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2.
Anaesthesia ; 75(1): 96-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31729019

RESUMO

Anaesthetists are thought to be at increased risk of suicide amongst the medical profession. The aims of the following guidelines are: increase awareness of suicide and associated vulnerabilities, risk factors and precipitants; to emphasise safe ways to respond to individuals in distress, both for them and for colleagues working alongside them; and to support individuals, departments and organisations in coping with a suicide.


Assuntos
Anestesistas/psicologia , Anestesistas/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Estresse Psicológico/diagnóstico , Suicídio/prevenção & controle , Suicídio/psicologia , Guias como Assunto , Humanos , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Fatores de Risco , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Suicídio/estatística & dados numéricos , Reino Unido
3.
Anaesthesia ; 74(11): 1365-1373, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31267513

RESUMO

Following a 2-3-month period of publicity, anaesthetists were invited to participate in an online survey that was administered by a third party company on behalf of the Association of Anaesthetists and ran between 3 September and 31 October 2018. Anaesthetists working in the UK or Ireland were asked about the presence or absence of welfare/support structures or resources in their workplace in the case of mental illness, addiction and/or suicide. Anaesthetists working anywhere in the world were also asked for their experiences of a colleague's suicide, defined as a colleague's taking his or her own life - whether intentional or not - while practising as an anaesthetist in the UK or Ireland, in the same department and at the same time as the respondent. Respondents were also asked about experiences of other suicides not meeting this definition. A total of 3638 responses were received. Most respondents were unaware of the existence of policies/guidance on mental illness, addiction or suicide, or of welfare leads, within their Trust or department. A total of 1916 cases of suicide meeting the survey's definition were reported by 1397 respondents, although the actual number of discrete cases is unknown because of likely multiple reporting of the same cases. A third of respondents who reported a suicide had experience of more than one case. Most reports were of suicide in the last 10 years, and most reported cases involved anaesthetic drugs. Deficiencies were noted in the support available and in the way the deaths were handled, although examples of good support were also described. A further 1715 respondents reported suicides that did not meet the primary definition. Overall, 92% of respondents reporting suicide experienced it through work, and 41% outside of work (total > 100% as some reported both). Although unable to provide estimates of suicide rates, or numerical associations between the features of the deaths, this survey highlights the considerable emotional and mental burden of suicide on anaesthetists.


Assuntos
Anestesistas/psicologia , Anestesistas/estatística & dados numéricos , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Humanos , Irlanda , Apoio Social , Sociedades Médicas , Reino Unido , Local de Trabalho/psicologia
5.
World Neurosurg ; 125: e289-e296, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30685367

RESUMO

BACKGROUND: The number of endovascular treatment procedures performed for cerebral aneurysms has markedly increased. However, little is known about the annual effective radiation dose to medical staff in neurointervention fields. We performed a retrospective observational study to investigate the real-time radiation dose to surgeons, nurses, anesthesiologists, and radiologic technologists during endovascular treatment of intracranial aneurysms. METHODS: We measured the real-time radiation doses for 2 weeks using standard and reinforced protection, during which 28 procedures were performed, including 23 coil embolizations for unruptured intracranial aneurysms. Four procedures were excluded because of an inadequately equipped sensor, which resulted in inappropriate data collection. The procedure time was defined from intubation to extubation. Five RaySafe i2 detectors were installed at the chest level of the operator, attending nurse, radiologic technologist, and anesthesiologist and just inside the front door of the hybrid operating room. RESULTS: The median doses per session with standard protection to the operator, attending nurse, anesthesiologist, and radiologic technologist were 11.16, 2.60, 4.76, and 1.93 µSv, respectively. The dose to the operator, attending nurse, and anesthesiologist had decreased to 6.63, 0.39, and 1.52 µSv under reinforced protection, respectively. However, the session dose for the radiologic technologist had increased to 3.12 µSv. CONCLUSIONS: We confirmed the differences in the amount of radiation exposure for different roles. An additional lead screen, which provided more effective protection on the operator side, was proved effective for attenuating radiation exposure during endovascular treatment. All personnel involved in the hybrid operating room were exposed to acceptable effective doses.


Assuntos
Procedimentos Endovasculares/efeitos adversos , Aneurisma Intracraniano/cirurgia , Exposição à Radiação/efeitos adversos , Idoso , Anestesistas/estatística & dados numéricos , Procedimentos Endovasculares/instrumentação , Desenho de Equipamento , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Duração da Cirurgia , Doses de Radiação , Proteção Radiológica/instrumentação , Radiologistas/estatística & dados numéricos , Estudos Retrospectivos
6.
BMC Anesthesiol ; 18(1): 188, 2018 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-30537934

RESUMO

BACKGROUND: A new patient monitoring technology called Visual Patient, which transforms numerical and waveform data into a virtual model (an avatar) of the monitored patient, has been shown to improve the perception of vital signs compared to conventional patient monitoring. In order to gain a deeper understanding of the opinions of potential future users regarding the new technology, we have analyzed the answers of two large groups of anesthetists using two different study methods. METHODS: First, we carried out a qualitative analysis guided by the "consolidated criteria for reporting qualitative research" checklist. For this analysis, we interviewed 128 anesthesiologists, asking: "Where do you see advantages in Visual Patient monitoring?" and afterward identified major and minor themes in their answers. In a second study, an online survey with 38 anesthesiologists at two different institutions, we added a quantitative part in which anesthesiologists rated statements based on the themes identified in the prior analysis on an ordinal rating scale. RESULTS: We identified four high-level themes: "quick situation recognition," "intuitiveness," "unique design characteristics," and "potential future uses," and eight subthemes. The quantitative questions raised for each major theme were: 1. "The Visual Patient technology enabled me to get a quick overview of the situation." (63% of the participants agreed or very much agreed to this statement). 2. "I found the Visual Patient technology to be intuitive and easy to learn." (82% agreed or very much agreed to this statement). 3. "The visual design features of the Visual Patient technology (e.g., the avatar representation) are not helpful for patient monitoring." (11% agreed to this statement). 4. "I think the Visual Patient technology might be helpful for non-monitor experts (e.g., surgeons) in the healthcare system." (53% of the participants agreed or strongly agreed). CONCLUSION: This mixed method study provides evidence that the included anesthesiologists considered the new avatar-based technology to be intuitive and easy to learn and that the technology enabled them to get an overview of the situation quickly. Only a few users considered the avatar presentation to be unhelpful for patient monitoring and about half think it might be useful for non-experts.


Assuntos
Anestesistas/estatística & dados numéricos , Monitorização Fisiológica/métodos , Realidade Virtual , Sinais Vitais/fisiologia , Adulto , Atitude do Pessoal de Saúde , Tecnologia Biomédica/métodos , Lista de Checagem , Feminino , Humanos , Masculino , Monitorização Fisiológica/instrumentação , Inquéritos e Questionários
8.
Ir Med J ; 111(1): 668, 2018 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-29869849

RESUMO

Consent to a medical intervention has legally and ethically evolved to a process prioritising autonomy and patient-led decision-making. This cross-sectional analysis investigated Irish anaesthetists' practices of taking consent. Following ethical approval, trainees and fellows of the College of Anaesthetists of Ireland were invited to participate in a 33 question online survey. One hundred and sixty responses (11.8%) were received, an equal number coming from consultants and trainees. The majority (93.7%) worked in a teaching hospital. Fifteen percent said their department had guidelines on obtaining consent for anaesthesia, but only 4.5% said their department used a separate consent form. Most (63.8%) do not usually document consent. A significant number rarely (21.8%) or never (27.8%) explained risks to patients. Lack of time was identified as the most frequent barrier (77.6%), with just under half first meeting the patient in the theatre holding-bay or the anaesthetic room. Forty-one percent felt the ultimate decision regarding which anaesthetic technique is employed should usually lie with the anaesthetist alone. These results suggest a wide variation in the practice of obtaining consent for anaesthesia. Less than half deemed their practice to be adequate in this regard, while 50% were concerned about litigation stemming from inadequate consent.


Assuntos
Anestesia , Anestesistas/ética , Anestesistas/legislação & jurisprudência , Consentimento Livre e Esclarecido/normas , Anestesistas/estatística & dados numéricos , Termos de Consentimento , Estudos Transversais , Tomada de Decisões , Humanos , Irlanda , Padrões de Prática Médica/ética , Padrões de Prática Médica/legislação & jurisprudência
9.
Br J Anaesth ; 120(4): 854-859, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29576126

RESUMO

BACKGROUND: Errors may occur during regional anaesthesia whilst searching for nerves, needle tips, and test doses. Poor visual search impacts on decision making, clinical intervention, and patient safety. METHODS: We conducted a randomised single-blind study in a single university hospital. Twenty trainees and two consultants examined the paired B-mode and fused B-mode and elastography video recordings of 24 interscalene and 24 femoral blocks conducted on two soft embalmed cadavers. Perineural injection was randomised equally to 0.25, 0.5, and 1.0 ml volumes. Tissue displacement perceived on both imaging modalities was defined as 'target' or 'distractor'. Our primary objective was to test the anaesthetists' perception of the number and proportion of targets and distractors on B-mode and fused elastography videos collected during femoral and sciatic nerve block on soft embalmed cadavers. Our secondary objectives were to determine the differences between novices and experts, and between test-dose volumes, and to measure the area and brightness of spread and strain patterns. RESULTS: All anaesthetists recognised perineural spread using 0.25 ml volumes. Distractor patterns were recognised in 133 (12%) of B-mode and in 403 (38%) of fused B-mode and elastography patterns; P<0.001. With elastography, novice recognition improved from 12 to 37% (P<0.001), and consultant recognition increased from 24 to 53%; P<0.001. Distractor recognition improved from 8 to 31% using 0.25 ml volumes (P<0.001), and from 15 to 45% using 1 ml volumes (P<0.001). CONCLUSIONS: Visual search improved with fusion elastography, increased volume, and consultants. A need exists to investigate image search strategies.


Assuntos
Anestesistas/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção , Percepção Visual , Cadáver , Nervo Femoral , Humanos , Método Simples-Cego
12.
Br J Anaesth ; 119(suppl_1): i99-i105, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29161392

RESUMO

Anaesthesia is the largest hospital-based specialty in the UK, and the activities of the anaesthesia workforce underpin the care of all patients in the hospital sector. Changes in the way care will be delivered in the future will impact on the workforce as a consequence of patient requirements and funding issues. This article considers these and other factors in the context of the current and future workforce.


Assuntos
Anestesistas/educação , Anestesistas/estatística & dados numéricos , Papel Profissional , Recursos Humanos/estatística & dados numéricos , Anestesistas/tendências , Humanos , Reino Unido , Recursos Humanos/tendências
14.
Anaesth Intensive Care ; 45(5): 624-630, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28911293

RESUMO

Drug errors amongst anaesthetists are common. Although there has been previous work on the system factors involved with drug error, there has been little research on the sequelae of a drug error from the anaesthetist's perspective. To clarify this issue, we surveyed anaesthetists regarding their most memorable drug error to identify associated factors and personal sequelae regarding their professional practice after the event. An online survey was sent anonymously to 989 Australian and New Zealand College of Anaesthetists (ANZCA) Fellows in March 2016 and the results were collected over the following two months. There were 295 completed surveys (29.8% response). The majority of respondents were male consultants, aged over 45 years. Reported drug errors occurred most frequently during normal working hours, and the most common drugs involved were non-depolarising muscle relaxants. In 34% of the errors, another anaesthetist was present, and their presence was felt to have contributed in 40.7% of these cases. About 20% of respondents reported that they did not receive adequate support after the event. Sleep patterns were affected in 14.4% of respondents, although very few found that the error had affected their capacity to function at work. These findings suggest that memorable drug errors can be significant enough to have adverse sequelae to anaesthetists, even if no patient harm occurs.


Assuntos
Anestesiologia/estatística & dados numéricos , Anestésicos/efeitos adversos , Anestesistas/estatística & dados numéricos , Erros de Medicação/estatística & dados numéricos , Adulto , Idoso , Anestésicos/administração & dosagem , Austrália , Consultores/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Inquéritos e Questionários
15.
Mil Med ; 182(3): e1762-e1766, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28290956

RESUMO

BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements. Our objective was to assess participant comfort with managing obstetric hemorrhage following our multidisciplinary in situ simulation training exercise. METHODS: This was a quality improvement project that utilized a comprehensive multidisciplinary in situ postpartum hemorrhage simulation exercise. Participants from the Departments of Obstetrics and Gynecology, Anesthesia, Nursing, Pediatrics, and Transfusion Services completed the training exercise in 16 scenarios run over 2 days. The intervention was a high fidelity, multidisciplinary in situ simulation training to evaluate hospital protocols, team performance, operational readiness, and system improvements. Structured debriefing was conducted with the participants to discuss communication and team functioning. Our main outcome measure was participant self-reported comfort levels for managing postpartum hemorrhage before and after simulation training. A 5-point Likert scale (1 being very uncomfortable and 5 being very comfortable) was used to measure participant comfort. A paired t test was used to assess differences in participant responses before and after the simulation exercise. We also measured the time to prepare simulated blood products and followed the number of postpartum hemorrhage cases before and after the simulation exercise. RESULTS: We trained 113 health care professionals including obstetricians, midwives, residents, anesthesiologists, nurse anesthetists, nurses, and medical assistants. Participants reported a higher comfort level in managing obstetric emergencies and postpartum hemorrhage after simulation training compared to before training. For managing hypertensive emergencies, the post-training mean score was 4.14 compared to a pretraining mean score of 3.88 (p = 0.01, 95% confidence interval [CI] = 0.06-0.47). For shoulder dystocia, the post-training mean score was 4.29 compared to a pretraining mean score of 3.66 (p = 0.001, 95% CI = 0.41-0.88). For postpartum hemorrhage, the post-training mean score was 4.35 compared to pretraining mean score of 3.86 (p = 0.001, 95% CI = 0.36-0.63). We also observed a decrease in the time to prepare simulated blood products over the course of the simulation, and a decreasing trend of postpartum hemorrhage cases, which continued after initiating the postpartum hemorrhage simulation exercise. DISCUSSION: Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Comprehensive hemorrhage protocols have been shown to improve outcomes related to postpartum hemorrhage, and a critical component in these processes include communication, teamwork, and team-based practice/simulation. As medicine becomes increasingly complex, the ability to practice in a safe setting is ever more critical, especially for low-volume, high-stakes events such as postpartum hemorrhage. These events require well-functioning teams and systems coupled with rapid assessment and appropriate clinical action to ensure best patient outcomes. We have shown that a multidisciplinary in situ simulation exercise improves self-reported comfort with managing obstetric emergencies, and is a safe and effective way to practice skills and improve systems processes in the health care setting.


Assuntos
Competência Clínica/normas , Pessoal de Saúde/normas , Simulação de Paciente , Hemorragia Pós-Parto/terapia , Ensino/normas , Anestesistas/estatística & dados numéricos , Bancos de Sangue/métodos , Bancos de Sangue/normas , Bancos de Sangue/estatística & dados numéricos , Transfusão de Sangue/métodos , Transfusão de Sangue/normas , Transfusão de Sangue/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Auxiliares de Emergência/estatística & dados numéricos , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Comunicação Interdisciplinar , Tocologia/estatística & dados numéricos , Complicações do Trabalho de Parto/terapia , Enfermagem Obstétrica/estatística & dados numéricos , Obstetrícia/estatística & dados numéricos , Equipe de Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/estatística & dados numéricos , Segurança do Paciente , Gravidez , Avaliação de Programas e Projetos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Melhoria de Qualidade , Ensino/estatística & dados numéricos , Recursos Humanos
16.
Am J Gastroenterol ; 112(2): 297-302, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27349340

RESUMO

OBJECTIVES: Previous studies have identified an increasing number of gastroenterology (GI) procedures using anesthesia services to provide sedation, with a majority of these services delivered to low-risk patients. The aim of this study was to update these trends with the most recent years of data. METHODS: We used Medicare and commercial claims data from 2010 to 2013 to identify GI procedures and anesthesia services based on CPT codes, which were linked together using patient identifiers and dates of service. We defined low-risk patients as those who were classified as ASA (American Society of Anesthesiologists) physical status class I or II. For those patients without an ASA class listed on the claim, we used a prediction algorithm to impute an ASA physical status. RESULTS: Over 6.6 million patients in our sample had a GI procedure between 2010 and 2013. GI procedures involving anesthesia service accounted for 33.7% in 2010 and 47.6% in 2013 in Medicare patients, and 38.3% in 2010 and 53.0% in 2013 in commercially insured patients. Overall, as more patients used anesthesia services, total anesthesia service use in low-risk patients increased 14%, from 27,191 to 33,181 per million Medicare enrollees. Similarly, we observed a nearly identical uptick in commercially insured patients from 15,871 to 22,247 per million, an increase of almost 15%. During 2010-2013, spending associated with anesthesia services in low-risk patients increased from US$3.14 million to US$3.45 million per million Medicare enrollees and from US$7.69 million to US$10.66 million per million commercially insured patients. CONCLUSIONS: During 2010 to 2013, anesthesia service use in GI procedures continued to increase and the proportion of these services rendered for low-risk patients remained high.


Assuntos
Procedimentos Cirúrgicos Ambulatórios/métodos , Anestesistas/estatística & dados numéricos , Endoscopia do Sistema Digestório/métodos , Gastroenterologia/métodos , Gastos em Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Ambulatórios/economia , Procedimentos Cirúrgicos Ambulatórios/tendências , Anestesistas/economia , Anestesistas/tendências , Sedação Consciente/economia , Sedação Consciente/métodos , Sedação Consciente/tendências , Sedação Profunda/economia , Sedação Profunda/métodos , Sedação Profunda/tendências , Endoscopia do Sistema Digestório/economia , Endoscopia do Sistema Digestório/tendências , Feminino , Gastroenterologia/economia , Gastroenterologia/tendências , Humanos , Armazenamento e Recuperação da Informação , Modelos Logísticos , Masculino , Medicare , Pessoa de Meia-Idade , Análise Multivariada , Estados Unidos , Adulto Jovem
17.
Br J Anaesth ; 117(6): 767-774, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27956675

RESUMO

BACKGROUND: Excessive workload may impact the anaesthetists' ability to adequately process information during clinical practice in the operation room and may result in inaccurate situational awareness and performance. This exploratory study investigated heart rate (HR), linear and non-linear heart rate variability (HRV) metrics and subjective ratings scales for the assessment of workload associated with the anaesthesia stages induction, maintenance and emergence. METHODS: HR and HRV metrics were calculated based on five min segments from each of the three anaesthesia stages. The area under the receiver operating characteristics curve (AUC) of the investigated metrics was calculated to assess their ability to discriminate between the stages of anaesthesia. Additionally, a multiparametric approach based on logistic regression models was performed to further evaluate whether linear or non-linear heart rate metrics are suitable for the assessment of workload. RESULTS: Mean HR and several linear and non-linear HRV metrics including subjective workload ratings differed significantly between stages of anaesthesia. Permutation Entropy (PeEn, AUC=0.828) and mean HR (AUC=0.826) discriminated best between the anaesthesia stages induction and maintenance. In the multiparametric approach using logistic regression models, the model based on non-linear heart rate metrics provided a higher AUC compared with the models based on linear metrics. CONCLUSIONS: In this exploratory study based on short ECG segment analysis, PeEn and HR seem to be promising to separate workload levels between different stages of anaesthesia. The multiparametric analysis of the regression models favours non-linear heart rate metrics over linear metrics.


Assuntos
Anestesia Geral , Anestesistas/estatística & dados numéricos , Frequência Cardíaca/fisiologia , Carga de Trabalho/estatística & dados numéricos , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Salas Cirúrgicas , Recursos Humanos em Hospital/estatística & dados numéricos , Estudos Prospectivos
18.
Br J Anaesth ; 117(6): 792-800, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27956678

RESUMO

BACKGROUND: The incidence of intraneural injection during trainee anaesthetist ultrasound guided nerve block varies between 16% in experts and up to 35% in trainees. We hypothesized that elastography, an ultrasound-based technology that presents colour images of tissue strain, had the potential to improve trainee diagnosis of intraneural injection during UGRA, when integrated with B-Mode ultrasound onto a single image. METHODS: We recorded 40 median nerve blocks randomly allocated to 0.25 ml, 0.5 ml, 1 ml volumes to five sites, on both arms of two soft embalmed cadavers, using a dedicated B-Mode ultrasound and elastography transducer. We wrote software to fuse elastogram and B-Mode videos, then asked 20 trainee anaesthetists whether injection was intraneural or extraneural when seeing B-Mode videos, adjacent B-Mode and elastogram videos, fusion elastography videos or repeated B-Mode ultrasound videos. RESULTS: Fusion elastography improved the diagnosis of intraneural injection compared with B-Mode ultrasound, Diagnostic Odds Ratio (DOR) (95%CI) 21.7 (14.5 - 33.3) vs DOR 7.4 (5.2 - 10.6), P < 0.001. Compared with extraneural injection, intraneural injection was identified on fusion elastography as a distinct, brighter translucent image, geometric ratio 0.33 (95%CI: 0.16 - 0.49) P < 0.001. Fusion elastography was associated with greater trainee diagnostic confidence, OR (95%CI) 1.89 (1.69 - 2.11), P < 0.001, and an improvement in reliability, Kappa 0.60 (0.55 - 0.66). CONCLUSIONS: Fusion elastography improved the accuracy, reliability and confidence of trainee anaesthetist diagnosis of intraneural injection.


Assuntos
Anestesistas/educação , Anestesistas/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Técnicas de Imagem por Elasticidade/métodos , Nervo Mediano/diagnóstico por imagem , Bloqueio Nervoso/métodos , Ultrassonografia de Intervenção/métodos , Cadáver , Humanos , Nervo Mediano/efeitos dos fármacos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
19.
BMC Anesthesiol ; 16(1): 88, 2016 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-27716076

RESUMO

BACKGROUND: Smartphones are used in many areas of anesthesia practice. However, recent editorial articles have expressed concerns about smartphone uses in the operating room for non-medical purposes. We performed a survey to learn about the smartphone use habits and views of Turkish anesthesia providers. METHODS: A questionnaire consisting of 14 questions about smartphone use habits during anesthesia care was sent anesthesia providers. RESULTS: In November-December 2015, a total of 955 participants answered our survey with 93.7 % of respondents responding that they used smartphones during the anesthetized patient care. Phone calls (65.4 %), messaging (46.4 %), social media (35.3 %), and surfing the internet (33.7 %) were the most common purposes. However, 96.7 % of respondents indicated that smartphones were either never or seldom used during critical stages of anesthesia. Most respondents (87.3 %) stated that they were never distracted because of smartphone use; however, 41 % had witnessed their collagues in such a situation at least once. CONCLUSIONS: According to the results of the survey, smartphones are used in the operating room often for non-medical purposes. Distraction remains a concern but evidence-based data on whether restrictions to smartphone use are required are not yet available.


Assuntos
Anestesia/normas , Anestesiologia/normas , Anestesistas/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Adulto , Anestesistas/normas , Atenção , Pesquisas sobre Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Salas Cirúrgicas , Turquia , Adulto Jovem
20.
BMC Anesthesiol ; 16(1): 60, 2016 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-27515450

RESUMO

BACKGROUND: Mortality from anaesthesia and surgery in many countries in Sub-Saharan Africa remain at levels last seen in high-income countries 70 years ago. With many factors contributing to these poor outcomes, the World Health Organization (WHO) launched the "Safe Surgery Saves Lives" campaign in 2007. This program included the design and implementation of the "Surgical Safety Checklist", incorporating ten essential objectives for safe surgery. We set out to determine the knowledge of and attitudes towards the use of the WHO checklist for surgical patients in national referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at the main referral hospitals in Mulago (Uganda), Kenyatta (Kenya), Muhimbili (Tanzania), Centre Hospitalier Universitaire de Kigali (Rwanda) and Centre Hospitalo-Universitaire de Kamenge (Burundi). Using a pre-set questionnaire, we interviewed anaesthetists on their knowledge and attitudes towards use of the WHO surgical checklist. RESULTS: Of the 85 anaesthetists interviewed, only 25 % regularly used the WHO surgical checklist. None of the anaesthetists in Mulago (Uganda) or Centre Hospitalo-Universitaire de Kamenge (Burundi) used the checklist, mainly because it was not available, in contrast with Muhimbili (Tanzania), Kenyatta (Kenya), and Centre Hospitalier Universitaire de Kigali (Rwanda), where 65 %, 19 % and 36 %, respectively, used the checklist. CONCLUSION: Adherence to aspects of care embedded in the checklist is associated with a reduction in postoperative complications. It is therefore necessary to make the surgical checklist available, to train the surgical team on its importance and to identify local anaesthetists to champion its implementation in East Africa. The Ministries of Health in the participating countries need to issue directives for the implementation of the WHO checklist in all hospitals that conduct surgery in order to improve surgical outcomes.


Assuntos
Anestesia/normas , Lista de Checagem , Conhecimentos, Atitudes e Prática em Saúde , Procedimentos Cirúrgicos Operatórios/normas , Adulto , África Oriental , Anestesiologia/normas , Anestesistas/normas , Anestesistas/estatística & dados numéricos , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Organização Mundial da Saúde
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