Poor agreement between data from the National Patient Registry and the Danish Patient Insurance Association.

INTRODUCTION: Septic arthritis after knee arthroscopy requires in-patient treatment and should thus be reported to the National Patient Registry (NPR). It also meets the requirements for financial compensation if claimed to the Danish Patient Insurance Association (DPIA). The aim of this study was to assess data from the two independent data sources, the NPR and DPIA, with a view to comparing the registration of septic arthritis after knee arthroscopy. MATERIAL AND METHODS: This was a retrospective study assessing two three-year periods. From the NPR, we initially received all contacts coded as arthroscopic knee surgery. A second NPR query was made for patients found in the first query who had had a hospital contact within 30 days postoperatively with codes indicating septic arthritis (450 patients). Correspondingly, the DPIA files of patients claiming an infection following knee arthroscopy were searched to identify those (157 patients) with post-arthroscopic septic arthritis. RESULTS: We found poor agreement between the 450 patients in the second NPR data extraction and the 157 verified patients from the DPIA. Only 105 patients from DPIA were found in the NPR, while 52 patients in the DPIA were not returned as part of the second NPR data extraction. CONCLUSION: Coding of infections after arthroscopy in the NPR is inconsistent and incomplete. An underreporting of septic arthritis to the DPIA might exist.

Partners' experiences of the postdischarge period after day surgery--a qualitative study.

AIMS AND OBJECTIVES: Day surgery shifts the responsibility of care from the hospital to patients and their families. This study explored how partners of day surgery patients experienced their role after patient discharge. BACKGROUND: Many surgical procedures formerly requiring inpatient care are now carried out on a day surgery basis, shifting responsibility of care to patients and their partners/relatives. Little is known about how partners of day surgery patients manage this responsibility. DESIGN: Qualitative descriptive. METHODS: Individual semi-structured interviews with 11 partners of day surgery patients who had undergone shoulder surgery. Systematic text condensation was used to analyse data. RESULTS: The following aspects were identified: the first is 'It's all about being there for the patient by taking care of the patient's needs and by mobilising one's network,' referring to the provision of reassurance, helping with activities of daily living, facilitating information, being on the alert for adverse events and taking an average 1-4 days off work. The second is 'Contributing to society as a partner,' referring to partners' sense of citizenship resulting from being carers. Finally, prior experiences of hospitalisation and illness appeared to impinge upon partners' ways of taking on the responsibility of care. CONCLUSION: Partners readily accepted their role as carers. This is essential for the day surgery concept to succeed. RELEVANCE TO CLINICAL PRACTICE: In the light of the continuing expansion of day surgery and the ensuing transfer of care to patients and their relatives, it is important for healthcare professionals to assess relatives' capability to care for day surgery patients.

Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial.

BACKGROUND AND OBJECTIVE: Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded study, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band. METHODS: One hundred and thirty-four healthy, non-smoking women scheduled for breast surgery were randomised either to P6 stimulation or to sham control. Wristbands were applied and covered with a dressing before induction of anaesthesia. Follow-up was carried out three times within 24 h postoperatively. Primary outcomes were postoperative nausea and/or vomiting. RESULTS: One hundred and twelve patients completed the study. There were no statistically significant differences in the incidence of nausea [P6 stimulation, 35.1% (95% confidence interval, CI 22.7-47.5%) versus sham control, 43.1% (95% CI 29.5-56.7%; P = 0.433)] or vomiting [P6 stimulation, 25.9% (95% CI 14.6-37.2%) versus sham control, 26.9% (95% CI 14.8-39.0%; P = 1.000)]. Approximately, one third of the patients reported side effects caused by the wristband, for example, redness, swelling and tenderness. CONCLUSION: We did not find the Vital-Band effective in preventing either nausea or vomiting after operation in women undergoing breast surgery.