Safety first--five years later. Belgian standards for patient safety in anaesthesia revisited

Belgian Standards for Patient Safety in Anaesthesia, established in 1989 by a joint effort of the Belgian Professional Association of Anesthesiologists and the Belgian Scientific Society of Anaesthesia and Resuscitation, were intended to be fully implemented within hospital practice by January 1st, 1995. In order to gather follow-up data with regard to this deadline, the Professional Association of Anesthesiologists conducted a survey in 1995: a questionnaire was circulated to all Belgian anaesthetists in order to evaluate the extent to which these guidelines had been implemented in clinical practice and to determine the areas in which residual noncompliance remained. 71% of responders complied with the safety guidelines as far as monitoring in the operating room was concerned. Nursing help was available to 95% of the responders. Concerning the requirement for continuous attendance during anaesthesia by a doctor anaesthetist, some questions remain: although the principle was accepted by 53% of responders, the practical consequences are such that flexibility in working conditions is hampered by the obligation to stay at the side of the anaesthetised patient, under all circumstances. The survey reveals that 65% of responders do not totally comply with this guideline of continuous attendance by a doctor. Many of them propose professional assistance by nursing staff with a specific education and training in anaesthesia.