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Published on: August 1, 2019
[Web-based for preanesthesia evaluation record: a structured, evidence-based patient interview to assess the
Sylvia Kramer1, Alexandra Lau, Michael Krämer
1Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité- Universitätsmedizin Berlin, Campus Mitte und Campus Virchow Klinikum.
Summary
A new web-based anesthesia evaluation record (WAR) streamlines preoperative assessments by using structured interviews. This improves access to patient information, enhancing anesthesiologist decision-making and patient safety.
Area of Science:
- Anesthesiology
- Health Informatics
- Patient Safety
Context:
- Anesthesia Preoperative Evaluation Clinics (APEC) face challenges accessing complete patient clinical information, hindering informed consent and leading to procedure delays.
- Current pre-anesthetic assessments vary significantly, posing quality assurance issues and increasing the risk of elective surgery cancellations.
- Incomplete pre-anesthetic evaluations can result in the untimely termination of scheduled procedures.
Purpose:
- To introduce a web-based anesthesia evaluation record (WAR) that standardizes and enhances the pre-anesthetic assessment process.
- To move the initial patient-anesthesiologist contact to an earlier stage, before the day of admission.
- To improve the quality of pre-anesthetic evaluations through structured, evidence-based interviews and risk stratification.
Summary:
- The WAR utilizes a structured, hierarchical interview based on guidelines, standard operating procedures (SOP), and evidence-based medicine (EBM).
- Patient answers are classified using agreed criteria and scoring systems, generating procedural recommendations for both anesthesiologists and patients.
- This system provides standardized risk criteria for quality assurance and aims to prevent short-notice cancellations due to incomplete preparation.
Impact:
- Enhances patient safety and optimizes the anesthesiologist's decision-making process.
- Facilitates earlier patient engagement in the anesthesia evaluation process.
- Reduces the incidence of elective operation cancellations stemming from inadequate pre-anesthetic procedures.
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01:25Assessment of apical radial pulse
Apical-Radial (A-R) Pulse Assessment
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Pre-Procedural Preparation
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01:14SBAR II: Application of SBAR
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SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
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General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Objectives and Importance:
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Objectives and Importance:
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