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Best practice for assessment of patients with varicose veins.
N Z Med J. 2008 May 23; 121(1274):42-9.NZ

Abstract

BACKGROUND

Varicose veins are a significant health problem which attract much medicolegal attention. Recent publications have suggested "best practice" regarding assessment of patients with varicose veins. A retrospective audit was performed comparing clinical practice in a New Zealand teaching hospital with suggested standards.

METHODS

Clinic letters from 80 patients awaiting varicose vein surgery were reviewed. Data were collated regarding presenting problem, relevant medical history, clinical findings on examination, further investigations, and outcome.

RESULTS

Presenting complaint was noted for 99% of patients but actual symptoms were only recorded for 41%. The degree of disability caused by varicose veins was documented for 33% and patient concerns in 4%. Half of the patients presented with leg ulcers but ankle-brachial indices (ABPIs) were only recorded in 26% of clinic letters. Duplex scanning was recommended prior to surgery for 69% of patients and hand held Doppler assessment of venous disease was recorded in 61% cases. Clinic letters did not specify the nature and extent of disease in 6% of cases, and although every patient was recommended for surgery, the exact procedure was specified in only 24%. Details of surgical risks and complications were only present in 20% of letters, and only 21% of patients received a printed information sheet.

CONCLUSIONS

The quality of the data recorded in the clinic letters of fell below suggested standards for assessment of patients with varicose veins. Improving the documentation of patient assessment will allow better communication between providers of healthcare and make clinical errors less likely.

Authors+Show Affiliations

Department of Vascular, Endovascular and Transplant Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18535645

Citation

Horrocks, Emma, et al. "Best Practice for Assessment of Patients With Varicose Veins." The New Zealand Medical Journal, vol. 121, no. 1274, 2008, pp. 42-9.
Horrocks E, Roake J, Lewis D. Best practice for assessment of patients with varicose veins. N Z Med J. 2008;121(1274):42-9.
Horrocks, E., Roake, J., & Lewis, D. (2008). Best practice for assessment of patients with varicose veins. The New Zealand Medical Journal, 121(1274), 42-9.
Horrocks E, Roake J, Lewis D. Best Practice for Assessment of Patients With Varicose Veins. N Z Med J. 2008 May 23;121(1274):42-9. PubMed PMID: 18535645.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Best practice for assessment of patients with varicose veins. AU - Horrocks,Emma, AU - Roake,Justin, AU - Lewis,David, Y1 - 2008/05/23/ PY - 2008/6/7/pubmed PY - 2008/6/18/medline PY - 2008/6/7/entrez SP - 42 EP - 9 JF - The New Zealand medical journal JO - N Z Med J VL - 121 IS - 1274 N2 - BACKGROUND: Varicose veins are a significant health problem which attract much medicolegal attention. Recent publications have suggested "best practice" regarding assessment of patients with varicose veins. A retrospective audit was performed comparing clinical practice in a New Zealand teaching hospital with suggested standards. METHODS: Clinic letters from 80 patients awaiting varicose vein surgery were reviewed. Data were collated regarding presenting problem, relevant medical history, clinical findings on examination, further investigations, and outcome. RESULTS: Presenting complaint was noted for 99% of patients but actual symptoms were only recorded for 41%. The degree of disability caused by varicose veins was documented for 33% and patient concerns in 4%. Half of the patients presented with leg ulcers but ankle-brachial indices (ABPIs) were only recorded in 26% of clinic letters. Duplex scanning was recommended prior to surgery for 69% of patients and hand held Doppler assessment of venous disease was recorded in 61% cases. Clinic letters did not specify the nature and extent of disease in 6% of cases, and although every patient was recommended for surgery, the exact procedure was specified in only 24%. Details of surgical risks and complications were only present in 20% of letters, and only 21% of patients received a printed information sheet. CONCLUSIONS: The quality of the data recorded in the clinic letters of fell below suggested standards for assessment of patients with varicose veins. Improving the documentation of patient assessment will allow better communication between providers of healthcare and make clinical errors less likely. SN - 1175-8716 UR - https://www.unboundmedicine.com/medline/citation/18535645/Best_practice_for_assessment_of_patients_with_varicose_veins_ L2 - https://medlineplus.gov/varicoseveins.html DB - PRIME DP - Unbound Medicine ER -