A clinical audit analysing the completion of junior clerking at the Surgical Admissions Unit at an acute District General Hospital, as impacted by short-staffing due to CoViD-19

Author(s) Sawhney R.; Seite E.; Fedder A.
Institution(s) (Sawhney, Seite, Fedder) East Lancashire Hospitals NHS Trust
Source British Journal of Surgery; Oct 2021; vol. 108
Database EMBASE
AbstractAims: The quality of junior clerking is essential to patient safety and care; it provides information vital to the management of surgical patients. This audit aimed to evaluate the completion of the General Admission Document (GAD) on the Surgical Admissions Unit to identify the impact of staff absences secondary to CoViD-19. Method(s): Admissions to the unit over a 5-day period (n=92) were evaluated against a checklist of the 26 items included on the GAD utilised by the trust, and daily handover sheets were used to identify staff absences. Mean completion was measured alongside thematic analysis of free-text remarks. Result(s): Handover sheets identified staff absences on 3 days. The overall mean completion of the GAD was 50.88% (95%CI: 46.65, 55.11, p<0.05). This was not significantly (p=0.074) impacted by staffing; mean completion was 48.47% (95%CI: 42.75, 54.20, p<0.05) on days with junior doctor absences, and 54.98% (95%CI: 49.14, 60.82, p<0.05) without. The major theme identified was deferring to the 'senior review' section of the GAD, suggesting a lack of awareness among juniors regarding the importance of a full junior clerking. Conclusion(s): Staff shortages secondary to CoViD-19 absences did not significantly impact the quality of junior clerking. However, the baseline completion of the GAD was noted to be poor regardless. Therefore, a teaching session during induction of the next cohort of doctors could be a sensible intervention to reiterate the importance of a full clerking.

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