Mitra Manasij, Basu Maitraye, Shailendra Kumar, Biswas Nupur
Department of Anesthesiology, MGM Medical College and LSK Hospital, Kishanganj, Purab Palli, Kishanganj, Bihar, India.
Department of Biochemistry, MGM Medical College and LSK Hospital, Kishanganj. Purab Palli, Kishanganj, Bihar, India.
J Family Med Prim Care. 2020 Sep 30;9(9):4592-4602. doi: 10.4103/jfmpc.jfmpc_722_20. eCollection 2020 Sep.
Anesthesia is a complex domain that is highly technical and skill based. Primary Care Physicians often have to do the initial evaluation of surgical patients they encounter during their daily practice before referring them to the surgical team. Thus, the Primary Care Physician's preliminary knowledge in anesthesia processes, risks involved and interventions that can be done to minimize these risks can improve patient-centered care and ultimately patient safety.
The study was conceptualized and conducted in the Department of Anesthesiology from January 2018 to December 2018 in a 600 bed Multispecialty teaching hospital in Bihar, India. The study aimed towards Anesthesia Care related Risk Identification and Reduction and encompassed process improvements.
Risk Severity Analysis of the Critical Steps of Anesthesia Care was done. The average Hazard Score reduced from 21.59 during January 2018 to March 2018 to 8.23 during April 2018 to June 2018 subsequently to 3.53 during July 2018 to September 2018 and finally to 2.12 during October 2018 to December 2018. Thus, there was an overall reduction of 90.18% in the Hazard Score from April'18 to June'18 quarter to October 2018 to December 2018 quarter.
Adverse Anesthesia/Sedation Events reported during the period from January 2019 to December 2019 was "Zero". A systematic approach towards Risk Reduction not only lead to reduction in Hazard Score and Process Improvement but also made the Anesthesia Care Safe which is evident in the consistency of reporting "Zero" Adverse Anesthesia/Sedation Events for the last one year.
麻醉是一个复杂的领域，高度依赖技术和技能。基层医疗医生在日常工作中遇到手术患者时，通常必须在将其转介给手术团队之前进行初步评估。因此，基层医疗医生对麻醉过程、所涉及的风险以及为最小化这些风险可采取的干预措施的初步了解，能够改善以患者为中心的护理，并最终提高患者安全性。
该研究于2018年1月至2018年12月在印度比哈尔邦一家拥有600张床位的多专科教学医院的麻醉科构思并开展。该研究旨在识别和降低与麻醉护理相关的风险，并涵盖流程改进。
对麻醉护理关键步骤进行了风险严重程度分析。平均危险评分从2018年1月至2018年3月的21.59降至2018年4月至2018年6月的8.23，随后降至2018年7月至2018年9月的3.53，最后降至2018年10月至2018年12月的2.12。因此，从2018年4月至6月季度到2018年10月至12月季度，危险评分总体降低了90.18%。
2019年1月至2019年12月期间报告的不良麻醉/镇静事件为“零”。系统的风险降低方法不仅导致危险评分降低和流程改进，还使麻醉护理更加安全，这在过去一年持续报告“零”不良麻醉/镇静事件中得到了体现。
