An evaluation of a time-saving anaesthetic machine checkout procedure

Although it is generally acknowledged that a pre-use checkout of the anaesthetic machine significantly improves patient safety, an evaluation of such procedures is uncommon. Previous studies have shown that anaesthetic personnel using different check routines are unable to detect the majority of pre-set technical malfunctions. We have shown that it is possible to develop an effective and time-saving check procedure by integrating seven simple steps into one continuous flow procedure, where the settings and results of one step are used in the following step to optimize step interaction. The method is a 'core' procedure adapted to machines sold after 1980 according to the current ISO standard (presently undergoing revision). A user inquiry demonstrated that this pre-use check has been easily adopted in departments of anaesthesia. Moreover, the inquiry showed that most departments would not accept a checkout procedure which required more than 5-6 min. A study on nurse anaesthetists performing this procedure in the operating suite showed an average checking time of approximately 3 min. A performance test was undertaken by activating four different malfunctions in an anaesthetic machine training simulator. Twelve of 17 nurse anaesthetists rapidly identified all faults, whereas five nurses missed one or two faults. Our study suggests that our check procedure (the seven point check) provides a time-saving method for effective pre-use control of the anaesthetic machine.