Not all surgery patients at Melbourne hospitals are being screened for coronavirus: Audit
Failure to record a crucial screening step for surgery patients at major Melbourne hospitals has raised serious concerns vulnerable patients may be exposed to the virus.
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Surgery patients may be entering operating theatres without being screened for COVID-19, raising alarms at the risk of spreading the virus to those in high danger.
An audit of surgery at major Melbourne hospitals has found there were only records to confirm 72 per cent of elective surgery patients had been screened for COVID0-19 before their operations.
For non-elective, emergency surgery patients the situation was even worse, with records only existing to show 38 per cent had been screened for COVID-19.
Coronavirus-positive patients may have more complications and greater mortality after surgery, as well as the risk of infecting patients and staff if admitted to hospital.
The Australian and New Zealand College of Anaesthetists says there is value in considering national guidelines around documenting COVID screening as well as supporting Safer Care Victoria to improve surgical safeguards.
Lead researcher Professor David Story said the finding did not necessarily mean undocumented patients had not undergone temperature checks and COVID questionaries while entering hospital, however the lack of official records created a gap that could expose many vulnerable people.
“We are not saying the patients weren’t screened, what we are saying is we can’t be certain they were screened,” Prof Story said.
“If we do screen and test, as we are at the moment in Victoria, it is very unlikely someone (with COVID-19) will get through.
“So now that we have built the fence it is a matter of keeping an eye on the fence.”
The COVID Screen Audit analysed 2197 patients who underwent surgery at two major Melbourne hospitals between April 1 and May 10, 2020, during nationally restricted surgery arrangements.
Results of the study published in the Australian Health Review found “better understanding of implementing screening practices in pandemics and other crises, particularly for non-elective patients, is warranted”.
While Victoria’s hospitals have ramped up screening for COVID-19 before surgery during the coronavirus’ second wave, Prof Story said little was known about the effectiveness the programs.
Prof Story has proposed a lowest acceptable limit of recording COVID-19 screening of 85 per cent for almost all surgical groups, with the strongest concerns for smaller hospitals who are returning to elective surgery after enforced breaks.
Medibank’s Chief Medical Officer Dr Linda Swan welcomed the findings, saying she hoped they would inform policies as hospitals worked to clear a huge backlog of surgical cases.
“Currently, there’s no national government policy surrounding the documentation of COVID-19 screening prior to surgery,” Dr Swan said.
“Relying on only swabbing all patients undergoing elective surgery is not the solution, as it’s not 100 per cent accurate in determining all COVID positive patients.
“Plus, with urgent (non-elective) cases, surgeons don’t have time to wait for a lab result. This study highlights the importance of thorough documentation of questionnaires and temperature checks for all surgeries.”
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