Rohil Singh Kakkar*

MS Ortho, Trauma and Orthopaedic Surgeon, Pune, India Faculty Member: Royal College of Surgeons, England (UK)

*Corresponding Author: Rohil Singh Kakkar, MS Ortho, Trauma and Orthopaedic Surgeon, Pune, India Faculty Member: Royal College of Surgeons, England (UK).

Received: November 04, 2022; Published: December 14, 2022

Abstract

Every surgical specialty recognizes the significance of precise and comprehensive operation notes for ensuring patient care as well as for generating data for research and auditing purpose. Orthopaedic operative notes at the author’s institution were audited against guidelines published by the Royal College of Surgeons of England regarding standard of content, completion and legibility. An orthopedic specialty specific template for writing operative notes has been proposed. Also, It has been proposed that all surgical specialty registrar level doctors should undergo training for writing operative notes and aide memoires be placed in the OT complex.

Keywords: Operative Notes; Audit; Orthopaedic Template; Aide Memoires

References

1. Al Hussainy H., et al. “Improving the standard of operation notes in orthopaedic and trauma surgery: the value of a proforma”. Injury11 (2004): 1102-116.
2. General Medical Council. “Good Medical Practice”. 3^rd London, UK. GMC (2001).
3. Basad E. “The importance of computer-based procedures for planning and documentation of orthopaedic surgery”. Orthopade3 (1999): 277-284.
4. Whitehead-Clarke T., et al. “Improving Operation Notes and Postoperative Care: An Audit of Current Practice”. Journal of Perioperative Practice5 (2015): 107-111.
5. Bateman ND., et al. “An audit of the quality of operation notes in an otolaryngology unit”. Journal of the Royal College of Surgeons of Edinburgh2 (1999): 94-95.
6. Morgan D., et al. “Improving operation notes to meet British Orthopedic Association guidelines”. The Annals of The Royal College of Surgeons of England 91 (2009): 217-219.
7. Din R., et al. “The use of an aide-memoire to improve the quality of operation notes in an orthopaedic unit”. Annals of The Royal College of Surgeons of England 5 (2001): 319-320.
8. The Royal College of Surgeons of England. “Good Surgical Practice”. London, UK: RCSENG - Professional Standards and Regulation (2008).
9. Y Ghani., et al. “Smart’ electronic operation notes in surgery: an innovative way to improve patient care”. International Journal of Surgery1 (2014): 30-32.
10. Fionn Coughlan., et al. “Audit of Orthopaedic Surgical Documentation”. Hindawi Publishing Corporation, surgery Research and Practice (2015).
11. Mustafa MKE., et al. “Assessing the Quality of Orthopaedic Operation Notes in Accordance with the Royal College of Surgeons Guidelines: An Audit Cycle”. Cureus8 (2020): e9707.
12. Anazor F., et al. “A Closed-Loop Audit for Orthopedic Trauma Operation Notes Comparing Typed Electronic Notes with Handwritten Notes”. Cureus 7 (2022): e26808.
13. Sweed TA., et al. “Audit of operation notes in an orthopaedic unit”. Journal of Orthopaedic Surgery (Hong Kong) 22 (2014): 218-2020.
14. Parth Arvind Shah., et al. “Improving the quality of orthopaedic elective and trauma operative notes: A completed audit loop study”. International Journal of Surgery Open (2016): 14-17.
15. Severn Audit and Research Collaborative in Orthopaedics (SARCO). “Assessing the quality of operation notes: a review of 1092 operation notes in 9 UK hospitals”. Patient Safety in Surgery 10 (2016): 5.

Citation

Citation: Rohil Singh Kakkar., et al. “An Audit of Orthopaedic Surgery Notes: Where Do We Stand Today?”.Acta Scientific Orthopaedics 6.1 (2023): 136-139.

Copyright

Copyright: © 2023 Rohil Singh Kakkar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.