Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2009
Multicenter StudyDrug administration errors: a prospective survey from three South African teaching hospitals.
This prospective study was undertaken to determine the incidence of drug administration errors by anaesthetists at three tertiary South African hospitals. Hospitals A and C treat adults predominantly, whereas Hospital B is a paediatric hospital. Anaesthetists completed an anonymous study form for every anaesthetic performed over a six-month period. ⋯ No major complication attributable to a drug administration error was reported. Despite an increasing awareness of the problem together with suggestions in the literature to reduce the incidence, drug administration errors remain fairly common in South Africa. Failure to institute suggested solutions will continue to compromise patient safety.
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Anaesth Intensive Care · Jan 2009
Multicenter StudyVentilation and weaning practices in Australia and New Zealand.
Using a one-day prospective point prevalence design, this study aimed to characterise the current practice of mechanical ventilation and weaning in Australian and New Zealand intensive care units. During 2005, a bi-national one-day survey of 55 intensive care units found the point-prevalence of mechanical ventilation to be 284/491(58%). Common modes used were synchronised intermittent mandatory ventilation with pressure support, pressure support ventilation (each 116/284, 41%) and pressure-control modes (48/284, 17%). ⋯ Apart from 24/255 (9.4%) patients who received only pressure support ventilation, weaning methods (attempted in 255 patients, 29 prior deaths) included: change to pressure support ventilation (186/255, 73%), T-piece (31/255, 12%) or other methods (14/255, 5.5%). The point prevalence of mechanical ventilation was greater than comparable international studies. Australian and New Zealand intensive care unit ventilatory practices are similar, but differ substantially from published international survey results, due to a near absence of assist/control, prominent use of pressure-control modes and a preference forpressure support ventilation weaning as opposed to T-piece.
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Anaesth Intensive Care · Jan 2009
Multicenter StudyUsers' opinions on intensive care unit alarms--a survey of German intensive care units.
Monitoring of physiologic parameters in critically ill patients is associated with an enormous number of alarms, leading to reduced clinical value with high sensitivity but low specificity. To evaluate opinions of intensive care unit (ICU) staff on current monitoring we conducted a survey of German ICUs. Furthermore, the survey aimed to assess requirements and requests for future alarm systems. ⋯ Free text commentaries focused on the need for reducing alarms caused by artefacts and called for improvement of the monitor-user interfaces. Our survey demonstrates the dissatisfaction of clinical staff with the current alarm systems regarding alarm frequency and specificity in German ICUs, thereby confirming data raised in single institutions. ICU staff's acceptance for new alarm algorithms like signal extraction or detection of trends as a basis for smart monitoring appealed to the majority of users.
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Anaesth Intensive Care · Jan 2009
Multicenter StudyA survey of anaesthetists' perspectives of communication in the operating suite.
We surveyed 222 anaesthetists attending a University of Western Australia conference (n = 110) and two public hospitals in Perth (n = 112) by anonymous questionnaire in March 2006 regarding communication issues in the operating suite. Forty-one percent (n = 92) responded. Questions concerned communication skills, experiences of good and poor communication and relationship to outcome, attitudes to music and communication courses. ⋯ Sixty-four percent of respondents would attend a communications course voluntarily, with implementation of a compulsory communications course supported by 45%. Most anaesthetists surveyed used staff first names and 94% believed poor communication caused procedural delay. The data suggest that further work is required to improve communication in the stressful operating room environment, particularly at the surgeon/anaesthetist interface.