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Anesthesia information management systems

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https://www.readbyqxmd.com/read/28099325/intraoperative-clinical-decision-support-for-anesthesia-a-narrative-review-of-available-systems
#1
Bala G Nair, Eilon Gabel, Ira Hofer, Howard A Schwid, Maxime Cannesson
With increasing adoption of anesthesia information management systems (AIMS), there is growing interest in utilizing AIMS data for intraoperative clinical decision support (CDS). CDS for anesthesia has the potential for improving quality of care, patient safety, billing, and compliance. Intraoperative CDS can range from passive and post hoc systems to active real-time systems that can detect ongoing clinical issues and deviations from best practice care. Real-time CDS holds the most promise because real-time alerts and guidance can drive provider behavior toward evidence-based standardized care during the ongoing case...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#2
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28089598/impact-of-focused-intraoperative-transthoracic-echocardiography-by-anesthesiologists-on-management-in-hemodynamically-unstable-high-risk-noncardiac-surgery-patients
#3
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28079663/general-anesthesia-and-fabry-disease-a-case-report
#4
Stefan Krüger, Albina Nowak, Torben Christoph Müller
Fabry disease is an inherited X-linked disorder characterized by the absence (in men) or deficiency (in women) in α-galactosidase A activity that causes a progressive accumulation of glycosphingolipids within lysosomes of cells of all the major organ systems. The subsequent organ damage that manifests in childhood and early adulthood presents a widely variable clinical picture of pain, hypertension, and cardiac, renal, nervous system, and lung dysfunction. We present 2 female patients with Fabry disease who required general anesthesia twice for gynecological and trauma surgery, respectively, and discuss their perioperative management based on new information in the medical literature...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#5
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27935775/anesthesia-information-management-systems
#6
Thomas Corey Davis
Anesthesia information management systems (AIMS) are rapidly gaining widespread acceptance. Aggressively promoted as an improvement to manual-entry recordkeeping systems in the areas of accuracy, completeness, quality improvement, billing, and vigilance, these systems record all patient vital signs and parameters, providing a legible hard copy and permanent electronic record. With well-documented financial incentives, as well as government subsidies, AIMS are becoming adopted at an unprecedented rate. With the goals of the federal government to enhance the use of the electronic medical record, there is an emerging belief that AIMS may soon be mandated, with more limited choices than currently available...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#7
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#8
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27871568/discrepancy-between-electroencephalography-and-hemodynamics-in-a-patient-with-cockayne-syndrome-during-general-anesthesia
#9
Masanori Tsukamoto, Takashi Hitosugi, Takeshi Yokoyama
Cockayne syndrome is a kind of progeria with autosomal chromosome recessiveness described first by Cockayne in 1936. Patients with this syndrome were characterized by retarded growth, cerebral atrophy, and mental retardation. We experienced an anesthetic management of a patient with Cockayne syndrome, who underwent dental treatment twice. The primary concern was discrepancy between electroencephalography and hemodynamics. The values of bispectral index showed a sharp fall to 1 digit and suppression ratio more than 40, while hemodynamics was stable during induction of anesthesia with sevoflurane 8%...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27785761/using-physiological-monitoring-data-for-performance-feedback-an-initiative-using-thermoregulation-metrics
#10
Matthias Görges, Nicholas C West, Simon D Whyte
BACKGROUND: Feedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist's mind, thereby improving perioperative temperature management...
October 26, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27755055/default-drug-doses-in-anesthesia-information-management-systems
#11
Luis I Rodriquez, Todd J Smaka, Michael Mahla, Richard H Epstein
BACKGROUND: In the United States, anesthesia information management systems (AIMS) are well established, especially within academic practices. Many hospitals are replacing their stand-alone AIMS during migration to an enterprise-wide electronic health record. This presents an opportunity to review choices made during the original implementation, based on actual usage. One area amenable to this informatics approach is the configuration in the AIMS of quick buttons for typical drug doses...
October 11, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27716193/keys-to-successful-implementation-of-a-french-national-quality-indicator-in-health-care-organizations-a-qualitative-study
#12
Mathias Waelli, Marie-Léandre Gomez, Claude Sicotte, Adrian Zicari, Jean-Yves Bonnefond, Philippe Lorino, Etienne Minvielle
BACKGROUND: Several countries have launched public reporting systems based on quality indicators (QIs) to increase transparency and improve quality in health care organizations (HCOs). However, a prerequisite to quality improvement is successful local QI implementation. The aim of this study was to explore the pathway through which a mandatory QI of the French national public reporting system, namely the quality of the anesthesia file (QAF), was put into practice. METHOD: Seven ethnographic case studies in French HCOs combining in situ observations and 37 semi-structured interviews...
October 6, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27608208/a-review-of-local-anesthetics-minimizing-risk-and-side-effects-in-cutaneous-surgery
#13
Kelly K Park, Victoria R Sharon
BACKGROUND: The specialty of dermatology relies heavily on local anesthesia for diagnosis and management of skin disease. The appropriate selection, preparation, administration, and monitoring of these medications affect surgical outcome and patient safety and satisfaction. OBJECTIVE: To perform a comprehensive literature review of the side effects and risks associated with local anesthetics used in cutaneous surgery. Current recommendations to reduce risk and minimize side effects are reviewed...
September 7, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27530457/a-systematic-review-of-near-real-time-and-point-of-care-clinical-decision-support-in-anesthesia-information-management-systems
#14
Allan F Simpao, Jonathan M Tan, Arul M Lingappan, Jorge A Gálvez, Sherry E Morgan, Michael A Krall
Anesthesia information management systems (AIMS) are sophisticated hardware and software technology solutions that can provide electronic feedback to anesthesia providers. This feedback can be tailored to provide clinical decision support (CDS) to aid clinicians with patient care processes, documentation compliance, and resource utilization. We conducted a systematic review of peer-reviewed articles on near real-time and point-of-care CDS within AIMS using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols...
August 16, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27346873/an-automated-real-time-method-for-the-detection-of-patients-at-risk-for-malignant-hyperthermia
#15
Stephen J Gleich, Kim Strupp, Robert T Wilder, Daryl J Kor, Randall Flick
BACKGROUND: Malignant hyperthermia (MH) is a rare anesthetic pharmacogenetic disorder that can be difficult to detect in its earliest phases. Prompt treatment is known to improve outcomes. The modern anesthesia information management systems (AIMS) collect enormous amounts of data. However, data lack context and are not able to provide real-time guidance. Utilizing our AIMS, we developed the capacity to incorporate decision support. AIMS: We describe the creation and evaluation of a real-time detection tool for MH...
September 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27270785/comparison-of-minute-distribution-frequency-for-anesthesia-start-and-end-times-from-an-anesthesia-information-management-system-and-paper-records
#16
Michael Phelps, Asad Latif, Robert Thomsen, Martin Slodzinski, Rahul Raghavan, Sharon Leigh Paul, Jerry Stonemetz
Use of an anesthesia information management system (AIMS) has been reported to improve accuracy of recorded information. We tested the hypothesis that analyzing the distribution of times charted on paper and computerized records could reveal possible rounding errors, and that this effect could be modulated by differences in the user interface for documenting certain event times with an AIMS. We compared the frequency distribution of start and end times for anesthesia cases completed with paper records and an AIMS...
June 7, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27111643/controlled-substance-reconciliation-accuracy-improvement-using-near-real-time-drug-transaction-capture-from-automated-dispensing-cabinets
#17
Richard H Epstein, Franklin Dexter, David M Gratch, Michael Perino, Jerry Magrann
BACKGROUND: Accurate accounting of controlled drug transactions by inpatient hospital pharmacies is a requirement in the United States under the Controlled Substances Act. At many hospitals, manual distribution of controlled substances from pharmacies is being replaced by automated dispensing cabinets (ADCs) at the point of care. Despite the promise of improved accountability, a high prevalence (15%) of controlled substance discrepancies between ADC records and anesthesia information management systems (AIMS) has been published, with a similar incidence (15...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27040571/quantifying-the-rambunctious-journey-of-the-anesthesia-provider-s-hands-during-simulated-routine-care
#18
Chuck Biddle, Kathryn Robinson, Benjamin Pike, Michael Kammerman, Beverly Gay, Brad Verhulst
BACKGROUND: The role of anesthesia providers in dispersing potentially pathogenic material from one patient to another during intraoperative care needs further study. In this study we aimed (1) to quantify the dispersion of a surrogate pathogen from a simulated patient's mouth to the anesthesia workstation during routine anesthetic induction, (2) to test the hypothesis that there would be fewer contamination sites by providers who used a double-gloving technique, and (3) to examine the effectiveness of between-case anesthesia apparatus disinfection...
August 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27039234/antibiotics-are-the-most-commonly-identified-cause-of-perioperative-hypersensitivity-reactions
#19
James L Kuhlen, Carlos A Camargo, Diana S Balekian, Kimberly G Blumenthal, Autumn Guyer, Theresa Morris, Aidan Long, Aleena Banerji
BACKGROUND: Hypersensitivity reactions (HSRs) during the perioperative period are unpredictable and can be life threatening. Prospective studies for the evaluation of perioperative HSRs are lacking, and data on causative agents vary between different studies. OBJECTIVE: The objective of this study was to prospectively determine the success of a comprehensive allergy evaluation plan for patients with HSRs during anesthesia, including identification of a causative agent and outcomes during subsequent anesthesia exposure...
July 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/26946134/endoscopic-ultrasonography-in-pediatric-patients-experience-from-a-tertiary-care-center-in-india
#20
Ramit Mahajan, Ebby George Simon, Ashok Chacko, D Viswanath Reddy, P Rupesh Kalyan, A J Joseph, Amit Kumar Dutta, Sudipta Dhar Chowdhury, Reuben Thomas Kurien
BACKGROUND AND AIMS: Although endoscopic ultrasound (EUS) is used in the management of various gastrointestinal (GI) diseases in adults, data on its role in children is limited. This study evaluated the indications, safety, and impact of EUS in children. METHODS: Records of children (<18 years age) who underwent EUS between January 2006 and September 2014 were reviewed retrospectively and analyzed. RESULTS: One hundred and twenty-one children (70 males, 51 females) aged 15...
January 2016: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
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