Audit of emergency obstetric referrals at a Tertiary Center in Kano

Introduction: Maternal and perinatal deaths could be prevented if functional referral systems are in place to allow pregnant women to get appropriate services when complications occur. Methodology: The study was a 1-year retrospective study of obstetric referrals in Aminu Kano Teaching hospital, from 1st January to 31st December 2019. Records of all emergency obstetrics patients referred to the hospital for 1 year were reviewed. A structured proforma was used to extract information such as sociodemographic characteristics of the patients, indications for referral, and pre-referral treatment. The care given at the receiving hospital was extracted from the patients' folders. An Audit standard was developed and the findings were compared with the standards in order to determine how the referral system in the study area perform in relation to the standard. Results: There were total of 180 referrals, the mean age of the women was 28.5 ± 6.3 years. Majority (52%) of the patients were referred from Secondary Centres and only 10% were transported with an ambulance. The most common diagnosis at the time of referral was severe preeclampsia. More than half of the patients (63%) had to wait for 30 to 60 minutes before they see a doctor. All the patients were offered high quality care and majority (70%) were delivered via caesarean section. Conclusion: There were lapses in the management of patients before referral; failure to identify high risk conditions, delay in referral, and lack of treatment during transit to the referral centre.

Morbidity and mortality of tetanus at Kenyatta National Hospital: a ten-year case audit

Introduction: Tetanus is a major health problem in developing countries, and is associated with high a morbidity and mortality. There are no recent local data in Kenya on the impact of the disease in terms of morbidity and mortality. The objective of this study was to describe the type, severity, risk factors, immunization history and outcome of tetanus patients at Kenyatta National Hospital (KNH). Method: This was a retrospective descriptive study of patients with a clinical diagnosis of tetanus admitted to KNH over ten years, who were aged 13 years and above. All available files with tetanus diagnosis were selected, and the patients' data were retrieved and analysed using SPSS Software version 21.0. Results: Out of 53 patients with tetanus, 50 (94.3%) were males and 3 (5.7%) were females. The mean age at presentation was 33.2 years (SD= 15.6). Only 4 (7.5%) patients had prior tetanus immunization. The commonest risk factor was acute injury - seen in 37 (69.8%) patients. The common site of injury was the lower limb - seen in 26 (49.1%) patients. The incubation period ranged from 3 to 90 days (IQR 7-17). Generalized tetanus was the commonest form found in 50 (94.3%) patients. Only 16 (30.2%) patients were managed in the Intensive Care Unit (ICU). The overall mortality was 49.1%. Conclusion: Tetanus mortality is still high as reported in many other studies. Most patients were males without prior immunization history. Only few patients were managed in Intensive Care Unit. We recommend advocacy on tetanus immunization and booster dosing

An audit of CT brain findings in adults with new-onset seizures in a resource restricted setting in South Africa

Background: Globally, adults presenting with seizures account for 1% ­ 2% of visits to emergency departments (EDs), of which 25% are new-onset seizures. Neuroimaging is essential as part of the initial workup. Multiple studies have demonstrated abnormal CT brain (CTB) findings in these patients. Objectives: To review the CTB findings in adults presenting with new-onset seizures in a resource restricted setting. Method: A retrospective review of 531 CTBs was conducted at a tertiary hospital in Gauteng on adults presenting to the ED with new-onset seizures. Results: The mean age of the patients was 45.6 ± 17.1 years, and the male to female ratio was 1.2:1. Generalised and focal seizure types were almost equally represented. Of the total 531 patients, 168 (31.6%) were HIV positive. The CTB findings were abnormal in 257 (48.4%) patients, albeit vascular pathology accounted for 21.9%. Infective pathology accounted for 14.1% with a statistically significant association with HIV (p = 0.003). Trauma related pathology was 2.4%, whilst neoplastic pathology was seen in 3.0%. Other causes included congenital pathology, calcifications, atrophy and gliosis. Clinical factors associated with abnormal CTB findings were age ≥ 40 years, HIV infection, hypertension, focal seizures, low Glasgow Coma Scale (GCS), raised cerebrospinal fluid (CSF) protein and presence of lymphocytes. Conclusion: A high yield of abnormal CTB findings was noted in adult patients who presented with new-onset seizures, supporting the use of urgent CTB in patients with certain clinical risk factors. Patients without these risk factors can be scanned within 24­48 h in a resource restricted setting.

An audit of licensed Zimbabwean radiology equipment resources as a measure of healthcare access and equity

Introduction: approximately two-thirds of the world's population has no access to diagnostic imaging. Basic radiological services should be integral to universal health coverage. The World Health Organization postulates that one basic X-ray and ultrasound unit for every 50000 people will meet 90% of global imaging needs. However, there are limited country-level data on radiological resources, and little appreciation of how such data reflect access and equity within a healthcare system. The aim of this study was a detailed analysis of licensed Zimbabwean radiological equipment resources.Methods: the equipment database of the Radiation Protection Authority of Zimbabwe was interrogated. Resources were quantified as units/million people and compared by imaging modality, geographical region and healthcare sector. Zimbabwean resources were compared with published South African and Tanzanian data.Results: public-sector access to X-ray units (11/106 people) is approximately half the WHO recommendation (20/106 people), and there exists a 5-fold disparity between the least- and best-resourced regions. Private-sector exceeds public-sector access by 16-fold. More than half Zimbabwe's radiology equipment (215/380 units, 57%) is in two cities, serving one-fifth of the population. Almost two-thirds of all units (243/380, 64%) are in the private sector, routinely accessible by approximately 10% of the population. Southern African country-level public-sector imaging resources broadly reflect national per capita healthcare expenditure.Conclusion: there exists an overall shortfall in basic radiological equipment resources in Zimbabwe, and inequitable distribution of existing resources. The national radiology equipment register can reflect access and equity in a healthcare system, while providing medium-term radiological planning data

An audit of the informed consent process at the surgical department of Korle Bu teaching hospital, Accra

Background: Surgeons carry out procedures on patients daily, many of which are invasive and may be associated with some risks and complications. The concept of informed consent in surgical practice was introduced after certain legal issues arose. Today patients are entitled to know and be accorded the right to determine what happens to their bodies. This study set out to determine if there had been any improvement in the informed consent process over the years, taking a closer look at the various aspects of the information given :This was a cross-sectional study carried out at the Department of Surgery, Korle Bu Teaching Hospital. One hundred consecutive post-operative patients were recruited and interviewed on information discussed at various stages during the preoperative period and on the administration of the consent form. Results: Thirty seven (66.0%) out of 56 elective cases felt they had been given enough information to their understanding to enable them give informed consent. Thirty (68.1%) out of 44 emergencies also felt they had been given enough information. Forty (71.4%) of elective cases were able tell what their diagnosis was but only 23 (41.0%) knew what procedure had been done. Similarly 32 (72.2%) emergency cases were able to tell what their diagnosis was but only 16 (36.3%) knew what procedure had been done. Conclusion: Informed consent in the Department of Surgery of the Korle Bu Teaching Hospital is unsatisfactory and needs to be improved

An Audit on pediatric surgery services at Sinnar Teaching Hospital: outcome and challenges

a valuable data for health authorities. The aim of this study was to reflect the burden and outcome of one pediatric surgery unit at Sinnar Teaching Hospital (STH). It also throws some light into challenges and obstacles that face running of pediatric surgery services outside of the capital. Methods: This was a retrospective, descriptive review. It included all the patients who presented to the Pediatric Surgery Unit at Sinnar Teaching Hospital (STH) and underwent emergency or elective operations during the period from January 2009 to December 2012. Results: A total number of 2400 patients were seen at the unit over four years. About half of them (1210) (50.4%) underwent emergency or elective operations. Inguinoscrotal conditions were the most frequently performed elective operations 450 (37%). Appendectomy was the commonest emergency operation: 169 (14%). Forty four (2%) were referred to Al-Jazeera or Khartoum States for further work-up or advanced care. The majority of the referred cases were those who required more specialized oncological or neurosurgical services, in addition to some patients who needed non-invasive interventions (like ESWL for instance) or multidisciplinary management(bladder exostrophy and proximal hypospadias). The overall mortality rate was 2.4% (n=52) with higher mortality rate noticed among neonatal conditions: 20% of it (n=10) due to lack of trained anesthetists, pediatric intensive care unit facilities, and delayed presentation.Conclusion: Conduction of a pediatric surgery service outside of the capital is challenging and faces various obstacles, but it is possible with a reasonable outcome. A wide variety of emergency and elective pediatric surgical conditions are seen and the majority of them could be managed properly at a state hospital level. Availability of well-established anesthetic and pediatric intensive care facilities, with trained nursing staff is the cornerstone for better quality services with minimum morbidity and mortality rates. Establishment of pediatric surgery services in the states would invariably decrease the central congestion and referral to capital hospitals. It can also minimize the unnecessary, and indeed, costly expenditure on referral,especially for low-and middle- income families

An Audit of Ear; Nose and Throat diseases in a Tertiary Health Institution in South-western Nigeria

Introduction: This study is aimed at determining the pattern of ear; nose and throat diseases and their relationship with socio-demographic factors with auditing intent in a tertiary hospital in South-western Nigeria. Methods: Medical records of patients managed at the Department of Otorhinolaryngology; University College Hospital; Ibadan; Nigeria from 2006 to 2010 were reviewed for all essential clinical data. Results: There were 2641 (52.8) males and 2360 (47.2) females. Two thousand and fifty (41) patients had age .15years old. Sixty three percent of the patients were Christians; 37 were Muslims and less than 1had other religions. There were more patients in lower occupational classes than those in the upper classes. The average number of patients with ear; nose and throat diseases managed per month was eighty three. Patients with ear diseases were 3136 (62.7); the nose diseases were 1153 (23.0); the throat diseases were 479 (9.6) and head/neck diseases were 233 (4.7). Conclusion: This study showed that otitis media; obstructive adenoid; foreign bodies in the ear and throat infections were the common ear; nose; throat disorders seen in patients aged .15years whereas; hearing loss; rhinosinusitis and tumors were the common disorders of ear; nose and throat seen in patients aged 16 years and above. Although these disorders are not yet considered to be of public health importance; they contribute significantly to the existing burden of health problems in our environment. Therefore; there is a need for improved public awareness on ear; nose and throat diseases respectively). Forty (30.8

Audits of Emergency Trolleys' Contents in Selected Hospitals in Botswana

Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment; as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana's hospitals' wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley; some units failed to check their emergency trolleys' contents daily. All 20 hospital wards or units that participated in this study; needed to improve the contents and maintenance of their emergency trolleys; otherwise in-hospital CPR efforts in Botswana might be doomed to failure; losing lives that could have been saved if emergency trolleys' equipment and supplies had been up to standard

A Medical Audit of the Management of Cryptococcal Meningitis in HIV-Positive Patients in the Cape Winelands (East) District; Western Cape

Background: Cryptococcal meningitis (CM) has become the most common type of community-acquired meningitis. CM has a poor outcome if the initial in-hospital treatment does not adhere to standard guidelines. The aim of this audit was to improve the quality of the care of human immunodeficiency virus (HIV) positive patients with CM in the Cape Winelands District.Method: Following an initial audit in 2008; the researchers and a new audit team introduced interventions; and planned a second audit cycle. The folders of 25 HIV-positive adults (admitted to three district hospitals; one regional hospital; and one tuberculosis hospital) were audited.Results: Spinal manometry was performed more consistently in the regional hospital; than in the district hospitals. Reasons for failing to reach the 14-day amphotericin B target were in-patient deaths; drug stock problems; and renal impairment. The renal monitoring of amphotericin B treatment was suboptimal. The quality of care at district hospitals appeared to be comparable to that found at the regional hospital. The in-patient referral for antiretroviral treatment (ART) counselling was better in the district hospital setting. However; both levels of care had difficulty in achieving the four-week target between the onset of amphotericin B and onset of ART.Conclusion: Deficiencies in the quality of care remained. Between the prior and current audit cycles; there was no consistent improvement in care at the regional hospital. An integrated care pathway document has been developed; and adopted as policy in the Cape Winelands district. Its impact on the quality of care will be evaluated by a dedicated audit team in the future

Surgical Research; Surgical Audit and Safe Surgery

N. A.

An audit of non-urgent general adult referrals to Stikland State Psychiatric Facility

Objectives. The national Department of Health strongly advocates the strengthening of primary health care systems; and recommendations for appropriate level of care referrals exist. Very few published data on the scope of current ambulatory specialised psychiatric hospital services in South Africa are currently available; making it difficult to assess whether these recommendations are being followed. As a starting point; an audit was conducted to obtain a profile of new non-urgent general adult patients seen at Stikland Hospital with a view to evaluating system needs and demands. Methods. The folders of 103 consecutively seen patients were selected for retrospective review. Patient demographic; referral and assessment information was entered into a single database. Descriptive statistics were compiled with reference to the above variables using SPSS. Results. Overall 58.3 of referrals were from the private sector. More than a third (36.7) of referral letters stated no clear reason for referral and 41.7 no psychiatric diagnosis; and 29.1 of patients were referred without psychotropic medication being started. On assessment 62.1 of patients were found to have a single Axis I diagnosis. Despite virtually no referral letters making any mention of them; substance use disorders (30.1); personality traits/disorders (35.9) and co-morbid medical illness (36.7) were commonly found on assessment. Conclusions. A significant portion of the patients in our sample could have been managed at primary care level and were referred prematurely. The overall quality of referral letters was poor; and they lacked vital information required for appropriate preassessment decision making. Undergraduate training focusing on these skills should be intensified; and consideration should be given to incorporating aspects of our findings into primary health care updates

Scale-up of a decentralized HIV treatment programme in rural KwaZulu-Natal, South Africa: does rapid expansion affect patient outcomes?

Objective:To describe the scale-up of a decentralized HIV treatment programme delivered through the primary health care system in rural KwaZulu-Natal, South Africa, and to assess trends in baseline characteristics and outcomes in the study population Methods The programme started delivery of antiretroviral therapy (ART) in October 2004. Information on all patients initiated on ART was captured in the programme database and follow-up status was updated monthly. All adult patients (≥ 16 years) who initiated ART between October 2004 and September 2008 were included and stratified into 6-month groups. Clinical and sociodemographic characteristics were compared between the groups. Retention in care, mortality, loss to follow-up and virological outcomes were assessed at 12 months post-ART initiation.Findings A total of 5719 adults initiated on ART were included (67.9% female). Median baseline CD4+ lymphocyte count was 116 cells/µl (interquartile range, IQR: 53­173). There was an increase in the proportion of women who initiated ART while pregnant but no change in other baseline characteristics over time. Overall retention in care at 12 months was 84.0% (95% confidence interval, CI: 82.6­85.3); 10.9% died (95% CI: 9.8­12.0); 3.7% were lost to follow-up (95% CI: 3.0­4.4). Mortality was highest in the first 3 months after ART initiation: 30.1 deaths per 100 person­years (95% CI: 26.3­34.5). At 12 months 23.0% had a detectable viral load (> 25 copies/ml) (95% CI: 19.5­25.5).Conclusion Outcomes were not affected by rapid expansion of this decentralized HIV treatment programme. The relatively high rates of detectable viral load highlight the need for further efforts to improve the quality of services

Pattern of Fatal Injuries in Addis Ababa; Ethiopia: A One-Year Audit

Background: Injury continues to account for a large number of clients attending emergency department in Addis Ababa. Reliable information on causes of death is essential to the development of health policies for prevention and control. The aim of this atudy was to identify the pattern and common causes of fatal injuries Methods: This is prospective study analyses autopsy data related to fatal injuries handled by Menilik II hospital between July1; 2006 -June 30; 2007. (Sene 24; 1998 - Sene 23; 1999) Results: A total of 2107 cases were analyzed. The victims were mostly male and the most vulnerable age group was found to be 15-44 years. Accidents versus homicide and accident versus suicide ratio was 1.8:1 and 5:1 respectively. Road traffic accidents were the most frequent causes of accident related death. Main means of homicide was hit by blunt or sharp object or firearm. More than 90of victims who committed suicide use hanging or poisoning.Ninety percent of deaths occur with in 24 hours of the injury and only 105 (5) died from the second day on wards. Eighty one percents of this patients had never received any medical care (either pre-hospital or hospital level). Conclusion: Road traffic accidents accounted for most causes of injury related deaths. Significant proportion of patients had no access to emergency medical care. The findings strongly suggest that more aggressive; regulatory; educational; and rapid emergency treatment is necessary to address the large number of injury related death

Audit of child and adolescent psychiatry in a teaching hospital in Nigeria: prevalence, pattern and implication for improved services

Objective. This study aimed to identify the socio-demographic characteristics; pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital; Ilorin; Nigeria.Method. A retrospective study; carried out at the Department of Behavioural Sciences of the hospital.Results. The age range of the 94 children seen was 7 - 19 years; with a mean of 16.38 years (standard deviation 2.49); 82 were aged 14 - 19 years and 17 7 - 13 years; while only 1 child was under 7 years old. The majority of the children lived with their parents in monogamous families with 5 or more children. The majority of the parents were educated and gainfully employed.The major diagnoses were schizophrenia (50); delirium (15) and seizure disorders (9). Of the patients 64 were managed as outpatients and 36 as inpatients. Drug therapy was involved in the majority of cases; and the most frequently prescribed medication was haloperidol; atypical antipsychotics such as risperidone being used in only 8 of cases.Most of the patients were referred from the primary care-associated departments of the hospital; i.e. the general outpatient department (40) and the internal medicine and paediatrics departments (29). Referrals from welfare; judicial and educational institutions were uncommon (3).Conclusion. The pattern of patient presentation and management had not changed to any great extent over the past two decades. The introduction of a child and adolescent psychiatric unit is expected to improve consultation/liaison psychiatry and also child psychiatric service delivery and research. Understanding of the prevalence and pattern of presentation of mental disorders and their management is also expected to help improve the strategic planning and organisation of the new clinic

Audit of Percutaneous Nephrostomy in Rabat Urological Centre

Objectives: To audit and compare the different techniques for percutaneous nephrostomy (PCN) and assess the indication of each. Methods: Between March 2009 and November 2009; the records of 27 patients who underwent percutaneous nephrostomy were retrospectively reviewed. PCN procedures were performed under ultrasonography (US); computed tomography (CT) guidance or blindly according to the grade of hydronephrosis. Results: US guided PCN were done for 15; CT guided PCN for 10 and blindly PCN for two patients. Overall success rate was 25 (92.6). US guided PCN had success rate of 13 (86.6); CT guided PCN eight (80) while blindly PCN 2(100). The overall complications were minimal. Conclusions: The success of PCN procedures depend mainly on the degree of hydronephrosis and selection of the appropriate image guidance

Health Facility-Based Maternal Death Audit in Tigray; Ethiopia

Background: Maternal deaths are often unrecognized and improperly documented in the health system. Objective: To identify causes of maternal death occurring in hospitals and determine avoidability of maternal death. Methods: The study assessed each death for the cause and surrounding circumstances as well as avoidable factors; by reviewing two years patient and facility records and interviewing individuals who were involved in caring for the deceased. Data were collected between December 2005 and May 2006. Result: A total of 34 maternal deaths were identified in five public hospitals in Tigray over a period of two years; ofwhich 12 (35.2) were reported to have been avoidable. The leading causes of death were infection; haemorrhage and hypertensive disorders. Avoidable factors were mainly related to hospital service or medical factors such as lack of blood for transfusion; delay in transfusion; and inappropriate treatment. Lack of transportation and delayed careseeking also contributed to avoidable maternal deaths. The quality of medical records was very poor. Nearly 73.5of maternal deaths were of rural residents and 20.5of those who died were under the age of 18; which shows that young girls and rural residents carry significant maternal Conclusions: Maternal deaths are not properly documented in health facilities. Improper care led to avoidable maternal death. Improving care and information systems is crucial to making pregnancy safer and reducing maternal death

Rising Caesarean Section Rates: an Audit of Caesarean Sections in a Specialist Private Practice

Background: Caesarean section (C/S) rates are increasing world wide; rates in the private sector in South Africa are reported to be particularly high. To the best of our knowledge; there has not been a recent audit of caesarean sections from the private health sector in KwaZulu-Natal. The aim of this study was to carry out an audit of C/S in a private practice. Methods: An audit of the patient records over a period of one year was done. No personal identifiers were noted or reported on. All relevant clinical data was pooled and used to analyse clinical information. Results: There were 364 deliveries in the study period and 209 of these were C/S; giving a rate of 60.4. The majority of the C/S were done for a previous C/S; maternal request and HIV status also contributed to the high rate. Conclusion: The high C/S rate in private practice is probably a window of the increased caesarean section rates world wide. This high rate is in keeping with trends in countries such as South America; and is much; much higher than the ideal rate in low-risk obstetric populations of 10.15suggested by the WHO

An Audit of PMTCT Services at a Regional Hospital in South Africa

Background : Prevention of mother-to-child transmission (PMTC) is a major intervention world-wide in the fight against the HIV pandemic; and has resulted in markedly reduced rates of mother-to-child transmission rates in well-resourced countries. However; our impression is that barriers to implementation of the programme exist at all levels of health care at all facilities providing maternal care. Aim To conduct a clinical audit of the PMTCT programme at a regional hospital. Methods Data was collected from an analysis of antenatal and medical records of women who attended antenatal care and delivered at a regional hospital from January-December 2007. Results :Of the 499 records analysed; 479 women (96) were offered testing; 473 accepted. Of those tested; 227 (48) were HIV positive. Only 15 (6.1) of the 246 who tested negative; were re-tested. CD4 counts were only done in 159 (70) of the 227 HIV-positive women. More importantly; only 134 (84.3) received their results. Of the 227 HIV positive women; only 131 were given 200mg Nevirapine at 28 weeks gestation; 185 (81.5) took Nevirapine before delivery; 143 took Nevirapine 2 hours before delivery and 84 (37) took Nevirapine 2 hours before delivery. 208 (91.6) of the babies were given Nevirapine at the correct time. Discussion This audit shows that progress has been made in the implementation of PMTCT of HIV at this regional hospital by the high uptake of HIV testing; however barriers to full implementation are caused by the lack of integration of testing; counselling and obtaining CD4 count results

Mortalite perinatale aux Cliniques Universitaires de Kinshasa. Bilan de 2 ans (2005-2007)

Les auteurs rapportent le bilan d'une enquete menee aux cliniques Universitaires de Kinshasa et portant sur deux ans (juin 2005 a mai 2007). L'objectif etait de degager la frequence et les causes de la mortalite infantile durant cette periode. Les dossiers et les registres des accouchees et des nouveaux-nes des departements de Gyneco-obstetrique et de Pediatrie ainsi que les archives du service des statistiques ont ete consultes. Le taux de mortalite perinatale est de 76;80 Naissances Vivantes. Les causes sont dominees par les infections (31;2); la prematurite (22); la detresse respiratoire (20;8) et les malformations congenitales (11). La plupart de ces causes sont evitables. Il existe un taux assez eleve de causes inconnues (15(15) dont la recherche necessite l'autopsie qui est difficilement acceptee par la population congolaise pour des raisons financieres ou religieuses. Nous recommandons une bonne prise en charge des gestantes aux consultations prenatales dans les hopitaux peripheriques; le traitement preventif intermittent et les moustiquaires impregnees contre la malaria; un equipement adequat des departements de Gyneco-obstetrique (moniteurs obstetricaux; echographes de haute resolution; trousses d'urgence regulierement approvisionnees) et de pediatrie (couveuses en bon etat; antibiotiques disponibles; surfactant; etc.)

An Audit of Anaesthetic Record Charts in the Orthopaedic Theatre of a Nigerian Teaching Hospital

Objective: The anaesthetic record is an essential part of a patient's record; providing useful information for the management of the patient. It is of medico-legal importance and can be used for quality assurance and researchpurposes. An analysis of anaesthetic record charts from a satellite operating theatre of the University of Port-Harcourt Teaching Hospital (UPTH) was undertaken to determine their legibility; correctness and completeness. Method: A retrospective analysis of the anaesthetic record charts from March 2003 to February 2004 of the orthopaedic theatre of the UPTH was undertaken. Results : A total of 232 anaesthetic record charts were analyzed. All entries were manually-written. Of these; 141 (60.9) were filled by anaesthetic registrars; the rest were filled by senior registrars 85 (36.5) and consultants 6 (2.6). One hundred and twenty-one charts (52.2) were legible; completely and correctly filled; but 47.8were incompletely filled; and 47.7had at least an illegible parameter. Conclusion: It is concluded from this analysis that the standard of anaesthetic record-keeping needs to be improved and consideration given to the use of computer-generated records which will eliminate the problems of illegible records