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ESRA19-0265 Calm: a non- pharmacological aide-memoire to reduce anxiety and improve patient experience in awake hand surgery
  1. CL Pan,
  2. I Lewin,
  3. T O’Neill and
  4. T Egan
  1. Royal London Hospital, Anaesthesia and Perioperative Medicine, London, UK


Background and aims Surgery in the awake patient is associated with elevated levels of perioperative anxiety. Our centre developed a non-pharmacological aide-memoire designed to reduce anxiety and improve patient experience across 4 different metrics: Comfort, Anxiety, Looking (the ability of the patient to see the operation), and Music.

Methods This quality improvement project was carried out at the Royal London Hospital. Prior to its introduction, patients were surveyed on the four components of the aide memoire to establish current practice. The aide was then introduced to all members of staff working on the plastics hand surgery list at the morning briefing. It formed a dedicated section of the WHO surgical time out for every patient. Following the introduction of the aid, a repeat survey was performed to determine its effectiveness in improving patient experience.

Results This aide memoire was effective in decreasing self-reported levels of anxiety and increase levels of comfort in our patients. The two main areas of anxiety in our pre-intervention survey related to patients being able to see or hear the procedure being performed. Subsequent to our intervention, the majority of patients were unable to see the surgery (as the drape was repositioned on their request) and had been given information which meant that they were able to listen to audio material of their choice during their procedure.

Conclusions This simple, non-pharmacological method of reducing anxiety is effective in our population of patients undergoing awake hand surgery. It is likely to have similar benefits for patients having other awake procedures in our hospital.

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