Aspiring Surgeon Changes Admission Procedures for Women
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Research by a young Scotland-based surgical trainee which highlighted failings to pregnancy test women before undergoing emergency surgery has single handedly changed hospital admission protocols in the area. In recognition of her work, Britain’s oldest surgical Royal College awarded her a medal and the opportunity to present her findings abroad at an international surgery conference.
All women admitted for emergency treatment should be routinely tested for pregnancy under guidelines but an audit by the female junior doctor at two hospitals in Scotland found it was actually being carried out in only one in five (20%) of cases.
The research undertaken by Matilda Powell-Bowns, 28, a year 1 surgical trainee currently based in Glasgow, will significantly reduce the number of female patients who could die – 58 in the UK in the last 10 years – from undiagnosed ectopic pregnancies when undergoing operations for other conditions. Matilda presented the data at last year’s Audit Symposium, which takes place during the Royal College of Surgeons of Edinburgh (www.rcsed.ac.uk) annual President’s Meeting, for which she was awarded the prestigious ‘Surgeons in Training’ medal.
The ground-breaking research has led NHS Tayside to change its practice and routine urinary pregnancy testing is now carried out in 100% of cases.Pregnancy testing has now been added to the pre-surgery checklist in which the whole surgical team run through rigorous airline pilot-style checks to ensure they have the right details for the patient and are conducting the correct procedures.
Last year a 37 year-old businesswoman underwent surgery to remove a cyst in her breast without knowing she was pregnant, and was later forced to have an abortion when the baby developed complications stemming from anaesthesia*.
“As a foundation doctor, when I commenced my audit I had very little insight into the journey I was about to embark on. The idea was very simple: do females of reproductive age who present to surgery acutely have a pregnancy test performed and documented? This idea grew into an 18 month project, with 150 participants and a dual cycle, closed loop audit. The results were striking so they were taken on by the clinicians and influenced a change in practice. Now all women undergoing surgery will have a pregnancy test instead of the one in five who were previously being screened.I was delighted to be awarded the ‘Surgeons in Training’ medal to congratulate my simple project. The prize was not only an accolade but an amazing opportunity: to present my work at an international conference in Colombo, Sri Lanka.”
According to the RCSEd President Mr. Ian Ritchie, who is also a consultant trauma and orthopaedic surgeon:
“Junior doctors and surgical trainees are at the very coalface of healthcare delivery, and as such are uniquely placed to reveal opportunities for improvement. Matilda’s research was highly incisive and, most impressively, her findings have already been put into practice, helping save lives straight away. Our Audit Symposium is an ideal platform to highlight possible methods of betterment and to share best practice in our profession.”
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