An audit on preoperative noncardiac surgery fitness evaluation in Assiut University Hospital for Children

Background
Surgery is a main event in an individual's life. The full surgical episode is known as perioperative interval. Perioperative process in general includes three stages: preoperative, intraoperative, and postoperative. The first stage (preoperative) includes giving of nursing care to the patients who are planned to undergo surgery. It was evident that through this stage, evaluation and education of the patient are the main responsibility of health service providers to have better results of the patients.
Objective
The purpose of the study was to assess the methods of performing preoperative fitness assessment for noncardiac patients in Assiut University Hospital for Children, to compare these methods with the standard methods, to confirm what is necessary and bypass needless investigations, and to provide a reference framework for the preoperative evaluation of children.
Patients and methods
The study was conducted at Assiut University Children Hospital. Data of children who attended the outpatient fitness assessment clinic during a 6-month period were collected and analyzed, and their management was compared with the standard management guidelines. All patients attended the outpatient fitness clinic during 6 months from 1 November 2017 to 30 April 2017. The authors collected all cases that attended the outpatient fitness clinic for surgery except cardiac surgeries.
Conclusion
It was concluded that preoperative blood tests are unnecessary in American Society of Anesthesiologists grade-1 patients undergoing minor/moderate surgery. A main cause of overtesting is the belief between junior staff that consultants wanted them or simply by habit. When compared with surgeon-ordered testing, anesthesiologist-ordered testing was more focused and less costly. There is a requirement to have guidelines for indicated tests in different groups of diseases and procedures to be ordered by the physicians to prevent unnecessary loss of time, money, and resources and to bypass overburdening laboratory staff.