27 de janeiro de 2016

Leitura recomendado: Using Examples Best When Classifying ASA Physical Status


Clinical Anesthesiology - January, 2016

San Diego — Despite being an important part of clinical practice for more than five decades, the American Society of Anesthesiologists (ASA) physical status classification system occasionally is criticized for its subjective nature, a trait that can lead to inconsistent assignments among health care professionals.

This problem can be ameliorated, a recent study has found, with the use of ASA-approved class-specific examples, which help anesthesia and nonanesthesia providers alike substantially increase their ability to determine the correct ASA class.


Caso queira, deixe seu e-mail nos comentários abaixo desta postagem ou solicite pelo e-mail anestesiasegura@sma.com.br e lhe enviaremos o artigo completo.

14 de janeiro de 2016

Artigo recomendado: Evaluation of Perioperative Medication Errors and Adverse Drug Events


Karen C. Nanji, Amit Patel, Sofia Shaikh, Diane L. Seger, David W. Bates

Anesthesiology 2016; 124:25-34

ABSTRACT

Background: The purpose of this study is to assess the rates of perioperative medication errors (MEs) and adverse drug events (ADEs) as percentages of medication administrations, to evaluate their root causes, and to formulate targeted solutions to prevent them.

Methods: In this prospective observational study, anesthesia-trained study staff (anesthesiologists/nurse anesthetists) observed randomly selected operations at a 1,046-bed tertiary care academic medical center to identify MEs and ADEs over 8 months. Retrospective chart abstraction was performed to flag events that were missed by observation. All events subsequently underwent review by two independent reviewers. Primary outcomes were the incidence of MEs and ADEs.

Results: A total of 277 operations were observed with 3,671 medication administrations of which 193 (5.3%; 95% CI, 4.5 to 6.0) involved a ME and/or ADE. Of these, 153 (79.3%) were preventable and 40 (20.7%) were nonpreventable. The events included 153 (79.3%) errors and 91 (47.2%) ADEs. Although 32 (20.9%) of the errors had little potential for harm, 51 (33.3%) led to an observed ADE and an additional 70 (45.8%) had the potential for patient harm. Of the 153 errors, 99 (64.7%) were serious, 51 (33.3%) were significant, and 3 (2.0%) were life-threatening.

Conclusions: One in 20 perioperative medication administrations included an ME and/or ADE. More than one third of the MEs led to observed ADEs, and the remaining two thirds had the potential for harm. These rates are markedly higher than those reported by retrospective surveys. Specific solutions exist that have the potential to decrease the incidence of perioperative MEs.

Caso queira, deixe seu e-mail nos comentários abaixo desta postagem ou solicite pelo e-mail anestesiasegura@sma.com.br e lhe enviaremos o artigo completo.


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