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Lim KS, Nielsen JR, Piekarski F, Gerth AM, Zhong G. What airway management information do anaesthetic charts prompt for? An audit of charts from 132 hospitals across Australia and New Zealand. Anaesth Intensive Care 2023; 51:43-50. [PMID: 36217287 DOI: 10.1177/0310057x221099033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Anaesthetists can make safer airway plans if they know which airway techniques worked previously and which ones did not. Anaesthetic charts do not always capture this information, however, and guidelines from the Australian and New Zealand College of Anaesthetists do not specify what details on airway management they should include. To assess how anaesthetic charts support airway documentation, we audited the airway management section of blank charts from 132 hospitals accredited for training by the Australian and New Zealand College of Anaesthetists. We evaluated charts for the presence of 17 clinically important data fields describing tracheal intubation, supraglottic airway use and bag-mask ventilation. Our audit revealed that data fields on anaesthetic charts focus more on tracheal intubation than bag-mask ventilation or supraglottic airway use. Nearly all charts (99%) had prompts for intubation and most had prompts for both operator technique and patient outcome. For supraglottic airway use, 95% of charts had at least one data field, but few had prompts for difficulty or outcome. For bag-mask ventilation, 58% of charts had a data field for difficulty but most of these were subjective; few (1.5%) included any outcome measures. Data fields describing bag-mask ventilation and supraglottic airway use were also inconsistent. In summary, data fields on Australian and New Zealand anaesthetic charts focus on tracheal intubation with consistent prompts for both operator method and outcome. The inclusion of fields for outcome and difficulty of bag-mask ventilation and supraglottic airway use could help clinicians make better records of airway management.
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Affiliation(s)
- Kar-Soon Lim
- Department of Anaesthesia and Pain Management, 2659Concord Repatriation General Hospital, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - James R Nielsen
- Department of Anaesthesia and Pain Management, 2659Concord Repatriation General Hospital, Sydney, Australia
| | - Florian Piekarski
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Alice M Gerth
- Department of Anaesthesia, Cambridge University Hospital, Cambridge, UK
| | - George Zhong
- Department of Anaesthesia and Pain Management, 2659Concord Repatriation General Hospital, Sydney, Australia
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The electronic health record: marching anesthesiology toward value-added processes and digital patient experiences. Int Anesthesiol Clin 2021; 59:12-21. [PMID: 34369398 DOI: 10.1097/aia.0000000000000331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Nielsen J. Boring Is Beautiful in Preoperative Assessment. Anesth Analg 2017; 125:1820. [DOI: 10.1213/ane.0000000000002412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Difficultintubationapp.com version 2.0: difficultairwayapp? Can J Anaesth 2017; 64:432-433. [DOI: 10.1007/s12630-017-0826-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/06/2016] [Accepted: 01/17/2017] [Indexed: 10/20/2022] Open
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Simpao AF, Tan JM, Lingappan AM, Gálvez JA, Morgan SE, Krall MA. A systematic review of near real-time and point-of-care clinical decision support in anesthesia information management systems. J Clin Monit Comput 2016; 31:885-894. [PMID: 27530457 DOI: 10.1007/s10877-016-9921-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022]
Abstract
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. Studies were identified by searches of the electronic databases Medline and EMBASE. Two reviewers screened studies based on title, abstract, and full text. Studies that were similar in intervention and desired outcome were grouped into CDS categories. Three reviewers graded the evidence within each category. The final analysis included 25 articles on CDS as implemented within AIMS. CDS categories included perioperative antibiotic prophylaxis, post-operative nausea and vomiting prophylaxis, vital sign monitors and alarms, glucose management, blood pressure management, ventilator management, clinical documentation, and resource utilization. Of these categories, the reviewers graded perioperative antibiotic prophylaxis and clinical documentation as having strong evidence per the peer reviewed literature. There is strong evidence for the inclusion of near real-time and point-of-care CDS in AIMS to enhance compliance with perioperative antibiotic prophylaxis and clinical documentation. Additional research is needed in many other areas of AIMS-based CDS.
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Affiliation(s)
- Allan F Simpao
- Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA.
| | - Jonathan M Tan
- Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA
| | - Arul M Lingappan
- Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA
| | - Jorge A Gálvez
- Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA
| | - Sherry E Morgan
- University of Pennsylvania Biomedical Library, Perelman School of Medicine, University of Pennsylvania, 3610 Hamilton Walk, Philadelphia, PA, 19104-6060, USA
| | - Michael A Krall
- The Permanente Federation and the Oregon Health and Science University, 10040 SW Balmer Circle, Portland, OR, 97219, USA
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Nielsen J. Ventilation success masks our prediction failure. Anaesthesia 2015; 70:1331-2. [DOI: 10.1111/anae.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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