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Anaesthetics quality indicators

• Percentage of high risk patients prescribed anti-sickness medication at the time of surgery so medication can be given promptly after the operation if required
• Percentage of high risk patients who did not require anti-sickness medication after their operation

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Percentage of high risk patients prescribed anti-sickness medication at the time of surgery so medication can be given promptly after the operation if required

How is the Trust doing?

Rolling year to date (January 2011 – December 2011)	77.2%
Rolling 2 years (January 2010 – December 2011)	80.5%

Higher percentage indicates better performance.

Although performance remains consistent for this indicator, it falls below the target of 95%. The Trust is focusing on making improvements during 2011-12 to increase the percentage of high-risk patients who are prescribed with anti-sickness medication.

Why is this indicator important?

Nausea and vomiting is a common complication after surgery and is known as post-operative nausea and vomiting. It can be emotionally and physically distressing and result in delayed hospital discharge. Certain surgical procedures such as laparoscopic (keyhole) and ear, nose and throat (ENT) surgery are associated with a greater risk of developing post-operative nausea and vomiting.

Post-operative nausea and vomiting occurs in around 30-40% of patients and can be as high as 80% of high-risk patients. A major component of the treatment for patients who develop post-operative nausea and vomiting is the administration of anti-sickness (anti-emetic) medication.

This indicator measures the percentage of high-risk patients prescribed anti-sickness medication at the time of surgery. A prescription enables this medication to be given without delay following surgery if required.

The Trust is aiming for 95% of high-risk patients to be prescribed with anti-sickness medication at the time of surgery. It is important to note that there will be some patients for whom anti-sickness medication may not be suitable (contra-indicated).

How do we measure this indicator?

The indicator is measured by the percentage of high risk patients undergoing surgery (ENT, general and laparoscopic surgery) who were prescribed with anti-sickness medication before or on the day of their operation.

Where does the data come from?

The data for this indicator is compiled from the Trust’s patient administration system called Lorenzo and the Prescribing and Information Communication System (PICS).

Percentage of high risk patients who did not require anti-sickness medication after their operation

How is the Trust doing?

Rolling year to date (January 2011 – December 2011)	65.1%
Rolling 2 years (January 2010 – December 2011)	65.3%

Higher percentage indicates better performance.

The Trust is performing well against this indicator with far fewer patients requiring anti-sickness medication post-operatively than would be expected in this high risk group. Performance will continue to be monitored to ensure it remains high.

Why is this indicator important?

Nausea and vomiting is a common complication after surgery and is known as post-operative nausea and vomiting. It can be emotionally and physically distressing and result in delayed hospital discharge. Certain surgical procedures such as laparoscopic (keyhole) and ear, nose and throat (ENT) surgery are associated with a greater risk of developing post-operative nausea and vomiting.

Post-operative nausea and vomiting occurs in around 30-40% of patients and can be as high as 80% in high-risk patients.

This indicator measures the percentage of high-risk patients who required anti-sickness medication (anti-emetics) after their surgery. Post-operative nausea and vomiting is not routinely recorded so this indicator was developed as a surrogate marker for the incidence of post-operative nausea and vomiting. As some patients may refuse anti-sickness medication, this indicator may under-represent the true incidence.

A number of factors can reduce the likelihood of high-risk patients developing post-operative nausea and vomiting. These include the use of regional anaesthetic techniques where appropriate, preventative anti-sickness medication and avoiding certain medications which can cause nausea and vomiting.

The Trust is aiming for as few patients as possible to require anti-sickness medication post-operatively.

How do we measure this indicator?

The indicator is measured by the percentage of high risk patients undergoing surgery (ENT, general and laparoscopic Surgery) who were given anti-sickness medication after their operation.

Where does the data come from?

The data for this indicator is compiled from the Trust’s patient administration system called Lorenzo and the Prescribing and Information Communication System (PICS).