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post anaesthesia recovery audit

E Roderick, J Hoyle, S M Yentis
Neuraxial anaesthesia is widely used in obstetrics and neurological complications are rare. However, when they occur, subsequent investigation and management are time-critical and correlate with the extent of neurological recovery. The Third National Audit Project recommended the implementation of guidelines in obstetric epidural management, including advice on monitoring for early signs of problems and acting upon concerns. However, no national guideline exists for postoperative management in the obstetric population...
January 10, 2017: Anaesthesia
Benjamin Deniau, Nacima Bouhadjari, Valentina Faitot, Antoine Mortazavi, Gilles Kayem, Laurent Mandelbrot, Hawa Keita
OBJECTIVE: To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia. STUDY DESIGN: Prospective single-centre study. METHODS: Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months)...
December 2016: Anaesthesia, Critical Care & Pain Medicine
Giuseppe Piccinni, Giuseppe Massimiliano De Luca, Alessandro De Luca, Simone Giungato, Mario Testini
Groin hernia repair by using the laparoscopic transabdominal preperitoneal (TAPP) repair approach presents lower post-operative pain with a quicker return to normal patient activity compared to the open technique. Nevertheless, the long learning curve, general anaesthesia, and increased costs due to devices are the arguments against TAPP. Currently, the only mesh fixation techniques are those using glue or tacks. We report the audit of two years follow-up about our experience using a self-gripping lightweight mesh Parietex ProGrip™ (Covidien, Trevoux, France)...
May 2015: Surgical Technology International
A Grover, E Duggan
We audited verbal handover of information by anaesthetists to recovery room nurses based on Situation, Background, Assessment and Recommendation. In Audit A, 100 handovers for elective procedures were included. For audit B, a second cohort of 100 patients was examined post educational session. There was an improvement in handover of medical background (46.15% Audit A, 77% Audit B, p < 0.001) and allergy status (42% Audit A, 56% Audit B, p = 0.048). Handing over immediate postoperative instructions remained unchanged (58% Audit A, 59% Audit B) and there was a 4% decline in verbal handover of instructions for ward care...
September 2013: Irish Medical Journal
D K Whitaker Chair, H Booth, P Clyburn, W Harrop-Griffiths, H Hosie, B Kilvington, M Macmahon, P Smedley, R Verma
1. After general, epidural or spinal anaesthesia, all patients should be recovered in a specially designated area (henceforth 'post-anaesthesia care unit', PACU) that complies with the standards and recommendations described in this document. 2. The anaesthetist must formally hand over the care of a patient to an appropriately trained and registered PACU practitioner. 3. Agreed, written criteria for discharge of patients from the PACU to the ward should be in place in all units. 4. An effective emergency call system must be in place in every PACU and tested regularly...
March 2013: Anaesthesia
T Ledowski, S Hillyard, A Kozman, F Johnston, E Gillies, M Greenaway, B C Kyle
Sugammadex is known to rapidly and completely reverse the effects of amino-steroidal neuromuscular blocking agents. However, the high costs of sugammadex have so far prevented its introduction as the standard reversal agent in most healthcare systems. At the Royal Perth Hospital, sugammadex was recently introduced as an unrestricted alternative to neostigmine for the reversal of amino-steroidal neuromuscular blocking agents. The aim of this retrospective observational audit was to investigate the impact of this change on clinical practice and associated healthcare costs...
March 2012: Anaesthesia and Intensive Care
P S Myles, R Wengritzky
BACKGROUND: Postoperative nausea and vomiting (PONV) is common but many episodes may be trivial or transient. The aim of the study was to develop a simple-to-use measure of the intensity and clinical impact of PONV. METHODS: We re-analysed data from a study enrolling 163 patients recovering from surgery and anaesthesia that had experienced or were at increased risk of developing PONV. A range of measures of PONV characteristics and quality of recovery were collected...
March 2012: British Journal of Anaesthesia
E Arakelian, L Gunningberg, J Larsson, K Norlén, H Mahteme
BACKGROUND: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) can prolong survival in selected patients with peritoneal carcinomatosis (PC). However, there is little data on patients' recovery process after this complex treatment. This study aimed to describe the in-hospital postoperative recovery and factors related to the recovery of patients who undergo CRS and HIPEC. METHOD: A retrospective audit of the electronic health record (EHR) was undertaken for 76 PC patients (42 women, 34 men) treated primarily with CRS and HIPEC between 2005 and 2006 in Sweden...
October 2011: European Journal of Surgical Oncology
Sunanda Gupta, Udita Naithani, Saroj Kumar Brajesh, Vikrant Singh Pathania, Apoorva Gupta
Critical incident monitoring is useful in detecting new problems, identifying 'near misses' and analyzing factors or events leading to mishaps, which can be instructive for trainees. This study was aimed at investigating potential risk factors and analyze events leading to peri-operative critical incidents in order to develop a critical incident reporting system. We conducted a one year prospective analysis of voluntarily reported 24- hour-perioperative critical incidents, occurring in patients subjected to anaesthesia...
August 2009: Indian Journal of Anaesthesia
S Anselme, S Boileau, M Vedel, C Muller, M-F Blech, H Bouaziz
OBJECTIVES: To study the assessment of hygiene practices in anaesthesia in Lorraine between 1998 and 2007, after recommendations from the French Society of Anaesthesia and Reanimation (SFAR) in December 1997, and different local actions. STUDY DESIGN: Two surveys performed at a nine-year interval in Lorraine hospitals. POPULATION AND METHOD: Questionnaires about risk infection management and hygiene practices were sent by post to all anaesthetists, nurse anaesthetists and recovery room nurses in 1998 (n=279) and in 2007 (n=259)...
January 2009: Annales Françaises D'anesthèsie et de Rèanimation
Y C Choy
Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors...
December 2006: Medical Journal of Malaysia
Khalid Samad, Mueenullah Khan, Hameedullah, Fauzia A Khan, Mohammad Hamid, Fazal H Khan
OBJECTIVE: To identify the factors that prolong the length of stay inthe post anaesthesia care unit (PACU). METHODS: This audit was conducted in the PACU of a university hospital. A special form was designed and filled for those patients who stayed unplanned in the PACU for more than two hours. All patients who were admitted to the PACU after surgery were included. Patients undergoing cardiothoracic surgery, those directly shifted to ICU and cases done under local anaesthesia were excluded...
March 2006: JPMA. the Journal of the Pakistan Medical Association
L Tiret, F Hatton, J M Desmonts, G Vourc'h
In order to set up measures to improve safety in anesthesia, the French Ministry of Health charged the Institut National de la Santé et de la Recherche Médicale (I.N.S.E.R.M.) with conducting an epidemiological survey of complications associated with anaesthesia. A prospective survey was carried out from 1978 to 1982 in a representative sample of 198,103 anaesthesias performed in 460 public and private institutions randomly selected throughout the country. There were 268 major complications associated with anaesthesia occurring during or within 24 hours after anaesthesia (incidence 1...
1988: Health Policy
G B Downey, A J O'Connell
We performed an audit of booked and unbooked admissions to a paediatric intensive care unit (PICU) after anaesthesia over a 19 month period in order to determine whether unbooked admissions were predictable, or whether there were any preventable anaesthetic factors responsible for PICU admission, and to evaluate the necessity of PICU admission in all study patients. Data was collected from the PICU database and from the medical records, especially the anaesthesia records, of unbooked admissions. There were 640 admissions to the PICU from the operating theatres, with 35 (5%) unbooked...
August 1996: Anaesthesia and Intensive Care
G J Laycock, L R McNicol
Arterial oxygen saturation was measured by pulse oximetry in 105 children (aged 2 weeks-14 years) during recovery from general anaesthesia. Oxygen saturation was monitored continuously from the time that anaesthesia ended in the operating theatre until the children were fit to leave the recovery ward. All children breathed room air during transfer to the recovery area; 81 children continued to breathe room air in the recovery ward while the remainder received supplementary oxygen. Fifty-six children became significantly hypoxaemic (oxygen saturation less than 90%) at some stage...
November 1988: Anaesthesia
F A Khan, N A Soomro, R S Kamal
Recovery from anaesthesia is a time of potential danger to the surgical patients. A retrospective audit of all recovery room admissions over a period of 18 months was carried out at the Aga Khan University Hospital. During this period 6978 patients were admitted to the recovery area and 695 had one or more complications. The complications were recorded by the recovery room nursing staff in a recovery log book. The breakdown of complications according to different physiological systems is discussed. Several surveys have reviewed complications in the western population, but in contrast, no study is available in Pakistani patients...
January 1991: JPMA. the Journal of the Pakistan Medical Association
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