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The cancellation of elective Tenckhoff Catheter insertions has significant ramifications for both healthcare professionals and patients. It leads to extended waiting times, heightened costs, and imposes physical and psychological distress on the patients. Our primary goals were to identify the root causes and factors that lead to the cancellation of elective daycare Tenckhoff Catheter insertions, analyze these causes, and work towards reducing the cancellation rate.
A hospital-based prospective study was carried out during two time periods: from January 1, 2023, to March 31, 2023, and from May 1, 2023, to August 31, 2023. The study aimed to assess the cancellation rate and identify the factors that contributed to these cancellations. Data collection was performed by both medical officers and staff nurses working in the daycare unit, and a Google form was utilized to gather the data.
During the research period, a total of 96 scheduled Tenckhoff catheter insertions were undertaken. Among these, 13 cases were canceled, accounting for 13.5% of the total. We categorized the contributing factors into two groups: preventable and non-preventable factors. Of these, 10 cases (10.4%) were attributed to preventable factors, including situations where patients refused surgery (4 cases), poor compliance leading to uncontrolled hypertension and fluid overload (3 cases), 1 patient who failed to disclose recent contact with CRE (carbapenem-resistant enterococcus), and 2 cases resulting from clinician-related factors (failure to detect thrombocytopenia and presuming Tenckhoff malfunction without proper assessment). The remaining 3 cases (3.1%) were associated with non-preventable factors, such as infection on the day of the operation, contact with CRE a day prior to surgery, and uncontrolled bleeding during the incision.
Conducting a thorough pre-operative evaluation plays a crucial role in decreasing the rate of cancellations for elective surgeries, particularly in the context of Tenckhoff insertions. The cancellation of elective Tenckhoff insertions can be categorized into two groups: preventable and non-preventable factors. Preventable factors, such as patient refusal, lapses in follow-up, or failure to disclose critical medical history, highlight areas where our communication skills during counseling and discussions could be enhanced to mitigate these issues. Additionally, the prevention of fluid overload or abnormalities in blood parameters can be achieved through more diligent monitoring and assessment during the pre-operative phase.