Key result
A national survey of 341 Thai nurse anesthetists revealed significant gaps in anesthesia safety, including inadequate personnel (64%), lack of 24-hour recovery rooms (46%), and frequent miscommunication (50%).
Cross-Sectional (n=341)
A national survey of Thai nurse anesthetists identified significant gaps in anesthesia quality and safety, including personnel shortages, inadequate supervision, and lack of 24-hour recovery rooms.
Exposes anesthesia safety gaps in Thailand; supports targeted quality initiatives but leaves open links to patient outcomes.
Background: The Royal College of Anesthesiologists of Thailand (RCAT) performed large-scale epidemiologic study of anesthesia-related complications and national incidents study in 2004 and 2007, respectively. Objectives: Evaluate the anesthesia service in Thailand with regard to status of quality and patient safety. Material and methods: A pre-planned structured questionnaire regarding demographic, administrative, preanesthetic, intraoperative postanesthetic variables and complications were requested to be filled in by nurse anesthetists attending the refresher course lecture of RCAT in February 2008. Descriptive statistics was used. Results: Three hundred fifty questionnaires were given and 341 respondents (97%) returned the questionnaires. Most of the respondents (90%) worked in government section. Thirty percent of respondents practiced in hospital without medical doctor anesthesiologist and 58% of nurse anesthetists worked in hospitals that have been accredited. Forty-six percent of respondents reported unavailability of a 24-hour recovery room. The questionnaires revealed of inadequacy of anesthesia personnel (64%), inadequate supervision during emergency condition (53%), inadequacy of patient information regarding anesthesia (57-69%), and low opportunity for patient to choose choice of anesthesia (19%). The commonly used monitoring were pulse oximeter (92% of respondents) and electrocardiography (63%). One-third (32%) of respondents had to provide of anesthesia for patients with insufficient NPO (non per oral) time. Common problems that the respondents experienced were miscommunication (49%), intraoperative cardiac arrest during the past year (35%), error related to infusion pump (24%) and medication error (8%). Fifty-five percent of respondents had to monitor at least one patient per month receiving spinal anesthesia. Conclusion: Suggested strategies for quality and patient safety improvement in anesthesia service are increasing personnel, increasing 24-hour recovery room, improvement of supervision, improvement of communication, compliance to guidelines and improvement of nurse anesthetist’s training regarding monitoring patient receiving spinal anesthesia and cardiopulmonary resuscitation.
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Charuluxananan et al. (2010) conducted a cross-sectional in Anesthesia service quality and patient safety (n=341). Anesthesia service quality and safety survey was evaluated on Status of quality and patient safety in anesthesia service. A national survey of 341 Thai nurse anesthetists revealed significant gaps in anesthesia safety, including inadequate personnel (64%), lack of 24-hour recovery rooms (46%), and frequent miscommunication (50%).
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