Improving the recognition of post-operative XXXX .

@entity1 @entity740 @entity810 @entity1011
The National Institute for Health and Care Excellence (NICE) state that @entity810 ( @entity810 ) is seen in 13-18% of all @entity1 being admitted to hospital and that other @entity1 will further go on to develop @entity810 during their time in hospital, with around 30-40% being in the operative setting. @entity810 has an estimated inpatient mortality of 20-30% in the UK and can lead to long-term morbidities like @entity740 .[2] @entity810 is under-recognised and badly managed despite its prevalence and seriousness, with NCEPOD report stating that only 50% of @entity1 with @entity810 received good care, that there was poor assessment of risk factors for @entity810 , and there was an unacceptable delay in recognising post-admission @entity810 in 43% of @entity1 .[4] Baseline data collected on the urology ward in Ninewells Hospital, showed that only five of 22 (23%) @entity1 undergoing urological surgery had post-operative @entity1011 measured on the ward within 48 hours (the primary method for detecting @entity810 ). Excluding @entity1 who were discharged the same day 5/16 (31%) received the blood test. The aim of the project was to increase the number of @entity1 returning to ward 9 post-surgery who receive a serum @entity1011 measurement within two days of their urological surgery, excluding daycases. Specifically, we wanted the reliability of this measurement to be 95% or over in ward 9 by 30 July 2014. This was to be done by raising awareness around @entity810 on ward 9 and changing protocol so that every @entity1 staying on ward 9 beyond their day of surgery should receive a post-operative @entity1011 . This would be tested for a set amount of time to see if @entity1 with @entity810 were being missed. Despite not being able to implement a set protocol, the percentage of @entity1 receiving post-operative @entity1011 measurements on ward 9 after a urological surgery still increased significantly. By interacting with the urology team and presenting our data, the knowledge and comprehension of the problem was altered. This lead to a change in culture and a significant increase in the number of post-operative @entity1011 measurements being taken. Through building relationships on the ward and sharing our data and knowledge there was an increase from 27% of @entity1 receiving post-op @entity1011 in our first week of collecting data, to 87% in our last week on ward 9. However, without a set tool or change in protocol this change appears to have not been sustainable as the percentage dropped to 42% two weeks later.
