The Galloway Community Hospital

1
The Galloway Community Hospital Satellite
Units Pre-Assessment/ Day Surgery Unit
History
Although this service is primarily a Nurse Led
Service, referrals can be and are made to the
Galloway Community Hospital based Consultant
Anaesthetists who review patients where
anaesthetic problems are highlighted at the time
of assessment. Advanced medical care now allows
greater multidisciplinary sharing of information
within pre-assessment. Patients are screened for
MRSA and treated prior to surgery. Also blood
results etc are acted upon which allows the
planned lists to go ahead as per schedule. Four
registered nurses are now involved within the
pre-assessment unit in GCH . The Unit works
very closely with DGRI in continuity planning and
development. Further training will continue with
staff in the department to improve and ensure the
future of this service.
The existence of the unit allows patients to
have their pre-assessment undertaken locally ,
whether the operation is taking place in DGRI or
Stranraer. This is advantageous to both the
patient and our department. Louise Marshall,
Charge Nurse, DSU, Theatres GCH , Stranraer
Nurse led pre anaesthetic assessment was
commenced in Garrick Hospital Stranraer in the
mid to late nineties. This system was set up in
conjunction with Dumfries and Galloway Royal
Infirmary (DGRI) to enable patients who were fit
for Day surgery to be admitted on the day of
surgery instead of utilising in patient beds. The
assessment included medical and social assessment
which would enable the patient to have a better
understanding of the surgery they were attending
for and also to be more prepared for surgery and
thus would improve patient throughput causing
less cancellations on day of surgery. Although
the clinics were nurse led valuable input was
also delivered by the consultant anaesthetist who
would be on hand if any problems were encountered
with medical/ anaesthetic care. These clinics
took place once or twice weekly depending ,. on
demand and nurse rostering. Up to eight patients
were seen at a clinic therefore 16 patients max.
per week As demand became greater on inpatient
beds, meetings were set up to discuss how to take
forward nurse led pre-assessment this was to
incorporate all elective inpatients being
pre-assessed, again freeing up emergency beds
(due to rurality patients were being admitted
12-24 hours prior to surgery). DGRI seconded a
Registered Nurse to project lead the development
of pre-assessment including the trial and use of
IT based systems that would enable the sharing of
information safely and securely between DGRI and
GCH (75 miles).
Present
July 2008 saw the Galloway Community Hospital Day
Surgery Unit begin to undertake the
pre-assessment of patients for Daycase/Inpatient
stays both for patients being admitted into the
Galloway Community Hospital , but also local
patients for admission to DGRI. Information is
exchanged and shared using Exellicare IT System.
This system allows nursing staff to follow a
ratified and evidence based pre-assessment tool
ensuring all patients are assessed clinically and
socially to a high quality standard. This
service has developed rapidly and in the last
year has gone from seeing 5 patients per week to
seeing on average 25 patients per week.

The Future

• Future developments could include
• pre-assessing patients for surgery out with
  Dumfries and Galloway i.e. Patients attending the
  Golden Jubilee Hospital for Orthopaedic Surgery/
  Cardiac Surgery etc.
• Funding x1 WTE pre-assessment nurse at the
  Galloway Community Hospital (currently the
  service is run and funded from the Day Surgery
  and Theatre Nursing Staff allocation)
• Audit of patient experience as part of the
  Scottish Patient Safety Initiative.