RESUMO
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
RESUMO
Background and Objective: During general anesthesia, inhaled anesthetic delivery system problems may contribute to anesthetic morbidity and mortality. The magnitude and pattern of these problems had not been established at Srinagarind Hospital. The objectives of this study are to identify the incidence and severity of common problems of inhaled anesthetic delivery system and find strategies for prevention.Methods: Prospective, descriptive study at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All patients received general anesthesia in the year 2005. Details of anesthetic management in all patients were recorded on the anesthetic charts on a routine basis. When inhaled anesthetic delivery system problems had occurred, the anesthesia provider responsible for the cases wrote a short description of the event on the anesthetic charts and reported to the authors to record more details in the incidence form for further analysis about the incidence and severity.Results: There were 8,904 consecutive general anesthetic patients in 2005. Sixteen inhaled anesthetic delivery system problems were recorded (0.18 %). One-third of problems involved the anesthetic ventilators. Human error was a contributing factor in a half of the cases. No patient suffered any lasting morbidity. Conclusions: The incidence of inhaled anesthetic delivery system problems was very low and not severe during the study period. This was probably due to the improvement in routines for preoperative equipment checks, regular equipment calibration and good monitoring system in our hospital. However, there is still a potential for serious problems and strategies to prevent human error should be implemented. In addition, an improved check between cases should be encouraged to reduce the occurrence of the problems. Keywords: anesthesia, complications, inhaled anesthetic delivery system