Utilisation of operation theatres at General De La Rey Hospital in the North West Province

Date
2012-01-10
Authors
Lobelo, Maria Eleanor
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BACKGROUND: Operating theatres in any hospital consume a large amount of resources. A well-functioning theatre complex is an important and essential component of a well functioning hospital. . The analysis is based on the socio-economic profile of patients and the time spent in theatre. METHODOLOGY: A cross-sectional study design was used involving a retrospective record review over a one year period (April 2009 to March 2010) was conducted. The variables for the study included, type of operations and their indications, profiles of patients and turn-around time in the theatre. In addition, a comparison between those who had elective and emergency surgery was done with regard to some variables such as profile of patients and turn-around time. The project was initiated after obtaining approval from the head of the department of the North West Provincial Department of Health and University of the Witwatersrand Human Research Ethics Committee (Medical). Confidentiality and anonymity were maintained all the time during collection, capturing, and reporting of the information RESULT: A total of 447 cases were performed during this period including 5.6% (25) elective cases and 94.4% (422) emergency cases. The majority of the operations performed at this Hospital included caesarean section and evacuation of uterus. In addition to that there were other procedures such as laparotomy, labial incision, perineorrhaphy, and dilatation and curettage. The type of procedures (elective or emergency) was significantly associated with ethnicity, employment and medical aid status and referral source of the subjects. The majority of the caesarean sections were performed due to maternal indications. More elective caesarean sections were performed for maternal indications (79%) than fetal indications (21%). There was one maternal complication (ruptured uterus) but no maternal mortality during this period. Whereas all the babies were alive after elective CS, there were seven stillbirths after emergency CS. An average of 110 minutes were spent by patients in theatre and at least 33% of the time was spend on the actual operation although there is no significant difference between elective and emergency patients with regard to time spent in the operating room (p = 0.46). Emergency patients took more time (25 minutes) before they were wheeled to theatre which is an area for improvement. The operating theatre was utilised only 5.9% of available time. This suggests that is opportunity to utilise the operating theatre for other cases. CONCLUSION: This is first formal study performed at a district hospital operating theatre in the North West Province. This study assisted in development of understanding of the function of the operating theatre at the General de la Rey Hospital. The findings of this would assist the hospital management to improve its function such as reduction of latent time for emergency patients and conducting more elective procedures.
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