Audit of patient experience of day-case inguinal hernia repair.
BACKGROUND
This study was prompted by a complaint from a patient citing he had suffered postoperative pain and scrotal bruising. We audit postoperative pain following inguinal herniorrhaphy and patient understanding of postoperative complications.


METHODS
A telephone survey was carried out to assess patient experience of day-case inguinal herniorrhaphy (DIH). Having identified that there was some dissatisfaction with the outcome of DIH, a prospective audit was carried out to assess causative factors. Changes in practice were made; chiefly, the provision of patient-information leaflets and the standardisation of intraoperative and postoperative analgesia. Repeat audit then assessed the effects of these changes.


RESULTS
Ten percent of patients had a poor understanding of postoperative complications following inguinal herniorrhaphy. Thirty-eight percent had early postoperative pain; wound infiltration of local anaesthetic at the end of inguinal herniorrhaphy reduced the incidence of early postoperative pain to 23%.


CONCLUSIONS
Audit is an important tool in surgical quality assurance for DIH. Small changes in practice with adherence to good protocols can have a marked effect on patients' experience.
Jaffer
U
U
Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. usman.jaffer@doctors.org.uk
Elmghrbee
A
A
Wilding
R
R
Cameron
A E P
AE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D003625:Data Collection; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications