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Implementation of a standardised questionnaire for documenting preoperative respiratory illness in paediatric
Abby Victoria Winterberg1,2, Stacie Richmond3, Nathaniel T G Tighe3,4
1Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA abby.v.hess@gmail.com.
Insights
A new questionnaire improved documentation of preoperative respiratory illness in children undergoing surgery. This quality improvement initiative successfully reduced risks associated with perioperative respiratory complications.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Quality Improvement
Background:
- Pediatric patients frequently exhibit respiratory illness symptoms before surgery.
- Perioperative respiratory complications are heightened by current or recent illness in children.
- A standardized process for documenting preoperative respiratory illness was lacking.
Purpose of the Study:
- To decrease pediatric perioperative respiratory adverse events.
- To implement a standardized process for documenting preoperative respiratory illness.
- To improve patient safety during the perioperative period.
Main Methods:
- A quality improvement initiative was launched.
- A standardized preoperative illness questionnaire was developed and implemented.
- The intervention was integrated into nurses' routine workflow and later adopted electronically.
Main Results:
- Standardized documentation of preoperative respiratory illness increased from 0% to 95%.
- Nurses rapidly adopted the new questionnaire and workflow.
- The intervention was successfully implemented across multiple operating room locations.
Conclusions:
- Standardized documentation of preoperative respiratory illness is achievable and effective.
- Implementing a preoperative illness questionnaire enhances patient safety.
- Further standardized preoperative processes are needed to fully address perioperative respiratory complications.
Abstract:
Paediatric patients often present with symptoms of respiratory illnesses in the weeks leading up to surgery. Current or recent illness can increase the risk of experiencing perioperative respiratory complications. Ideally, children with recent illnesses should be identified before coming to the hospital to determine the safest course of action. We recognised that our system lacked a standardised process for documenting preoperative respiratory illness during the preoperative phone call. The global aim of this quality improvement initiative was to decrease paediatric perioperative respiratory adverse events. The SMART Aim (Specific, Measurable, Achievable, Relevant and Time-bound) was to increase the percentage of patients with standardised documentation of preoperative respiratory illness from 0% to 90% by 1 March 2023. Implementation of a standardised preoperative illness questionnaire increased standardised illness documentation from 0% to 95%. Nurses quickly adopted this intervention and easily integrated it into their routine workflow. Clinical leaders elected to implement the intervention electronically across all three operating room (OR) locations (main OR, satellite location and procedure centre). Future implementation of additional standardised preoperative processes will be needed to improve the global aim of decreasing perioperative respiratory complications.
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