Structured Handover in Trauma and Orthopaedics
- Trivedi S, Moss R, Wardle K, Alio Z, Naqui Z
- Upper Limb & Hand Unit, SRFT, Mar 2014
- Identified key areas of improvement for safe handover of patients
Ward based Trauma Equipment for a Tertiary Trauma Centre
- Nash J, Fulford D, Divecha H, Naqui Z
- Upper Limb & Hand Unit, SRFT, Mar 2014
- Identified key trauma equipment required for the care of trauma patients in a Tertiary Trauma Centre
Upper Limb & Hand Trauma: Referral Patterns and Waiting Times
- Fulford D, Wright A, Stokes A, Jeyam M, Naqui Z
- Upper Limb & Hand Unit, SRFT, Jan 2014
- Evaluated waiting times and tertiary referral patterns of Hand & Upper Limb Trauma
Incidence of re-operation in distal radius fractures treated with volar locking plates
- Bitar S, Wasimi M, Naqui Z
- Upper Limb & Hand Unit, SRFT, Nov 2013
- Evaluated the nature and pattern of referrals to a tertiary wrist practice for re-do radial fracture work.
Orthopaedic Readmission rates and the financial implications?
- Howgate D, Reading J & Naqui Z
- Upper Limb & Hand Unit, SRFT, July 2012
- Evaluated the financial implications of elective and trauma readmissions within 30 days.
Elective Consent Audit
- Arshad S & Naqui Z
- Upper Limb & Hand Unit, SRFT, July 2012
- Looking at the rate of and pattern of consenting in the patient pathway in the Orthopaedic Dept.
Quality & Safety: How accurate are our operation notes?
- Mohammed H & Naqui Z
- Upper Limb & Hand Unit, SRFT, Sept 2011
- Looking at the content and accuracy of the elective and trauma operation notes in the notes.
The scanning and coding accuracy of operation notes?
- Somanchi V & Naqui Z
- Upper Limb & Hand Unit, SRFT, Sept 2011
- Looking at scanning practices for operation notes and proposal of strategies to improve.
Is the Orthopaedic OPD Safe, Clean & Personal?
- Yasin N & Naqui Z
- Upper Limb & Hand Unit, SRFT, Sept 2011
- Assessing the quality and safety in Orthopaedic outpatients.
Management of fragility fractures in fracture clinic
- Naqui Z, Younis F, Jugdey R, Freeman L, Warner JG & Hodgson SP
- Upper Limb Unit, Royal Bolton Hospital, May 2007
- Looked at the ‘medical’ management of osteoporotic fragility fractures
- Analysed data from 150 women – found no osteoporosis management in 98%
- Action: Protocol devised and proposed appointment of osteoporosis specialist nurse
Outcomes of Hip resurfacing and Ceramic Hybrid THR
- Naqui Z, Roberts C, Bamford DJ, O’Connor MA
- Hip Unit, Stepping Hill Hospital, June 2006
- Found similar demographics of population undergoing surgery and no difference in complication rates or short term outcomes. Small numbers.
- Action: Re-audit with increased follow-up and numbers. Formal Oxford Hip scores.
Postoperative Hyponatreamia in Fracture Neck of Femur patients
- MacLaren K & Naqui Z
- Dept. of Orthopaedics, SRFT, July 2005
- Examined incidence of post-operative hyponatraemia in DHS & Hemi-arthroplasty patients. Found high incidence of 3.87% Delayed discharge whilst patient’s electrolytes are corrected.
- Action: Re-audit after guidance on fluid prescription, avoid dextrose.
Fracture Neck of Femur – Management and outcomes of surgery
- MacLaren K & Naqui Z
- Dept. of Orthopaedics SRFT, May 2005
- 156/165 Patients operated on within 4 days (94.6%) 9 patients waited >4 days due to waits for imaging, pt unwell & theatre time. However no increase in mortality rate.
- Action: Re-audit, closer evaluation of delays and mortality rates.
Peri-operative Prophylactic Antibiotic administration in Orthopaedics
- Owen J, Naqui Z & Arshad S
- Dept. of Orthopaedics, SRFT, Mar 2005
- Prospective study of 47 pts. 20% pts received some form of inadequate cover. 88% Due to doctor omissions, 12% due to nurse omissions.
- Action: Re-Audit, Responsibility of all staff to ensure ABx administration; ?use generic sticker.
Mortalities in Dept of Orthopaedics for the Year 2002
- Taylor B & Naqui Z
- Department of Orthopaedics Wythenshawe Hospital, May 2003
- Admissions, 2 elective deaths (PE, sepsis), 28 emergency/trauma deaths.
- Overall mortality trauma/emergencies = 2.4%.
- Av time to theatre for NOF# 71 hrs. 30 day Mortality % = 8.5%
- Action: Re-audit, Improve time to theatre for NOF#
Blood Product usage in Lower Limb Arthroplasty.
- Samuel R & Naqui Z
- Department of Orthopaedics Wythenshawe Hospital, Mar 2003
- 46.3% of patients grouped or x-matched inappropriately
- (19.5% under-matched, 26.8% over-matched). Blood required in 26.8% of operations, Blood given appropriately in 81.8% of cases.
- Action: Re-audit, Stricter adherence to Max Blood Order Schedule.
Theatre Time Usage during Weekends
- Shetty A, Naqui Z & Borrill JK
- Department of Orthopaedics Wythenshawe Hospital, July 2003
- Cases (Jan – Jun 2003), Mean operating time per weekend – 9 hrs 32 mins
- Majority of cases morning and afternoon
- Action: Need Dedicated Trauma list for Saturday and Sunday
Physiotherapy led Knee pain clinic
- Roberts M, Naqui Z & Ryan WG.
- Department of Orthopaedics, Royal Bolton Hospital, Nov 2001
- Trial period clinic. Found reduced clinic waiting times, appropriate use of investigations including MR Scan. 75% knee problems managed by the physiotherapy team.
- Action: Re-audit, Full implementation of Physiotherapy knee clinic. ?Other Physio clinics.
Fracture Neck of Femur – closing the audit loop
- Naqui Z & Livingstone BN
- Department of Orthopaedics, Wigan Infirmary, Mar 2000
- Found improvement in documentation, better co-operation between Care of Elderly and Orthopaedic teams and reduced time to theatre.
- Action: Re-audit to further improve results.
Fracture Neck of Femur – Management and outcomes of surgery
- Naqui Z & Livingstone BN
- Department of Orthopaedics, Wigan Infirmary, Oct 1999
- Found considerable delays in time to theatre due to inter-speciality communication problems and poor quality of medical documentation. No NOF# fast-tracking.
- Action: Improve documentation, Fast-track #NOF, improve intra and interdepartmental communication.
Back Pain ‘whose problem is it anyway?’
- Naqui Z
- A&E referral audit Wythenshawe Hospital, Mar 1999
- Found considerable differences in casualty officers in – signs and symptoms looked for, investigations organised, quality of documentation, referral criteria and specialty referred to.
- Action: Re-audit, Formal back pain SHO teaching, red-flag protocol and proforma
Diabetes Mellitus ‘The Benchmark of High Standards of Primary Care’
- Naqui Z
- GP audit University College London, July 1995
- Prize winning audit at medical school. Found ill defined and disorganised care of diabetics at inner-city practice, wide differences in follow-up.
- Action: Clear recording of HbA1C, notes should be clearly marked, commence a diabetic clinic.