Missed steps in the preanesthetic set-up.

Area of Science:

• Anesthesiology
• Patient Safety
• Operating Room Management

Background:

• Anesthesiologists perform numerous tasks under time pressure during anesthetic induction.
• The operating room environment can lead to missed preparatory steps, intentionally or unintentionally.
• Patient safety necessitates thorough pre-induction preparation.

Purpose of the Study:

• To determine the incidence of missed preparatory steps before anesthesia induction.
• To identify specific steps that are frequently missed.
• To explore correlations between missed steps and operating room variables.

Main Methods:

• A "Revised Preanesthetic Set-Up" checklist was used to assess 200 surgical procedures.
• Data on missed steps and operating room/case variables were collected.
• Statistical analysis was performed to identify correlations.

Main Results:

• Twenty-three missed steps were identified across the procedures.
• Most frequent omissions included manual resuscitation device availability and functional suction.
• Missed steps were more common in regional anesthesia cases, high case load rooms (≥5 cases), and when attending anesthesiologists completed set-up.

Conclusions:

• Missed steps occur at a significant and quantifiable rate in pre-anesthetic preparation.
• Implementing measures to reduce missed steps is crucial for enhancing patient safety.
• Standardized checklists and process improvements are recommended.