Case Number 6557
Request Date 17/02/2019
Completion Date 13/03/2019

 

Details of the Request

This request is to audit implementation of the RCOG/BSGE statement about choice and pain-relief in hysteroscopy.

1. a) Have your hysteroscopists read the following statement issued by the RCOG in December 2018 - Y/N?

b) Have your hysteroscopy managers read the following statement – Y/N?

 

2. Please are ALL your hysteroscopy patients from the outset routinely offered the choice of having hysteroscopy as a day case procedure

a) under GA – Y/N?

b) under regional anaesthetic – Y/N?

c) with IV sedation?

 

3. Do your hysteroscopy consent forms contain tick-boxes to enable a patient to choose

a) GA – Y/N?

b) regional anaesthesia – Y/N?

c) IV sedation – Y/N?

 

4. Have all your outpatient hysteroscopy teams received written instruction to monitor the patient throughout the procedure, to ask if she is experiencing pain, and to stop if the patient asks or is showing signs of severe pain or distress – Y/N?

 

5. Do all your hysteroscopy clinics routinely record ALL patients’ VAS pain-scores a) as hysteroscope passes through the cervix – Y/N, b) at biopsy – Y/N?

 

6. Does your hysteroscopy department send all its patients the RCOG’s Patient Information Leaflet, published on its website - Y/N?

 

7. Does your hysteroscopy department intend to start using the RCOG leaflet – Y/N?

If so, in which month/year?

 

8. If your hysteroscopy department uses its own Patient Information Leaflet, please may I have a link to it?

 

9. Does the leaflet include ALL the key points listed (below) by the RCOG – Y/N?

 

Details of the Response

1. a) Have your hysteroscopists read the following statement issued by the RCOG in December 2018?

Yes, hysteroscopists have read the statement

 

b) Have your hysteroscopy managers read the statement?

Yes we have dedicated day surgery TWR list and give women the choice of outpatient/local anaesthetic and GA hysteroscopy.

 

2. Please are ALL your hysteroscopy patients from the outset routinely offered the choice of having hysteroscopy as a day case procedure a) under GA?

Yes

 

b) under regional anaesthetic?

Local Anaesthetic available in the OPH clinic

 

c) with IV sedation?

No

 

3. Do your hysteroscopy consent forms contain tick-boxes to enable a patient to choose a) GA?

Yes

 

b) regional anaesthesia?

Yes

 

c) IV sedation?

Possible but not routinely offered

 

4. Have all your outpatient hysteroscopy teams received written instruction to monitor the patient throughout the procedure, to ask if she is experiencing pain, and to stop if the patient asks or is showing signs of severe pain or distress?

All staff has been trained appropriately but no written instructions

 

5. Do all your hysteroscopy clinics routinely record ALL patients’ VAS pain-scores a) as hysteroscope passes through the cervix?

Yes

 

b) at biopsy?

Yes

We record pain score with the procedure (not specifically when the scope passes the cervix) and pain with pipelle. We record pain score (1 to 10) with hysteroscopy and pipelle

 

6. Does your hysteroscopy department send all its patients the RCOG’s Patient Information Leaflet, published on its website?

We send departmental leaflet – sent to requester.

 

7. Does your hysteroscopy department intend to start using the RCOG leaflet? If so, in which month/year?

We have our own – sent to requester.

 

8. If your hysteroscopy department uses its own Patient Information Leaflet, please may I have a link to it?

Sent to requester.

 

9. Does the leaflet include ALL the key points listed (below) by the RCOG?

Outpatient hysteroscopy (OPH) is a procedure carried out in the outpatient clinic that involves examination of the inside of your uterus (womb) with a thin telescope.

Yes

 

There are many reasons why you may be referred for OPH, such as to investigate and/or treat abnormal bleeding, to remove a polyp seen on a scan or to remove a coil with missing threads.

Yes

 

The actual procedure usually takes 10–15 minutes. It can take longer if you are having any additional procedures.

Yes

 

You may feel pain or discomfort during OPH. It is recommended that you take pain relief 1–2 hours before the appointment.

Yes

 

If it is too painful, it is important to let your healthcare professional know as the procedure can be stopped at any time.

Yes

 

You may choose to have the hysteroscopy under general anaesthetic. This will be done in an operating theatre, usually as a daycase procedure.

No

 

Possible risks with hysteroscopy include pain, feeling faint or sick, bleeding, infection and rarely uterine perforation (damage to the wall of the uterus). The risk of uterine perforation is lower during OPH than during hysteroscopy under general anaesthesia.

Yes