Anaesthesia and intensive care
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Anaesth Intensive Care · Mar 2008
Generalisability of behavioural skills in simulated anaesthetic emergencies.
A reliable assessment of clinical performance requires multiple cases, as performance varies between cases depending on previous experiences and knowledge of the case. However, behavioural attributes, including communication and teamwork, may be expected to be less dependent on specific case knowledge and thus be more stable across cases. This has implications for training and assessment design. ⋯ Twenty anaesthesia trainees were rated in three simulated emergencies by four assessors. The psychometric properties of scores for behaviour were determined and were compared with scores for medical management and overall performance. We found that scores for behaviour were less dependent on the specific clinical context than the scores for overall performance and medical management, implying transferability of crisis management behaviours between cases.
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Anaesth Intensive Care · Mar 2008
Adverse physiological events under anaesthesia and sedation: a pilot audit of electronic patient records.
Review of perioperative activity including adverse events, throughput and compliance with 'best practice', can theoretically be used to optimise healthcare delivery. Computer-based analysis of electronic patient records could provide a practical means to manage quality improvement. This pilot study examined the effectiveness of such a system in practice. ⋯ The adverse event incidence during colonoscopy and laryngospasm/hypoxia during desflurane anaesthesia was 6.3% and 1.3% respectively. This decreased to 2.8% (P <0.005) and 0.13% (P <0.0001) respectively for the nine months following feedback and the introduction of guidelines. Anaesthesia information systems can be an effective quality improvement tool and may enhance existing tools such as incident reporting systems.
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Anaesth Intensive Care · Mar 2008
Job satisfaction, stress and burnout in anaesthetic technicians in New Zealand.
Anaesthetic technicians play a key role in the operating room, yet little is known about their levels of job satisfaction or workplace stress. A blinded, confidential single mail-out survey was posted to anaesthetic technicians in New Zealand. The survey consisted of demographic information, a job satisfaction survey, the Maslach Burnout Inventory and the Short Form 12. ⋯ High to moderate levels of emotional exhaustion (48%), depersonalisation (39%) and low levels of personal accomplishment (58%) were indicators of burnout. The Short Form 12 revealed high levels of physical impairment in 24% and emotional impairment in 35% of respondents. These data suggest that work is needed to evaluate anaesthetic assistants' job structure and actively manage their important physical and emotional sequelae.