Department of Surgery

DEPARTMENT OF SURGERY

NATIONAL HOSPITAL ABUJA

QUALITY OF CARE POLICY AND OPERATIONAL GUIDELINES

NHA/CD/QOCP/SUR/001

Dr. IGOCHE M.

HEAD OF DEPARTMENT

1.0    INTRODUCTION

The department of surgery was established in 1999. It is currently made up of multiple surgical subspecialties rendering both elective and emergency services across the field of general surgery, neurosurgery, urological surgery, cardio-thoracic surgery, plastic and reconstructive surgery as paediatric surgery high quality and state-of-the-art equipment. By extension we also cover the trauma centre and offer training of residents to international standards.

We are currently accredited to train residents up to Part II Fellowship in general surgery, neurosurgery, paediatric surgery in the West African College of Surgery and the National Postgraduate College while we have part accreditation in urology and burns and  plastics in the both colleges.

Vision statement

To provide prompt and standardized care of the surgical patients using the best available, verifiable, modern and holistic surgical facilities and skills to achieve the best possible outcome by a well-trained and motivated workforce.

Mission statement

To train competent, confident and highly qualified surgeons to render patient centred efficient service and to conduct standard research that will advance the course of knowledge and safety.

2.0    QUALITY ASSURANCE POLICY

• We ensure daily review of all in-patient by the consultants.
• The senior registrars on-call review patients’ clinical progress daily and during call hours as need arises.
• We ensure clear documentation of patient’s clinical progress by team on-call and the managing team.
•  
• Each sub subspecialty is responsible for designing their standard operating procedures.
• There is weekly review of unit discharge summaries and a monthly departmental morbidity and mortality meeting.
• The body of consultants meets every 1^st Friday of the month to review departmental activities and proffer solutions to identified lapses and ensure maintenance of standard quality practice.

 

3.0    STRENGTH OF THE DEPARTMENT

• The department can boost of consultants in all relevant subspecialties of surgery.
• We are blessed with modern equipment and supported with equipment quality adjuncts to facilitate the best possible outcome.
• Our fellows are top notched professionals who are board certified examiners in the regional postgraduate colleges.
• Our practice is subjected to weekly peer review at the morbidity meetings as well as multidisciplinary team approach to patient management.
• We are abreast of the current research and we give attention to training and research in the various subspecialties of surgery.
• Our treatment is prompt and efficient and we have feedback mechanism to review patient satisfaction.

Services Provided

1. Clinical services – the department provides routine specialist services in
   1. general surgery, neurosurgery, urological surgery, cardio-thoracic surgery, plastic and reconstructive surgery as well as paediatric surgery
   2. emergency services covering the surgical emergency spectrum.
   3. Training:-

• Training of Residents from within and outside the hospital
• Other health workers

4.0 Operational Guidelines:

 

The department operates 24 hours services across all subspecialties.

Operating Hours  –    8.00am to 4.00pm – elective hours

• 00pm –  8.00am  –  call hours
•  

There is a call duty roster submitted at all patient entry point with the contact telephone number of the doctors for ease of communication.

All patient admitted to the department shall be by written referral and all communications across department shall be by written referrals.

 

Emergency Services

• All emergency consult shall be attended by the unit registrars within 15mins of collection and by the senior registrar within 45mins of receipt.
• The consultant shall make a documented input within two (2) hours of the receipt of all written consults.
• There shall be casualty officer at the surgical accident and emergency unit and trauma unit who shall be available to review patients within five (5) minutes of triage and commence resuscitation and consult to the necessary subspecialties.
• Emergency communication can be by a direct telephone call to the unit registrar to be followed by the written consult. Unanswered call be escalated by calling the unit senior registrar up to the unit consultant as the need arises.  Text messages shall not be accepted as a means of communication in the department.
• All patients admitted through the emergency unit shall be through the express permission of the unit consultant. Consults across department shall be with the documented permission of the consultant.
• All emergency surgeries shall be with the documented permission of the unit consultant. There shall be documented post-operative review of post-operative emergency cases within one hour of the arrival on the ward.

 

Elective Services

• Each subspecialty shall hold consultant led outpatient clinic once a week.
• Each consultant shall be seen through a written referral.
• All patient admissions from the outpatient clinic shall be with the documented permission of the consultant.
• All patients for elective surgery shall be admitted not later than 24 hours before surgery.
• All admitted patients shall be clerked by the unit registrars within one hour of admission
• All elective surgical patient shall be reviewed by the consultant the day before surgery.
• Elective operation list shall arrive in the operating theatre before 2pm the day before surgery.
• The unit consultant shall draw up a checklist for preoperative work up of the unit patients which shall be ticked and accompany the patient to the theatre.
• Informed consent shall be obtained by not less than a senior registrar for all elective cases and not later than 24 hours before surgery.
• The site of surgery shall be clearly marked by the senior registrar the night before the surgery.
• All patient for elective surgery shall make payment for surgery before admission and the sighting of surgery fee receipt shall be part of all unit pre-operative checklist.
• All elective operation shall be within the documented permission of the unit consultant
• The order of running the elective list shall be the prerogative of the managing consultant.
• No case shall be cancelled without the documented permission of the unit consultant
• Documentation of operative procedures shall be done by the unit senior registrar
• There shall be postoperative ward round by the senior registrar at the end of every elective list
• All patients discharge shall be by the documented permission of the consultant
• All discharge summaries shall be written within one hour of patient discharge and included in the patient folder

5.0    DEPARTMENTAL ACTIVITIES

Weekly Activities and Schedules

Academic Activities

Day	Activity	Time
Monday	Departmental Seminar	8.00 am  –  9.30 am
Tuesday	Bedside Presentation	3.00 pm –  4.00 pm
Thursday	Surgical / Radiological Meeting	3.00 pm –  4.00 pm
Friday	Journal Review / Discharge Summary/ Morbidity / Mortality Meeting	3.00 pm –  4.00 pm
Saturday	Essay Writing / OSCE Practical	8.30 am

Outpatient Clinic

Day	Team	Time
Monday	General Surgery II	9.30 am  –  1.00 pm
	Cardiothoracic Surgery	9.30 am  –  1.00 pm
	Burns & Plastic Surgery	12noon  –  4.00 pm
Tuesday	General Surgery I	9.30 am  –  1.00 pm
	Neurosurgery II	12noon   –  4.00 pm
Wednesday	Paediatric Surgery	9.30 am  –  1.00 pm
	Urology	12noon  –  4.00 pm
Thursday	Neurosurgery I	9.30 am  –  1.00 pm

Operation Days

Day                       Team                    Time                               Venue

Day	Team	Time	Venue
Monday	Urology	8.00am   –  4.00 pm	Main Theatre
	Paediatrics	8.00am   –  4.00 pm	Kids OR
Tuesday	General Surgery II	12noon  –  3.00 pm	Radiology dept
	Paediatrics	8.00am   –  4.00 pm	Kids OR
Wednesday	General Surgery II	8.00am   –  4.00 pm	Main Theatre
	Cardiothoracic	8.00am   –  4.00 pm	Main Theatre
	Neurosurgery	8.00am   –  4.00 pm	Main Theatre
	General Surgery I	12noon  –  4.00 pm	Endoscopy
Thursday	General Surgery I	8.00am   –  4.00 pm	Main Theatre
	General Surgery II	10am –  2pm	Endoscopy
	Cardiothoracic	10am –  2pm	Endoscopy
	Paediatrics	8.00am   –  4.00 pm	Kids OR
Friday	Neurosurgery	11am  –  4pm	Main Theatre
	BPU	11am  –  4pm	Main Theatre
	Urology	11am  –  4pm	Main Theatre

 

Ward Rounds

• Both units review their patients daily with a consultant led teaching round once weekly.
• All patients are reviewed daily by the Senior Registrar
• Call hours are covered by the units on call
• We operate unit call duty with a registrar and senior registrar in each unit sleeping in.

6.0 ORGANOGRAM

7.0 HEALTH AND SAFETY POLICY

 

• All staff are expected to practice universal precautions and to make use of basis PPE available at every service point in the hospital.
• All staff are encouraged to report all health challenges to the staff clinic and incase of contact with patients infected body fluid and fomites. They shall call the HOD for upward escalation to the hospital Infection Control Unit
• All cases of assaults should be reported from Units to HOD for report to management.

8.0 POLICY ON MINIMUM STANDARDS

 

We shall practice internationally acceptable standard based on current evidences which can change from time to time.

9.0 LIST OF STAFF

 

S/N	NAME	QUALIFICATIONS		SUBSPECIALTY		Designation
Consultants (18)
1.	Dr. O. A. Badejo	MBBS, FWACS		Gen Surgery		Consultant
2.	Dr. O. O. Olaomi	B.Sc, MBBCh, FWACS, FICS		Gen Surgery /  Trauma		Consultant
3.	Dr. C. S. Batta	MBBS, FWACS		Gen Surgery		Consultant
4.	Dr. Yau A. G	MBBS, FWACS, MSc, LaparascopicSurgeon		Gen. Surgery		Consultant
5.	Dr. Usman Gwaram	MBBS, FMCS		Gen Surgery / Trauma		Consultant
6.	Dr. O. G. Okoye	MBBS, FWACS, FMCS, Postgraduate fellowship in Trauma		Gen Surgery / Trauma		Consultant
7.	Dr. Apollo K. D.	MBBS, FWACS, Postgraduate fellowship in Trauma		Trauma / Ortho Surgeon		Consultant
8.	Prof. E. A. Ameh	MBBS, FWACS, FICS		Pead Surgery		Consultant
9.	Dr. P. A. Anyanwu	MBBS, FWACS		Paed Surgery		Consultant
10.	Dr. M. I. Ighoche	MBBS, FWACS		Paed Surgery		Consultant
11	Dr. Y. B. Adamu	MBBS, FWACS		Cardiothoracic		Consultant
12.	Dr. N. Anumenechi	MBBS, FWACS		Cardiothoracic		Consultant
13.	Dr. C. U. Ugwuanyi	MD, FMCS, FNIMC		Neurosurgery		Consultant
14.	Dr. Yusuf Salman	MBBS, FWACS, FMCS		Neurosurgery		Consultant
15.	Dr. I. O. Lawal	MBCh.B, FWACS		Urology		Consultant
16.	Dr. O. Omukhudu	MBBS, FWACS		Urology		Consultant
17.	Dr. Edith Terna-Yawe	MBBS, FWACS		Burns & Plastic		Consultant
18.	Dr. OikehOjeamen	MBBS, FWACS		Burns & Plastic		Consultant
Registrars/Medical officers (43)
1.	Dr. Nweke Clinton		MBBS, FWACS, FMCS		Urology	Post-part II fellow
2.	Dr. Mansur Idris		MBBS, FWACS		Neurosurgery	Post-part II fellow
3.	Dr. Omeke C. J		MBBS, FWACS		General Surgery	Post-part II fellow
4.	Dr. Irowa O. O.		MBBS, FWACS		General Surgery	Post-part II fellow
5.	Dr. JamiuAdebiyi		MBBS, FWACS		Neurosurgery	Post-part II fellow
6.	Dr. OladeleShittu O.		MBBS		Gen Surgery 1	Senior registrar
7.	Dr. Echebiri Promise		MBBS		Gen Surgery	Senior registrar
8.	Dr. AjibolaOluwatosin		MBBS		Gen Surgery	Senior registrar
9.	Dr. OnuhChibuike M.		MBBS		Pead Surgery	Senior registrar
10.	Dr. Ibrahim Salamatu H.		MBBS		Paed Surgery	Senior registrar
11.	Dr. Oghenekaro E.		MBBS		***Paed Surgery	Senior registrar
12.	Dr. OlubunmiMajekodunmi		MBBS		Paed Surgery	Senior registrar
13.	Dr. UdeigweChisom Rachael		MBBS		Paed Surgery	Senior registrar
14.	Dr. OlatunjiBoluTejesun		MBBS		Paed Surgery	Senior registrar
15.	Dr. Udoh Robert Ibibio		MBBS		Cardiothoracic	Senior registrar
16.	Dr. Suleiman KehindeAyuba		MBBS		Cardiothoracic	Senior registrar
17.	Dr. Olayiwola Ibrahim		MBBS		Cardiothoracic	Senior registrar
18.	Dr. Okpata Cyril		MBBS		Neurosurgery	Senior registrar
19.	Dr. BabalolaTemitope		MBBS		Neurosurgery	Senior registrar
20.	Dr. AyoguObinna M.		MBBS		Neurosurgery	Senior registrar
21.	Dr. Kpoduwei Selekeowei		MBBS		***Neurosurgery	Senior registrar
22.	Dr. Ikechi Ekpendu		MBBS		***Neurosurgery	Senior registrar
23.	Dr. UthmanUthman		MBBS		Neurosurgery	Senior registrar
24.	Dr. Essien Ubong		MBBS		Neurosurgery	Senior registrar
25.	Dr. Kassim Jabir		MBBS		Neurosurgery	Senior registrar
26.	Dr. AtinkoIkeyah Sunday		MBBS		Urology	Senior registrar
27.	Dr. ObuhIkenna		MBBS		Urology	Senior registrar
28.	Dr. Osilama Kelvin Orbih		MBBS		Urology	Senior registrar
29.	Dr. Bello Abdulkarim		MBBS		Urology	Senior registrar
30.	Dr.BrownUgobongOwoh		MBBS		Urology	Senior registrar
31.	Dr. Udosen Utobong M.		MBBS		Urology	Senior registrar
32.	Dr. Ukaegbu Oji Uduma		MBBS		***Urology	Senior registrar
33.	Dr. AshomsYakubu Iliya		MBBS		Burns & Plastic	Senior registrar
34.	Dr. Onuh Eunice		MBBS		Burns & Plastic	Senior registrar
35.	Dr. Felix Avwovwoughe		MBBS		Not applicable	Registrar
36.	**Dr. Daniel Boukeregha		MBBS		Not applicable	Registrar
37.	Dr. P. Inedu		MBBS		Not applicable	Registrar
38.	Dr. Naomi Musa		MBBS		Not applicable	Registrar
39.	Dr. Victor Gana		MBBS		Not applicable	Registrar
40.	Dr. Moses M.		MBBS		Not applicable	Registrar
41.	Dr. Bello KarimatuKatagum		MBBS		Not applicable	Registrar
42.	**Dr. Famuyiwa Joseph Agboola		MBBS		Not applicable	Registrar
43.	**Dr. Epepe		MBBS		Not applicable	Registrar

 contact email: hod.surgery@nationalhospital.gov.ng