Anaesthesia and intensive care
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Anaesth Intensive Care · May 2023
Long-term capacity planning for obstetric surgical suites using quantile linear regression.
Obstetric surgical suites differ from most inpatient surgical suites, serving one specialty, and often small. We evaluated long-term capacity planning for these operating rooms. The retrospective cohort study included all caesarean births in three operating rooms over 28 years, 1994 through 2021, plus all other obstetric procedures over the latter 19 years. ⋯ The annual total for the index increased linearly, Pearson correlation coefficient of 0.98, supporting validity of the finding that long-term capacity can be planned with linear regression. The difference between 0.9 and 0.1 quantiles in weekly totals of the index exceeded annual rate of growth, supporting validity of the finding that variability week to week is very large relative to growth. These results help decision-makers ensure that operating rooms and staff meet referring hospitals' needs.
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Anaesth Intensive Care · May 2023
The goals of care framework and the perioperative period: A practical approach.
The goals of care (GOC) framework (2014) is an illness phase categorisation system that enables limitations of medical treatment (LOMT) to be documented and communicated within a healthcare system. It incorporates a clinical assessment of illness phase and GOC discussion on aims and LOMT for an episode of care. Together, this results in documentation of a GOC category that guides treatment escalation decisions during episodes of patient deterioration. ⋯ A historical tendency for automatic and unilateral suspension of limitations during surgery may be susceptible to ethical or medicolegal challenge. This article highlights the difference between the GOC framework and 'not for resuscitation' framework, considers the unique considerations of the perioperative period and addresses misconceptions of the GOC framework in patients undergoing surgery. Finally, it provides an approach to the GOC framework for patients considered for surgery by emphasising illness phase assessment and the need for the GOC category to accurately reflect the clinical situation throughout the perioperative period, guiding treatment escalation intraoperatively and postoperatively.
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Anaesth Intensive Care · May 2023
A survey of operating theatre staff on the impact of automated medication dispensing systems in operating theatres in an Australian hospital.
There is a lack of published literature investigating the impact of anaesthesia-specific automated medication dispensing systems on theatre staff. This study aimed to investigate the perspectives of theatre staff from multiple disciplines on their experience using anaesthesia stations three years after implementation at our Western Australian quaternary hospital institution. A web-based survey was distributed to 440 theatre staff, which included consultant anaesthetists, anaesthetic trainees, nurses, anaesthetic technicians and pharmacists, and 118 responses were received (response rate 26.8%). ⋯ Sixty-seven percent of anaesthetic medical staff agreed that controlled medication (e.g. schedule 8 and schedule 4 recordable) transactions were more efficient with the anaesthesia stations, and 66.67% agreed that the anaesthesia stations improved accountability for these transactions. Sixty-seven percent of anaesthetic medical staff preferred to use anaesthesia stations and 21.2% of all the responders preferred a manual medication trolley (P ≤ 0.001). This survey of user experience with anaesthesia stations was found to be predominantly positive with the majority of theatre staff and anaesthetic medical staff preferring anaesthesia stations.