Orthopaedic Patients' satisfaction in outpatient experience of A University Hospital

The orthopaedic surgery department was formed in 1982 at College of Medicine, King Faisal University and King Fahd University Hospital, Al-Khobar. At present there are four adult orthopaedic clinics and two pediatric orthopaedic clinics with an annual number of over 9000 patients. Offering services is one thing and providing satisfaction is another. To date no patient satisfaction survey was conducted for orthoapedic patients at our hospital. This prospective survey was conducted to assess the satisfaction of adult orthopaedic patients with regard to care offered at King Fahd University Hospital, Al-Khobar., to identify existing shortfalls and to find ways to improve them. Four hundred adult orthopaedic patients were interviewed by a predetermined questionnaire. Patients were randomly selected, from each clinic and the satisfaction was graded as poor, fair, good, and excellent. Once the questionnaire was completed, patients were asked a final question for and overall satisfaction on a two-point scale of [satisfied and unsatisfied]. The questionnaire assessed appointments, courtesy, professional aspects, registration, Nurses and Doctors. Four hundred patients completed the questionnaire. The average age of patients was 48.4 years [14-92 SD +/- +/- 35.1]. Saudi nationals comprised 67% and non-Saudis were 33%. On a four-point scale excellent and good was taken as satisfied and a total of 92.3% were satisfied but this dropped to 85.5% on a two-point scale. Patients who were educated [graduate level] their satisfaction level was higher than those of the uneducated P<.001. Seventy-five percent of the patients were dissatisfied with the delay in appointments P <0.001 and 304 patients were not satisfied due to the time they spent in the hospital P<0.001 This survey indicates that most patients attending orthopaedic clinics at King Fahd University Hospital, Al-Khobar were satisfied with the care they were offered but dissatisfied by the delay in obtaining the appointments, and the time they spent in the hospital. The authors recommend measures to improve services so that more orthopaedic patients will be satisfied

Comparison of ceftriaxone and cefuroxime for surgical prophylaxis in othopaedic practice

Aims: To assess the effect of a single dose of Ceftriaxone as compared to three doses Cefuroxime and its economic implications. Prospectively 60 consecutive patients [Group A] undergoing Orthopaedic surgery, were given a single dose of Ceftriaxone 1 gram intravenously, prophylactically 30 minutes preoperatively. In comparison the control group of 60 patients received Cefuroxime 1.5 gram preoperatively and 2 doses of 750 mg postoperatively [Group B]. The duration of the operation and they type of operation was recorded. Post operatively the patients were followed up for a year to find any infection related to the surgery. There were 17 males in Group A and 21 in Group B and the rest were females. The average age in the study group was 34.65 years [range 14-66 years] and in the control group the mean age was 35.5 year [range 16-80 years]. The duration of surgery was 112.2 minutes [35-210 minutes] in Group A and 108.5 minutes [40-200 minutes] in Group B, respectively. In the ceftriaxone group there was no postoperative wound infection as compared to the cefuroxime group in which three patient had infection [5%] which was clinically significant and the pValue was 0.24. One superficial and 2 deep infection. this study indicates that a single dose of 1 gram of ceftriaxone was more effective and economically better than the 3 doses of cefuroxime for prophlaxis in orthopaedic surgery. Moreover in the present climate of stringent hospital budgets, using ceftriaxone will save nursing time and cost per patient for prophylaxis in othopaedic surgery