Is postnatal Doctors review essential for Elective C section patients? 

Introduction

Determine whether patients following uncomplicated elective C section requires a senior house officer review prior to discharge by the midwives. This research is conducted to ensure safe and effective early discharges to improve patient care.

 

Methodology

Randomised Trial of 44 patients from Norfolk Ward (postnatal) was selected between the months of June and July 2024.Inclusion and exclusion criteria was set. Sample of 44 patienst were analysed.After exclusion the remaining sample of 21 patients were analased. Resources below was used to gather all the necessary information.

Results

Afterthe exclusioncriteria 21 patients were analysed, out of these 17patients were made Midwifery lead care on day 1. The remaining 4 were not discharged due to the following reason -Wound infetion, hematoma, newly diagnosed pre-eclampsia and new knee pain.

After SHO review- 13/17 patients were discharge with no further investigations . 4/17 patients were prescribed ferrous fumarate by SHO on day I.

4/21 patients were made Midwifery lead care on post op note however all of these 4 were seen by SHO postnatally.

It was also noted that post C section, discharge summaries were not completed in theatres by the SHO.

 

Conclusion

Little intervention is required from the SHO on Day 1 postnatally, with the postnatal midwives able to do the required postnatal checks. The most common intervention is the administration of Ferrous fumarate. Surgeons are not routinely documenting that patients may be discharged to midwifery-led care on the operation note.The following changes have beenmade.

 

1.The Caesarean Section Guideline should include guidance on ‘Discharge to midwifery care’ at the time of Caesarean Section

2.Surgeons should document whether the patient can be discharged to midwifery led care or not for every LSCS. If this is done, there is no need for the SHO to review the patient.

3.Surgeons and assistants are to be reminded to complete the Discharge summary in theatre and this to be added to the Trust induction booklet.