Safety Checklist for Position Changes Under Anaesthesia
This initiative presents a safety checklist for patients undergoing position changes under anaesthesia. Developed by Dr. Kareem Hussein, Dr. Irene Leonard, and Dr. Michael Moore at Beaumont Hospital, the checklist aims to enhance patient safety during surgical procedures by minimizing risks associated with position adjustments. The checklist facilitates a smooth transition through safety parameters, reduces the likelihood of adverse events, and improves staff readiness in managing patients under anaesthesia.
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Presentation Transcript
Introduction of a safety checklist for patients undergoing changes of position under anaesthesia Dr Kareem Hussein, Dr Irene Leonard and Dr Michael Moore, Anaesthesia Department, Beaumont Hospital Correspondence to: kareemhhussein@outlook.ie
Background: Change initiative: Optimal patient positioning to facilitate surgical access frequently requires achange of position from the usual starting supine position. Pre- and post- change of patient position safety checklist (Figure 1, 2) devised and implemented in Neuro-surgical operating theatres. Changes of position under anaesthesia pose many potential risks to patients including, but not limited to, physical injury, interruption of crucial monitoring, airway compromise, haemodynamic instability, impairment of ventilation and dislodgement of intravascular and invasive monitoring lines. Results: We devised a user-friendly checklist which facilitates a rapid and seamless transition through checks of basic safety parameters. Staff education delivered to an initial pilot group. Laminated checklists disseminated and displayed in prominent locations at key pilot sites. Aim of the checklist: Reduce risk and improve patient safety during changes of position under anaesthesia. Practice runs completed with pilot group staff prior to roll-out. Provide a practical tool to Anaesthesia trainees to ensure safe and confident clinical practice when managing position changes of patients under anaesthesia.
Figure 1 Figure 2
Plan to establish as a standard of care across all anaesthesia sites at Beaumont Hospital. Documentation of completed checklist will be filed with Anaesthesia record in patients medical notes. Survey Results A survey was completed after using the checklist to assess its usefulness and risks which have been prevented by using the checklist (Figure 3). The most common issues identified was traction/disconnection of monitoring cables. Electronic copy can be easily created if future e- records implemented. 90 Value to patients 80 70 Actual patient injury arising directly from positioning under anaesthesia is uncommon but can have devastating consequences. 60 50 40 This checklist provides a practical tool to guide staff and enhance their ability to reduce risk and improve patient safety during periods of increased risk associated with position changes under anaesthesia. 30 20 10 0 User-friendly? Can reduce positioning related adverse events? Identified issues? Recommend implementing this checklist? Figure 3 Yes No
