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Anesthesia information management systems

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
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.]
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
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
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
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
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
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
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
Anil A Marian, Emine O Bayman, Anita Gillett, Brent Hadder, Michael M Todd
BACKGROUND: The American Society of Anesthesiologists Physical Status classification (ASA PS) of surgical patients is a standard element of the preoperative assessment. In early 2013, the Department of Anesthesia was notified that the distribution of ASA PS scores for sampled patients at the University of Iowa had recently begun to deviate from national comparison data. This change appeared to coincide with the transition from paper records to a new electronic Anesthesia Information Management System (AIMS)...
2016: BMC Medical Informatics and Decision Making
Joseph B Rinehart, Tiffany C Lee, Kayleigh Kaneshiro, Minh-Ha Tran, Coral Sun, Zeev N Kain
BACKGROUND: As part of ongoing perioperative surgical home implantation process, we applied a previously published algorithm for creation of a maximum surgical blood order schedule (MSBOS) to our operating rooms. We hypothesized that using the MSBOS we could show a reduction in unnecessary preoperative blood testing and associated costs. STUDY DESIGN AND METHODS: Data regarding all surgical cases done at UC Irvine Health's operating rooms from January 1, 2011, to January 1, 2014 were extracted from the anesthesia information management systems (AIMS)...
April 2016: Transfusion
Christopher W Connor, Michael Herzig
We describe a novel location and timekeeping system for a large, multifacility practice group using an app installed on mobile devices belonging to the staff. The system can be used independently of physical time clocks and without extracting information from anesthesia information management systems. The app creates geofences, reporting automatically when the user enters or departs the vicinity of a facility. The app displays the location of staff at all facilities, providing situational awareness. The leaving order of staff was adjusted daily using app data for the previous workload...
May 15, 2016: A & A Case Reports
Antoine Lamer, Mathieu Jeanne, Romaric Marcilly, Eric Kipnis, Jessica Schiro, Régis Logier, Benoît Tavernier
Abnormal values of vital parameters such as hypotension or tachycardia may occur during anesthesia and may be detected by analyzing time-series data collected during the procedure by the Anesthesia Information Management System. When crossed with other data from the Hospital Information System, abnormal values of vital parameters have been linked with postoperative morbidity and mortality. However, methods for the automatic detection of these events are poorly documented in the literature and differ between studies, making it difficult to reproduce results...
June 2016: Computer Methods and Programs in Biomedicine
Allan F Simpao, Jorge A Galvez, W Randall England, Elicia C Wartman, James H Scott, Michael M Hamid, Mohamed A Rehman, Richard H Epstein
Surgical procedures performed at the bedside in the neonatal intensive care unit (NICU) at The Children's Hospital of Philadelphia were documented using paper anesthesia records in contrast to the operating rooms, where an anesthesia information management system (AIMS) was used for all cases. This was largely because of logistical problems related to connecting cables between the bedside monitors and our portable AIMS workstations. We implemented an AIMS for documentation in the NICU using wireless adapters to transmit data from bedside monitoring equipment to a portable AIMS workstation...
February 2016: Anesthesia and Analgesia
Richard H Epstein, Franklin Dexter, David P Maguire, Niraj K Agarwalla, David M Gratch
BACKGROUND: Reducing fresh gas flow (FGF) during general anesthesia reduces costs by decreasing the consumption of volatile anesthetics and attenuates their contribution to greenhouse gas pollution of the environment. The sevoflurane FGF recommendations in the Food and Drug Administration package insert relate to concern over potential toxicity from accumulation in the breathing circuit of compound A, a by-product of the reaction of the volatile agent with legacy carbon dioxide absorbents containing strong alkali such as sodium or potassium hydroxide...
April 2016: Anesthesia and Analgesia
George Silvay, Zdravka Zafirova
Admission on the day of surgery for elective cardiac and noncardiac surgery is the prevalent practice in North America and Canada. This approach realizes medical, psychological and logistical benefits, and its success is predicated on an effective outpatient preoperative evaluation. The establishment of a highly functional preoperative clinic with a comprehensive set up and efficient logistical pathways is invaluable. This notion in recent years has included the entire perioperative period, and the concept of a perioperative anesthesia/surgical home (PASH) is gaining popularity...
June 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Carolina Sobrinho Ribeiro, Joana Irene de Barros Mourão
BACKGROUND AND OBJECTIVES: Anesthesia is still a major concern for patients, although the anesthetic complications have decreased significantly. Additionally, the role assigned to the anesthesiologist remains inaccurate. The aim of this study was to evaluate the concerns with anesthesia and assess the patient's knowledge about the anesthesiologist's duties. METHODS: Prospective study conducted over three months with patients in the preoperative anesthetic visit in a university hospital...
November 2015: Brazilian Journal of Anesthesiology
Paule E Beaulé, Aaron A Frombach, Jae-Jin Ryu
BACKGROUND: The introduction of 4-joint operating rooms (ORs) to meet provincial wait time targets represented a major change in practice, providing an opportunity to optimize patient care within an OR time allotment of 8 hours. We reviewed our success rate completing 4 joint replacements within 8 hours and defined benchmarks for successful completion. METHODS: We reviewed the surgeries performed in the 4-joint ORs between May and October 2012. Using prospectively collected data from the Surgical Information Management System, each surgery time was divided into the following components: anesthesia preparation time (APT), surgical preparation time (SPT), procedure duration, anesthesia finishing time (AFT) and turnover time...
December 2015: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Jens W Krombach, William A Edwards, James D Marks, Oliver C Radke
BACKGROUND: The use of printed or electronic checklists and other cognitive aids has gained increasing interest from anesthesia providers and professional societies. While these aids are not currently considered standard of care, the perceptions of the clinician might have an impact on their adoption. OBJECTIVES: We conducted a comprehensive survey to study the current opinions of anesthesia provider on the use of checklists and other cognitive aids. PATIENTS AND METHODS: A questionnaire was developed by a departmental checklist focus group, which aimed to identify the perception of health care checklists in general as well as specific checklists for routine and crisis situations in anesthesia...
August 2015: Anesthesiology and Pain Medicine
Seshadri C Mudumbai
Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS...
January 2016: Journal of Medical Systems
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