Adverse physiological events under anaesthesia and sedation: a pilot audit of electronic patient records
| Autor: | Guy L. Ludbrook, R. J. Willis, Cliff Grant, E. A. Hampson, R. Semenov |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Under anaesthesia Quality management Medical Records Systems Computerized Quality Assurance Health Care Sedation Laryngismus Conscious Sedation Blood Pressure Pilot Projects Audit Critical Care and Intensive Care Medicine Healthcare delivery Heart Rate Tachycardia Bradycardia Medicine Humans Anesthesia False Positive Reactions Adverse effect Hypoxia Intraoperative Complications Aged Anesthetics Clinical Audit Isoflurane business.industry Perioperative Colonoscopy Middle Aged Oxygen Anesthesiology and Pain Medicine Data Interpretation Statistical Emergency medicine Hypertension Female medicine.symptom Hypotension business Desflurane |
| Zdroj: | Anaesthesia and intensive care. 36(2) |
| ISSN: | 0310-057X |
| Popis: | Review of perioperative activity, including adverse events, throughput and compliance with ‘best practice’, can theoretically be used to optimise healthcare delivery. Computer-based analysis of electronic patient records could provide a practical means to manage quality improvement. This pilot study examined the effectiveness of such a system in practice. All intraoperative patient notes and physiological data were collected over 17 months in a rural hospital using data from an electronic record-keeping system. Algorithms were developed to automatically identify potential adverse events based on physiological measures. Each computer-identified event was reviewed by a panel of three anaesthetists and assessed for validity, severity and probable cause. Two areas were identified to pilot quality improvement activities—sedation for colonoscopies and inhalational anaesthesia with desflurane. Specific ‘inhouse’ guidelines were created for these procedures and feedback on the patterns of adverse events were provided to anaesthetic staff. A total of 138 separate adverse events were identified for all operative cases over 17 months, with an overall adverse event incidence of 3.3%. The adverse event incidence during colonoscopy and laryngospasm/hypoxia during desflurane anaesthesia was 6.3% and 1.3% respectively. This decreased to 2.8% (P Anaesthesia information systems can be an effective quality improvement tool and may enhance existing tools such as incident reporting systems. |
| Databáze: | OpenAIRE |
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