ONE DAY SURGERY OF INGUINAL HERNIA- A SAFE AND ECONOMICALLY EFFICIENT PROCEDURE

Uvod: Rastući trend suvremenog načina organizacije rada zdravstvene skrbi predstavlja jednodnevna kirurgija. Cilj istraživanja: Prikazati da je liječenje preponske kile u jednodnevnoj kirurgiji siguran za bolesnike i ekonomski isplativ. Istaknuta je uloga medicinske sestre kod pripreme bolesnika u jednodnevnoj kirurgiji i opisan je algoritam njezina rada. Metode: Radi se o retrospektivnom istraživanju provedenom na Zavodu za opću i onkološku kirurgiju Klinike za kirurgiju KBC u Rijeci u periodu od 1. siječnja 2015. godine do 31. prosinca 2017. godine. Podatci su dobiveni pretraživanjem cjelokupnog bolničkog informacijskog sustava te uvidom u arhiviranu medicinsku dokumentaciju. Rezultati: Istraživanje je obuhvatilo 285 ispitanika oba spola; prevladavale su osobe muškog spola (93,6%). Ingvinalna kila bila je prisutna kod 95% muškaraca, a bedrena samo u žena. Prosječna dob bolesnika bila je 45 godina. Na zahvat se čeka 46 dana. Dominira ASA 1 kategorija procjene rizika od anestezije kao i spinalni blok u izboru anestezije. Kod 34 (12%) bolesnika javljale su se komplikacije od kojih najčešće hematom, serom i bol. Hospitaliziralo se 14 (5%) osoba od kojih je jedna reoperirana. Većina bolesnika imali su indeks tjelesne težine (ITT) do 30, udaljenost bolnica-kuća do 50 kilometara, odsustvo komorbiditeta, propisanu terapiju za bol te malu kilu. Popunjenost kontrolnih kirurških lista je 76.8% dok je premještajnih operacijskih 100%. Izravna dobit iznosi HRK=984,80 po postupku. Zaključak: jednodnevna kirurgija preponske kile siguran je i financijski povoljan postupak.Introduction: The growing trend of modern way health care work organiziation is represented by one-day surgery. Aim: Demonstrating whether groin hernia treatment in one-day surgery is safe and economically viable for patients. The nurse's role in preparing patients for one-day surgery is emphasised and the algorithm of her work is described. Methods: This is a retrospective study conducted at the Department of General and Oncologic Surgery, Surgery Clinic at Clinical Hospital Center Rijeka, from January 1th, 2015 to December 31st, 2017. The data was obtained by searching the integrated hospital information system and by accessing archived medical records. Results: the study included 285 examinees of both sexes, men predominate (93,6%). Inguinal hernia was present in 95% of men, and femoral only in women. The average age of the patient was 45 years. Waiting period for the procedure is 46 days. The ASA 1 category of anesthesia risk assessments dominates as well as the spinal block in the choice of anesthesia. Complications occurred in 34 (12%) patients and were most commonly hematoma, seroma and pain. Fourteen (5%) of them were hospitalized, one of which was reoperated. Most patients had a body mass index (BMI) of up to 30 (88.8%), hospital-house distance was up to 50 kilometers, absence of comorbidity, prescribed pain therapy and small hernia. Completion of the surgical safety checklist amounts to 76.8% while it amounts to a 100% for the transfering operation list. Direct profit values HRK=984,80 per procedure. Conclusion: one-day surgery of groin hernia is a safe and finantially viable procedure