Early discharge after gynaecological surgery

Abstract

Objective: To determine the safety and acceptability of early discharge after major gynaecological surgery.

Design: Retrospective study of patients discharged home on the third day after surgery. Questionnaire to determine patients' attitudes.

Setting: District general hospital with an associated 'Hospital at Home Scheme'.

Subjects: 102 women listed for major gynaecological surgery living within the catchment area of the Hospital at Home and considered good surgical risks.

Main outcome measures: Safety, re-admission rates, nursing time planned and utilised, patients' attitudes.

Results: There were no serious complications. Only three patients required re-admission. Less nursing time was required than expected: allocated, 24 h; utilised, less than 10 h for 45%; no night cover for 70.5%. Patient aides performed most of the nursing. There was no excess burden for general practice (45.7% required a home visit). The scheme proved popular with patients. Analgesia and catheter care needed to be improved.

Conclusion: Discharge on the third postoperative day into an augmented domiciliary care service is safe, popular and cost effective.