Improving the rigour of VACTERL screening for neonates with anorectal malformations
| Autor: | Jonathan Sutcliffe, Govind V S Murthi, Bala Eradi, Richard John England |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Clinical audit
Heart Defects Congenital Pediatrics medicine.medical_specialty Referral health care facilities manpower and services Limb Deformities Congenital Anal Canal Audit Kidney 03 medical and health sciences 0302 clinical medicine Esophagus Neonatal Screening health services administration 030225 pediatrics Pediatric surgery medicine Humans Prospective Studies Prospective cohort study Intensive care medicine Referral and Consultation Retrospective Studies Clinical Audit business.industry Infant Newborn Retrospective cohort study General Medicine medicine.disease VACTERL association Anorectal Malformations Spine Trachea 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Surgery Imperforate anus business |
| Zdroj: | Pediatric surgery international. 33(7) |
| ISSN: | 1437-9813 |
| Popis: | Screening investigations for the vertebral, anorectal, cardiac, tracheo-oesophageal, renal and limb (VACTERL) association form an important part of the management of neonates with anorectal malformations (ARMs). We developed a proforma to define investigations and indications for referral. The aim of the current study was to determine if the proforma could improve screening rigour. Four centres performed a 3-year retrospective audit of neonates with ARM. Following introduction of a proforma, the same data were collected prospectively for consecutive neonates over a further 2 years. The appropriate investigation of each component of the VACTERL association and the corresponding referral required for each abnormal result were defined. The proportion of patients undergoing appropriate investigation and referral was compared against these standards. An audit standard of 90% was set for each criteria. Prior to implementation of the proforma, 86 patients were audited, with a further 69 patients after. The audit standard was met in 7 criteria before introduction of the proforma in comparison to 10 criteria afterwards. The completeness of VACTERL screening and its documentation improved following introduction of the proforma. Performance remains imperfect. Review of specific criteria (such as definition of vertebral body screening) will help address this. |
| Databáze: | OpenAIRE |
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