GMC numbers

Encouraging noises from anaesthesia and surgery alike

Very few patients have been missed

software seems to work well overall (would be improved with a big button for "add a new case" on the front page. Also one case so far with interchanged surname and forename: personally I would have had surname first in the audit form.)

 

How are you getting on elsewhere? Please add your voice!

 

Dave Saunders

Newcastle upon Tyne

 

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