McGarrity L, O'Connor R, Young S
Department of Anaesthesia, North and South Glasgow NHS Trusts, Scotland, UK.
Int J Obstet Anesth. 2008 Oct;17(4):322-8. doi: 10.1016/j.ijoa.2008.04.006.
In May 2005 the Obstetric Anaesthetists' Association (OAA) and Association of Anaesthetists of Great Britain and Ireland published a document entitled Guidelines for Obstetric Anaesthetic Services. This survey investigated if standards recommended in this document were being met more than six months after its release.
An OAA-approved questionnaire was sent to all obstetric anaesthesia lead clinicians across the UK, using the OAA mailing database. Standards investigated were those in relation to anaesthesia for caesarean section and postnatal audit programmes. The availability of 14 recommended clinical guidelines within departments of obstetric anaesthesia was also investigated.
The response rate for the national survey was 79.3%. Not all departments met the standards set out in the guidelines for anaesthesia for caesarean section with only 61.2% of obstetric units having consultant-led elective lists carried out independently of emergency procedures. Eighty percent of units surveyed had postnatal audit programmes in place but only 58.8% generated a regular report from such programmes. The clinical guidelines recommended for obstetric departments were available to varying degrees. Guidelines for haemorrhage, preeclampsia and difficult/failed intubation were available in all units but only 34.6% of units had all 14 recommended guidelines available.
This national survey illustrates to what extent UK departments meet national guidelines for provision of obstetric anaesthesia services. It also highlights areas for improvement nationally and could be used by individual units to plan resources in the future.
2005年5月,产科麻醉医师协会(OAA)和大不列颠及爱尔兰麻醉医师协会发表了一份题为《产科麻醉服务指南》的文件。本次调查旨在探究该文件发布六个多月后,其中所推荐的标准是否得到了落实。
利用OAA邮件数据库,向英国所有产科麻醉首席临床医生发送一份经OAA批准的调查问卷。所调查的标准涉及剖宫产麻醉和产后审计项目。同时还调查了产科麻醉科室是否具备14项推荐临床指南。
全国性调查的回复率为79.3%。并非所有科室都达到了剖宫产麻醉指南所规定的标准,只有61.2%的产科单位有由顾问主导的择期手术清单,且独立于急诊程序进行。80%的被调查单位设有产后审计项目,但只有5&8%的单位能定期从此类项目中生成报告。推荐给产科科室的临床指南在不同程度上可供使用。所有单位都有关于出血、先兆子痫和困难/失败插管的指南,但只有34.6%的单位具备全部14项推荐指南。
这项全国性调查说明了英国各科室在多大程度上符合提供产科麻醉服务的国家指南。它还突出了全国范围内有待改进的领域,各单位未来可据此规划资源。