Clinical Audit on the Quality of Pre-Anaesthesia Assessment based on Predefined Pre-anaesthesia Assessment Form

Objective: To determine the percentage completion of individual GQI indicators and the overall percentage of completed predefined Pre-anaesthesia assessment forms and identify any areas for improvement in the documentation of pre-anaesthesia assessment. Study Design: Cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Sialkot Pakistan, from Mar to Sep 2021. Methodology: Patients who reported to the operation theatre during the study period for elective surgery after having undergone formal pre-anaesthesia assessment preoperatively based on predefined Pre-anaesthesia assessment form (PAAF) were included. The quality of Pre-anaesthesia assessments from completion was assessed using a modified Global Quality Index with twenty-seven components. Results: The overall completion rate for all pre-anaesthesia assessment form components was 77.10±30.26%. The lowest completed items were local examination (0.00%), airway assessment, neck mobility, mouth opening, thyromental distance (24,10.61%), weight (25, 11.36%), GIT (86, 38.64%) and CNS/GCS (108, 48.48%) assessment, pre-operative vitals (121, 54.55%) and family history (129, 58.33%). Conclusion: We need to improve the quality of pre-anaesthesia assessment forms at our institution by ensuring that all relevant information is collected and documented.