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Background and Objective: During anesthesia and the post-operative period, standard equipment and monitoring are essential. Srinagarind hospital has over one thousand items of equipment for its 20 operating rooms and 2 post-anesthesia care units (PACU). Based on a survey between October 2007 and September 2008, it was discovered that 18 items of anesthetic equipment went missing, worth between 30,000 and 40,000 Baht. The objectives of this study were to identify the factors related to equipment loss and to find strategies to prevent or mitigate losses.Methods : We conducted qualitation research, using basic data regarding equipment losses derived from a problem-solving fishbone diagram that emerged during a departmental seminar in November 2008. Our responsive study ran between March and August 2009. The department provided the anesthetic equipment in all of the operating rooms and PACUs with checklist logs. When equipment went missing, researchers invited related personnel to discuss the loss and to find strategies for prevention (Focus group discussion). The summary of the data collected and response protocols were later presented at a departmental conference.Results : The focus group discussions during study period involved 150 personnel, comprising anesthesia personnel (60/150, 40%), operating room personnel (30/150, 20%), intensive care personnel (20/150, 13.3%) and laundry personnel (40/150, 26.7%). The study revealed that the intradepartmental factors related to equipment loss were personnel, work pattern, management, time of work, the involved equipment and the budget. But extradepartmental factors had specific differences depend on personnel groups. The process resulted in four intradepartmental preventive guidelines and some activities within and outside the department.Conclusions : The factors related to anesthetic equipment loss involved both within and outside the department. Preventive guidelines have been established, including some activities both within and outside the department.Keywords : Anesthetic Equipment Loss
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Objective: To identify the incidence and causes of drug error during anesthesia .Design: Prospective descriptive studyMethods: Our research was a part of a multi-center study conducted by the Thai Royal College of Anesthesiologists aimed at surveillance of anesthetic related complications in Thailand in 2003. We collected the data from all the cases receiving anesthesia service at Srinagarind Hospital between January 1 and December 31, 2003, in order to enumerate drug errors during anesthesia and to determine the cause of the error in order to improve the quality of service. Drug error was reported by anesthesia personnel and attenuated anesthesiologists. A drug administration error is defined as, “a mistake in the administration of a drug”. Errors include: the incorrect medication, the incorrect route, the incorrect time, drug overdose, wrong patient, omitted medication and medications given but no record of the drug. We had record about patient’s sex, age and ASA physical status, type of operation, place and time of event, type of the mistake and the outcome.Results: Drug error during anesthesia incidence was 12.26:10,000 (based on 10,607 patients). While the highest rate occurred in the neonatal patient group (newborns to 1 month of age), most drug errors occurred during daytime and among patients with an ASA status of between I and II. Only minor physiological disturbances occurred in most patients. The most common causes of errors was the lack of double checking before administration and miscommunication among members of the anesthetic team.Conclusion: The medication error rate was relatively low and primarily due to inattention. The anesthetic team should take steps to ensure double-checking before administering medications.
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Introduction: Doing research about routine patient care, so-called Routine to Research or R2R, can increase both the quantity of articles and quality of care. Objective: To determine the number of R2R-related articles by anesthesia providers at the Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, and their utilization.Study Design: descriptive studyMethods: Questionnaires to the corresponding authors of papers published between 2002 and 2005. We excluded case reports from the study and focused on basic data of researchers, number of articles that received funding, the number of R2R-related articles and their utilization. The data were analyzed and presented using descriptive statistics.Results: All 40 questionnaires were returned, representing 22 anesthesiologists’ articles (55%) and 18 nurse anesthetists’ articles (45%). Eighteen articles (45%) received funding. Thirty-six articles (90%) were classified as R2R-related articles: 12% have already been applied to routine patient care; 6 had potential for application provided they received suitable encouragement; 10% had less potential for application; and, 8% were non-applicable because of an unavailability of medications or equipment.Conclusion: Based on articles published by anesthesia providers at the Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, between 2002 and 2005, R2R-related articles comprised 90%, but only one-third have been applied to routine patient care while another 16.7% (or 15% of all articles) have potential for applications were they to receive suitable encouragement.