Surgery 1: Day surgery

Supervisor

Jennifer Wheatley

Department

Paediatrics

Email

wheatley@unimelb.edu.au

Objectives

Background

Large numbers of children are admitted and treated as day surgery patients. The requirements of the service are to provide an efficient, streamlined process but also maintain excellence in surgical care of children. The service should consist of adequate preoperative preparation both prior to and on the day of admission, appropriate medical assessment and a pleasant physical environment during the waiting period. Parents need to understand the full implications of the anaesthetic and operation and give informed consent. In the course of transfer to theatre, anaesthetic process, recovery process, discussion with parents regarding post-operative care, staff need to be medically astute and efficient but also reassuring and aware of parent's concerns and questions. Parents need to be well informed about what to do and who to contact in the event or post-operative problems and leave the hospital feeling confident about the procedure that has been performed and their ability to cope with the healing process.

1. To examine the day surgery service in a limited patient group (3 patients) in terms of its fulfillment of criteria of excellence
2. For each of the patients selected briefly indicate the nature of the procedure, anaesthetic given, common potential complications and the nature of post-operative care
3. Discuss the concerns of the parents (and patients where appropriate) during various phases of the day surgery experience - the preparation for hospitalization, the preoperative period (assessment, consent, waiting), the operation (anaesthetic, waiting room experience, recovery room), the post-operative period (pain management, post-operation explanations and instructions, remainder of the recovery experience). A follow up contact with the parents by phone or by personal contact would also be appropriate
4. Discuss the successful aspects and negative aspects of the service from the patients and parents (and staff - if possible) perspective. The student should aim for a 'rounded' approach to this study that includes an understanding of the logistics of providing an efficient medical service and how the patients and parents as individuals fit into this model. In particular, the student should appreciate the following: personal stresses, physical environment, all aspects of the medical procedure from the child and family's perspective, aftercare

Resources and learning opportunities

1. Observation of the day surgery process by tracking selected patients and interview of patients and parents
2. Discussion with and observation of nursing and medical staff in the Day surgery unit
3. Meetings with Jennifer Wheatley (surgeon)