Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice?
Objective To determine whether pregnancy status, gynaecological history, date of last menstrual period and contraceptive use are documented in emergency female admissions of reproductive age admitted to general surgery. Design This is a retrospective study. Setting This study was conducted in the Un...
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| Veröffentlicht in: | World journal of surgery 2015-12, Vol.39 (12), p.2849-2853 |
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| creator | Powell-Bowns, M. Wilson, M. S. J. Mustafa, A. |
| description | Objective
To determine whether pregnancy status, gynaecological history, date of last menstrual period and contraceptive use are documented in emergency female admissions of reproductive age admitted to general surgery.
Design
This is a retrospective study.
Setting
This study was conducted in the United Kingdom.
Population
Females of reproductive age (12–50 years) admitted as an emergency to general surgery with abdominal pain were considered in this study.
Methods
Retrospective analysis of medical notes of emergency female admissions with abdominal pain between January and September 2012. We recorded whether a pregnancy test result was documented (cycle 1). Results were analysed and a prompt added to the medical clerk-in document. We re-audited (cycle 2) between January and June 2013 looking for improvement.
Main outcome measures
Documented pregnancy status within 24 h of admission and prior to any surgical intervention.
Results
100 case notes were reviewed in stage 1. 30 patients (30 %) had a documented pregnancy status. 32 (32 %), 25 (25 %) and 29 (29 %) had a documented gynaecology history, contraceptive use and date of last menstrual period (LMP), respectively. 24 patients underwent emergency surgery, 6 (25 %) had a documented pregnancy status prior to surgery. Of 50 patients reviewed in stage 2, 37 (75.0 %) had a documented pregnancy status (
p
|
| doi_str_mv | 10.1007/s00268-015-3204-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1731792324</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3859077861</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4927-49f748a771c58323a52b3e61142a62a81567313fd024297ed2c4a7ffe9b54cc33</originalsourceid><addsrcrecordid>eNqFkc1u1DAcxC1ERZfCA3BBlrhwaIq_EidcUNl-gbbqSm3F0fI6_yyuEnuxE6E8Fa-IsykIISFOjpzfjEczCL2i5IQSIt9FQlhRZoTmGWdEZOIJWlDBWcY440_RgvBCpG_KD9HzGB8IobIgxTN0yApWFSWvFujHmTdDB67XvfUO-wavA2yddmbEt-lyiMf4cnQajG_91hrd4isbex_GY3yme5gUKx17fA0u9mFI_9cQrK-xdjVeetcHbWC3N7-PgK3D5x2ELewfGMJseVp3NsbExPf4znaAGx-wxsuv2m33mnVy6a2BDy_QQaPbCC8fzyN0f3F-t7zKVjeXn5anq8yIislMVI0UpZaSmrxMZeicbTgUlAqmC6ZLmhcy9dLUhAlWSaiZEVo2DVSbXBjD-RF6O_vugv82QOxVSmigbbUDP0RFk1xWqWeR0Dd_oQ9-CC6l21OiZLKcKDpTJvgYAzRqF2ynw6goUdOaal5TpTXVtKaaNK8fnYdNB_Vvxa_5ElDNwHfbwvh_R_Xl8-3HCyLzSiYtm7UxyVLN4Y_Y_0z0E_ueu3Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1731482784</pqid></control><display><type>article</type><title>Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Powell-Bowns, M. ; Wilson, M. S. J. ; Mustafa, A.</creator><creatorcontrib>Powell-Bowns, M. ; Wilson, M. S. J. ; Mustafa, A.</creatorcontrib><description>Objective
To determine whether pregnancy status, gynaecological history, date of last menstrual period and contraceptive use are documented in emergency female admissions of reproductive age admitted to general surgery.
Design
This is a retrospective study.
Setting
This study was conducted in the United Kingdom.
Population
Females of reproductive age (12–50 years) admitted as an emergency to general surgery with abdominal pain were considered in this study.
Methods
Retrospective analysis of medical notes of emergency female admissions with abdominal pain between January and September 2012. We recorded whether a pregnancy test result was documented (cycle 1). Results were analysed and a prompt added to the medical clerk-in document. We re-audited (cycle 2) between January and June 2013 looking for improvement.
Main outcome measures
Documented pregnancy status within 24 h of admission and prior to any surgical intervention.
Results
100 case notes were reviewed in stage 1. 30 patients (30 %) had a documented pregnancy status. 32 (32 %), 25 (25 %) and 29 (29 %) had a documented gynaecology history, contraceptive use and date of last menstrual period (LMP), respectively. 24 patients underwent emergency surgery, 6 (25 %) had a documented pregnancy status prior to surgery. Of 50 patients reviewed in stage 2, 37 (75.0 %) had a documented pregnancy status (
p
< 0.001), with 41 (82 %) having both gynaecological history (
p
< 0.0001) and contraceptive use (
p
< 0.0001) documented. 40 patients (80 % had a documented LMP (
p
< 0.0001). 7 patients required surgery, of whom 6 (85.7 %) had a documented pregnancy test prior to surgery (
p
= 0.001). All pregnancy tests were negative.
Conclusions
A simple prompt in the surgical admission document has significantly improved the documentation of pregnancy status and gynaecological history in our female patients, particularly in those who require surgical intervention. A number of patient safety concerns were addressed locally, but require a coordinated, interdisciplinary discussion and a national guideline. A minimum standard of care, in females of reproductive age, should include mandatory objective documentation of pregnancy status, whether or not they require surgical intervention.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-015-3204-4</identifier><identifier>PMID: 26296839</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Cardiac Surgery ; Child ; Contraception - methods ; Documentation ; Ectopic Pregnancy ; Elective Setting ; Emergencies ; Female ; General Surgery ; Gynaecological History ; Hospitalization ; Humans ; Last Menstrual Period ; Medical Records ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Scientific Report ; Patient Admission ; Patient Selection ; Pregnancy ; Pregnancy Status ; Pregnancy Tests ; Reproductive History ; Retrospective Studies ; Surgery ; Surgical Procedures, Operative - methods ; Surgical Procedures, Operative - standards ; Thoracic Surgery ; United Kingdom ; Vascular Surgery ; Young Adult</subject><ispartof>World journal of surgery, 2015-12, Vol.39 (12), p.2849-2853</ispartof><rights>Société Internationale de Chirurgie 2015</rights><rights>2015 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4927-49f748a771c58323a52b3e61142a62a81567313fd024297ed2c4a7ffe9b54cc33</citedby><cites>FETCH-LOGICAL-c4927-49f748a771c58323a52b3e61142a62a81567313fd024297ed2c4a7ffe9b54cc33</cites><orcidid>0000-0003-1083-4466</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-015-3204-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-015-3204-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26296839$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Powell-Bowns, M.</creatorcontrib><creatorcontrib>Wilson, M. S. J.</creatorcontrib><creatorcontrib>Mustafa, A.</creatorcontrib><title>Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice?</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Objective
To determine whether pregnancy status, gynaecological history, date of last menstrual period and contraceptive use are documented in emergency female admissions of reproductive age admitted to general surgery.
Design
This is a retrospective study.
Setting
This study was conducted in the United Kingdom.
Population
Females of reproductive age (12–50 years) admitted as an emergency to general surgery with abdominal pain were considered in this study.
Methods
Retrospective analysis of medical notes of emergency female admissions with abdominal pain between January and September 2012. We recorded whether a pregnancy test result was documented (cycle 1). Results were analysed and a prompt added to the medical clerk-in document. We re-audited (cycle 2) between January and June 2013 looking for improvement.
Main outcome measures
Documented pregnancy status within 24 h of admission and prior to any surgical intervention.
Results
100 case notes were reviewed in stage 1. 30 patients (30 %) had a documented pregnancy status. 32 (32 %), 25 (25 %) and 29 (29 %) had a documented gynaecology history, contraceptive use and date of last menstrual period (LMP), respectively. 24 patients underwent emergency surgery, 6 (25 %) had a documented pregnancy status prior to surgery. Of 50 patients reviewed in stage 2, 37 (75.0 %) had a documented pregnancy status (
p
< 0.001), with 41 (82 %) having both gynaecological history (
p
< 0.0001) and contraceptive use (
p
< 0.0001) documented. 40 patients (80 % had a documented LMP (
p
< 0.0001). 7 patients required surgery, of whom 6 (85.7 %) had a documented pregnancy test prior to surgery (
p
= 0.001). All pregnancy tests were negative.
Conclusions
A simple prompt in the surgical admission document has significantly improved the documentation of pregnancy status and gynaecological history in our female patients, particularly in those who require surgical intervention. A number of patient safety concerns were addressed locally, but require a coordinated, interdisciplinary discussion and a national guideline. A minimum standard of care, in females of reproductive age, should include mandatory objective documentation of pregnancy status, whether or not they require surgical intervention.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiac Surgery</subject><subject>Child</subject><subject>Contraception - methods</subject><subject>Documentation</subject><subject>Ectopic Pregnancy</subject><subject>Elective Setting</subject><subject>Emergencies</subject><subject>Female</subject><subject>General Surgery</subject><subject>Gynaecological History</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Last Menstrual Period</subject><subject>Medical Records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Scientific Report</subject><subject>Patient Admission</subject><subject>Patient Selection</subject><subject>Pregnancy</subject><subject>Pregnancy Status</subject><subject>Pregnancy Tests</subject><subject>Reproductive History</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Procedures, Operative - methods</subject><subject>Surgical Procedures, Operative - standards</subject><subject>Thoracic Surgery</subject><subject>United Kingdom</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkc1u1DAcxC1ERZfCA3BBlrhwaIq_EidcUNl-gbbqSm3F0fI6_yyuEnuxE6E8Fa-IsykIISFOjpzfjEczCL2i5IQSIt9FQlhRZoTmGWdEZOIJWlDBWcY440_RgvBCpG_KD9HzGB8IobIgxTN0yApWFSWvFujHmTdDB67XvfUO-wavA2yddmbEt-lyiMf4cnQajG_91hrd4isbex_GY3yme5gUKx17fA0u9mFI_9cQrK-xdjVeetcHbWC3N7-PgK3D5x2ELewfGMJseVp3NsbExPf4znaAGx-wxsuv2m33mnVy6a2BDy_QQaPbCC8fzyN0f3F-t7zKVjeXn5anq8yIislMVI0UpZaSmrxMZeicbTgUlAqmC6ZLmhcy9dLUhAlWSaiZEVo2DVSbXBjD-RF6O_vugv82QOxVSmigbbUDP0RFk1xWqWeR0Dd_oQ9-CC6l21OiZLKcKDpTJvgYAzRqF2ynw6goUdOaal5TpTXVtKaaNK8fnYdNB_Vvxa_5ElDNwHfbwvh_R_Xl8-3HCyLzSiYtm7UxyVLN4Y_Y_0z0E_ueu3Q</recordid><startdate>201512</startdate><enddate>201512</enddate><creator>Powell-Bowns, M.</creator><creator>Wilson, M. S. J.</creator><creator>Mustafa, A.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1083-4466</orcidid></search><sort><creationdate>201512</creationdate><title>Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice?</title><author>Powell-Bowns, M. ; Wilson, M. S. J. ; Mustafa, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4927-49f748a771c58323a52b3e61142a62a81567313fd024297ed2c4a7ffe9b54cc33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiac Surgery</topic><topic>Child</topic><topic>Contraception - methods</topic><topic>Documentation</topic><topic>Ectopic Pregnancy</topic><topic>Elective Setting</topic><topic>Emergencies</topic><topic>Female</topic><topic>General Surgery</topic><topic>Gynaecological History</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Last Menstrual Period</topic><topic>Medical Records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Scientific Report</topic><topic>Patient Admission</topic><topic>Patient Selection</topic><topic>Pregnancy</topic><topic>Pregnancy Status</topic><topic>Pregnancy Tests</topic><topic>Reproductive History</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Procedures, Operative - methods</topic><topic>Surgical Procedures, Operative - standards</topic><topic>Thoracic Surgery</topic><topic>United Kingdom</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Powell-Bowns, M.</creatorcontrib><creatorcontrib>Wilson, M. S. J.</creatorcontrib><creatorcontrib>Mustafa, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Powell-Bowns, M.</au><au>Wilson, M. S. J.</au><au>Mustafa, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice?</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2015-12</date><risdate>2015</risdate><volume>39</volume><issue>12</issue><spage>2849</spage><epage>2853</epage><pages>2849-2853</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Objective
To determine whether pregnancy status, gynaecological history, date of last menstrual period and contraceptive use are documented in emergency female admissions of reproductive age admitted to general surgery.
Design
This is a retrospective study.
Setting
This study was conducted in the United Kingdom.
Population
Females of reproductive age (12–50 years) admitted as an emergency to general surgery with abdominal pain were considered in this study.
Methods
Retrospective analysis of medical notes of emergency female admissions with abdominal pain between January and September 2012. We recorded whether a pregnancy test result was documented (cycle 1). Results were analysed and a prompt added to the medical clerk-in document. We re-audited (cycle 2) between January and June 2013 looking for improvement.
Main outcome measures
Documented pregnancy status within 24 h of admission and prior to any surgical intervention.
Results
100 case notes were reviewed in stage 1. 30 patients (30 %) had a documented pregnancy status. 32 (32 %), 25 (25 %) and 29 (29 %) had a documented gynaecology history, contraceptive use and date of last menstrual period (LMP), respectively. 24 patients underwent emergency surgery, 6 (25 %) had a documented pregnancy status prior to surgery. Of 50 patients reviewed in stage 2, 37 (75.0 %) had a documented pregnancy status (
p
< 0.001), with 41 (82 %) having both gynaecological history (
p
< 0.0001) and contraceptive use (
p
< 0.0001) documented. 40 patients (80 % had a documented LMP (
p
< 0.0001). 7 patients required surgery, of whom 6 (85.7 %) had a documented pregnancy test prior to surgery (
p
= 0.001). All pregnancy tests were negative.
Conclusions
A simple prompt in the surgical admission document has significantly improved the documentation of pregnancy status and gynaecological history in our female patients, particularly in those who require surgical intervention. A number of patient safety concerns were addressed locally, but require a coordinated, interdisciplinary discussion and a national guideline. A minimum standard of care, in females of reproductive age, should include mandatory objective documentation of pregnancy status, whether or not they require surgical intervention.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>26296839</pmid><doi>10.1007/s00268-015-3204-4</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-1083-4466</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | World journal of surgery, 2015-12, Vol.39 (12), p.2849-2853 |
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| language | eng |
| recordid | cdi_proquest_miscellaneous_1731792324 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Abdominal Surgery Adolescent Adult Cardiac Surgery Child Contraception - methods Documentation Ectopic Pregnancy Elective Setting Emergencies Female General Surgery Gynaecological History Hospitalization Humans Last Menstrual Period Medical Records Medicine Medicine & Public Health Middle Aged Original Scientific Report Patient Admission Patient Selection Pregnancy Pregnancy Status Pregnancy Tests Reproductive History Retrospective Studies Surgery Surgical Procedures, Operative - methods Surgical Procedures, Operative - standards Thoracic Surgery United Kingdom Vascular Surgery Young Adult |
| title | Documentation of Pregnancy Status, Gynaecological History, Date of Last Menstrual Period and Contraception Use in Emergency Surgical Admissions: Time for a Change in Practice? |
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