Shannon Philp

The role of transversus abdominis plane blocks in women undergoing total laparoscopic hysterectomy: A retrospective review

Introduction:  The transversus abdominis plane (TAP) local anaesthetic block is beneficial in patients undergoing open pelvic surgery; however, there are no data on its use in women undergoing laparoscopic gynaecologic surgery.

Patients' satisfaction with fast-track surgery in gynaecological oncology.

This study investigates the experience and satisfaction with care of fast-tracked gynaecological patients. The Sydney Gynaecological Oncology Group, New South Wales, Australia, has previously shown the benefits of a fast-track surgery programme for gynaecology patients with both complex benign gynaecological pathology and gynaecological malignancy. The question of whether these benefits translate into a positive experience for fast-tracked patients, in the context of their hospital stay and healthcare team care, has not been previously explored in detail. A self-administered satisfaction questionnaire incorporating the European Organisation for Research and Treatment of Cancer (EORTC) cancer in-patient satisfaction with care measure (INPATSAT-32) questionnaire with additional questions was administered to 106 gynaecology participants at Royal Prince Alfred Hospital. Participants reported high levels of satisfaction with patient care and support received from doctors, ward nurses and the hospital as a service and care organisation, within the context of a fast-track surgical programme. Early hospital discharge after gynaecological surgery results in both enhanced recovery after surgery (ERAS) and high levels of patient satisfaction.

Perioperative outcomes after total laparoscopic hysterectomy compared with fast‐track open hysterectomy – A retrospective case–control study

Aims:  To examine perioperative outcomes after total laparoscopic hysterectomy compared with fast‐track open hysterectomy using a retrospective case–control study.

Patients' perspectives of fast-track surgery and the role of the fast-track clinical nurse consultant in gynecological oncology.

This study examines the role of the fast-track nurse in gynecology from a patient perspective. The fast-track nurse is a specialist nursing role, which coordinates patient care, in addition to providing specialized clinical care. Semistructured interviews were conducted with women who had fast-track surgery for gynecological cancer.

Patient satisfaction with inpatient care provided by the Sydney Gynecological Oncology Group

Purpose: Patient satisfaction with the provision of hospital oncology services can have a significant impact on their overall treatment experience. Aims: To assess patient satisfaction with the inpatient hospital services in the gynecological oncology setting using the IN-PATSAT32 questionnaire developed by the European Organization for Research and Treatment of Cancer (EORTC). Methods: A modified version of the IN-PATSAT32 questionnaire with additional 16 items was administered to 52 adult surgical inpatients admitted with the Sydney Gynecological Oncology Group. All participants were provided with an information leaflet regarding the survey and written consent obtained. Results: A high response rate (100%) from patients with varied social, ethnic, and educational backgrounds confirmed the acceptability of the survey. Standard of medical care provided, frequency of doctors’ visits, exchange of information with doctors, friendliness of the staff, and state of the room ranked highly (>95%) on the patient satisfaction scales. Problems were identified with ease of access to and within the hospital, quality of food, and exchange of information with other hospital staff. Conclusions: Overall the satisfaction with inpatient care was rated very highly in most areas. Deficiencies in certain elements of provision of medical care to the patients were identified and steps have been taken to improve upon these shortcomings.

A prospective study assessing patient satisfaction at a large tertiary gynecologic oncology/dysplasia unit.

Background: Patient satisfaction is an important quality assurance measure in the delivery of health care. We conducted a prospective study to assess patient satisfaction at a large tertiary oncology/dysplasia unit. Aims: To assess current patient satisfaction at a large tertiary oncology/dysplasia unit and identify potential areas for improvement. Methods: This was a prospective study of patients attending a tertiary oncology/dysplasia unit. Patients were invited to participate and, if they agreed, were given a validated questionnaire to complete at the end of their consultation. Descriptive statistics were then used to analyze the data and identify potential areas of improvement. Results: One hundred eighty-seven patients were recruited, and 96% of patients were satisfied with the overall level of care received. Significant positive features of the service included helpfulness of the staff, cleanliness of the facility, and measures implemented to respect patient privacy. Lack of patient parking, waiting times in the clinic, difficulties in contacting the service, and locating the building were identified as areas for improvement. Conclusion: Patients attending our facility were largely satisfied with the overall level of care received. Nonclinical factors including parking, waiting times, and access to the service were identified as areas for improvement.

Facilitating psychosexual adjustment for women undergoing pelvic radiotherapy: pilot of a novel patient psycho-educational resource.

This pilot study aimed to obtain feedback on the feasibility, safety and acceptability of a psychosexual rehabilitation booklet developed for women undergoing pelvic radiation therapy (PRT) and to explore womens sexual, informational and supportive care needs post‐PRT rehabilitation.

Development and Extended Experience with a Fast Track Surgery Program in a Gynaecological Oncology Service

Introduction: Fast Track Surgery (FTS) programs combine a variety of techniques to optimise patient outcomes and as a consequence minimise length of stay. Methods: An overview of the development of the FTS program at our hospital is followed by an audit of the experience of 3 full years of patients managed by FTS principles. Results: Over the 3-year audit period, 251 patients were operated upon and managed by FTS principles. Seventy three in year 1, 99 in year 2 and 79 in year 3. Average age was 54, average weight 71.2 kg (Range 38-192kg) and average BMI 27.5 (Range 17-69). One hundred and thirty nine patients (55%) were considered overweight or obese. Two hundred and twenty seven patients (90%) were able to tolerate early oral feeding. Average operating time was 2.3 hours (range 1-10). Average EBL was 286 mL with average Hb change of 10.6g/L. Eight patients (3%) received intraoperative blood transfu- sions. Median LOS was 3 days. Fifty eight (23%) were discharged on day 2. ALOS was 3.8 days, slightly longer in ma- lignant patients (4.1 days) compared to benign patients (3.4 days). Average LOS declined from 4.2 days in year 1 to 3.7 days in year 3. Eleven patients (4%) were readmitted. Complications were deemed acceptable based upon RANZCOG Quality Indicators. Conclusions: Our extended experience confirms the feasibility and safety of undertaking a FTS program in patients with complex benign gynaecological pathology and gynaecological malignancy.

Optimising recovery after surgery: Predictors of early discharge and hospital readmission

Fast track surgery (FTS) programs minimise the stress response after surgery and allow for enhanced recovery.

Direct hospital costs of total laparoscopic hysterectomy compared with fast‐track open hysterectomy at a tertiary hospital: a retrospective case‐controlled study

To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast‐track open hysterectomy.