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Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims Regional anaesthesia offers several advantages including early recovery and early discharge. The incidence of long-term complications with Peripheral Nerve blocks (PNB)is 0.02%.Follow up is important to understand the local incidence rate, for early detection and timely intervention of treatable cause and improving patient trust and assurance.We aimed to evaluate our follow up practice and further improve it.
Methods We are a specialist orthopaedic centre performing more than 2000 PNBs in a year. Patient records were reviewed retrospectively over two weeks. Follow up pathway was determined depending on patient’s post operative destination of either discharged home or to the inpatient ward.Telephonic follow up for day case patients and a baseline survey for junior doctors/nurses in the ward was done to evaluate our practice.
Results 101 peripheral nerve blocks were performed on 76 patients in two weeks .17% of these patients were discharged home the same day. Less than 30% of these patients had a follow up before discharge. While 63% received verbal aftercare instructions, only 27% received written instructions. For inpatients, 35 junior doctors and nurses were surveyed. While 45% reported documenting about limb observations post block, only 37% routinely advised about post nerve block limb precautions.
PNB follow up pathway
Conclusions Limited Follow up,deficiency in aftercare instructions and knowledge of junior doctors/nurses has been recognised. We recommend written instructions should be provided to all day cases and regular teaching sessions for junior doctors/nurses. Further improvement with development of a local patient care pathway and possibly exploring digital based F/U in future.