Authors (including presenting author) :
WONG KK(1), WONG KHK(1), WONG WY(2), KWOK YL(2)
Affiliation :
(1)Department of Orthopaedic and Traumatology, Kwong Wah Hospital
(2)Department of Anaesthesiology & Operating Theatre, Kwong Wah Hospital
Introduction :
In order to decompress or drain fluid or air from area of surgery, surgical drains will be inserted.
It will be removed in the first few days after operation. Removal is usually a simple procedure that is done at bedside via a simple pulling mechanism.
A retained and broken drain during removal is very rare, easily overlooked, and avoidable but can lead to serious complications. Moreover, retaining it inside the joint will increase the risk of neurovascular injury, irritating pain, and infection; additional surgery may be required to tackle complications caused by retained drain.
Objectives :
After using this new drainage, regardless of the operation process and post-operative care in the ward, it can be ensured that there is no residual or broken part of the drainage tube in the patient's body. The workflow of applying drainage not only become easier, and over 95% responded agree that can improve the patient safety. Last but not least, it is hoped that in the future, it will can be applied to surgeries that need postoperative drainage
Methodology :
Introduce new drains for orthopedics cases (a drain with permanent marking at the tip of the drain) which aims to reduce the complexity of documentation and handover in handling drainage system during operation and post-operatively. Hence, nursing procedure can be smoother.
We recorded the length of drainage used in all orthopedic cases for 2 weeks to identify lengths that were commonly used by surgeons. After discussion with surgeons, 3 different perforation lengths (3cm, 5cm and 7cm) were introduced. We monitored 6 months to ensure no discoloration was identified at permanent marking of the drain.
With this type of drain, surgeons do not need to shorten drains case by case, scrub nurses do not need to measure the original and shortened length of drain. It helps to reduce errors caused by measurement, calculation, documentation and handover regarding the length of drain. On the other hand, during drainage removal in ward by nurses, presence of black marking at tip indicates that the drainage has been completely removed. The nursing procedure is simplified, and the time to recheck integrity of drainage removal is greatly reduced.
Result & Outcome :
The results and findings of this research are targeted to reflect useful information and comments from 10 surgeons and 33 operation theatre nurses. Over 90% responded satisfied and agreed that this new design wound drain improve post-operative drainage measurement error.
