Abstract
Anesthesia is a medical field that has consistently demonstrated improvements in patient safety and can serve as a model for the rest of healthcare. Technological innovations, careful attention to retrospective analysis, instilling a culture of identifying errors, and valuing continuous learning are fundamental tenets of this field. In doing so, anesthesia continues to evolve with dramatic improvements in practice patterns emerging year by year. Despite the dramatic reduction in patient safety incidents, much can still be done to improve anesthesia delivery safety. One such area proving challenging to improve upon is human errors in anesthesia delivery, such as inadvertent drug administration. Another area needing improvement is balancing the needs of surgeons, surgical sites, patient expectations, chronic disease, and financial costs. This chapter reviews the history of establishing a safety culture in anesthesia and incidents demonstrating the need for continuous improvement in anesthesia delivery while analyzing the challenges associated with advancing patient safety.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Li G, Warner M, Lang BH, Huang L, Sun LS. Epidemiology of anesthesia-related mortality in the United States, 1999–2005. J Am Soc Anesthesiol. 2009;110(4):759–65.
Gaba DM. Anaesthesiology as a model for patient safety in health care. BMJ. 2000;320(7237):785–8.
Lagasse RS. Anesthesia safety: model or myth? A review of the published literature and analysis of current original data. J Am Soc Anesthesiol. 2002;97(6):1609–17.
Miller RD, Pardo M. Basics of anesthesia e-book. Elsevier Health Sciences; 2011.
Shojania KG, Duncan BW, McDonald KM, Wachter RM, Markowitz AJ. Making health care safer: a critical analysis of patient safety practices. Evid Rep Technol Assess (Summ) 2001;(43):i–x.
Jacques PJ, Patel N, Higgins MS. Improving anesthesiologist performance through profiling and incentives. J Clin Anesth. 2004;16(7):523–8.
Weld LR, Stringer MT, Ebertowski JS, Baumgartner TS, Kasprenski MC, Kelley JC, Cho DS, Tieva EA, Novak TE. TeamSTEPPS improves operating room efficiency and patient safety. Am J Med Qual. 2016;31(5):408–14.
Monk TG, Hurrell M, Norton A. Toward standardization of terminology on anesthesia information management systems. Interface—Newsl Soc Technol Anesth. 2004;15:1–4.
Donham RT, Mazzei WJ, Jones RL. Association of Anesthesia Clinical Directors’ procedural times glossary: glossary of times used for scheduling and monitoring of diagnostic and therapeutic procedures. Am J Anesthesiol. 1996;23.
Cooper JB. Towards patient safety in anaesthesia. Ann Acad Med Singap. 1994;23(4):552–7.
Aziz MF, Dillman D, Fu R, Brambrink AM. Comparative effectiveness of the C-MAC video laryngoscope versus direct laryngoscopy in the setting of the predicted difficult airway. J Am Soc Anesthesiol. 2012;116(3):629–36.
Cheney FW, Posner KL, Lee LA, Caplan RA, Domino KB. Trends in anesthesia-related death and brain damage: a closed claims analysis. J Am Soc Anesthesiol. 2006;105(6):1081–6.
Cheney FW. The American Society of Anesthesiologists Closed Claims Project: what have we learned, how has it affected practice, and how will it affect practice in the future? J Am Soc Anesthesiol. 1999;91(2):552–6.
ASA guidelines, statements and clinical resources. https://www.asahq.org/standards-and-guidelines.
Metzner J, Posner KL, Lam MS, Domino KB. Closed claims’ analysis. Best Pract Res Clin Anaesthesiol. 2011;25(2):263–76.
Davis JE, Sugioka K. Selecting the patient for major ambulatory surgery: surgical and anesthesiology evaluations. Surg Clin North Am. 1987;67(4):721–32.
Bert JM, Hooper J, Moen S. Outpatient total joint arthroplasty. Curr Rev Musculoskelet Med. 2017;10(4):567–74.
Pendharkar AV, Shahin MN, Ho AL, Sussman ES, Purger DA, Veeravagu A, Ratliff JK, Desai AM. Outpatient spine surgery: defining the outcomes, value, and barriers to implementation. Neurosurg Focus. 2018;44(5):E11.
Kaafarani HM, Han K, El Moheb M, Kongkaewpaisan N, Jia Z, El Hechi MW, van Wijck S, Breen K, Eid A, Rodriguez G, Kongwibulwut M. Opioids after surgery in the United States versus the rest of the world: the International Patterns of Opioid Prescribing (iPOP) multicenter study. Ann Surg. 2020;272(6):879–86.
Stone AB, Wick EC, Wu CL, Grant MC. The US opioid crisis: a role for enhanced recovery after surgery. Anesth Analg. 2017;125(5):1803–5.
Wu CL, King AB, Geiger TM, Grant MC, Grocott MP, Gupta R, Hah JM, Miller TE, Shaw AD, Gan TJ, Thacker JK. American society for enhanced recovery and perioperative quality initiative joint consensus statement on perioperative opioid minimization in opioid-naïve patients. Anesth Analg. 2019;129(2):567.
Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surg. 2017;152(11):1066–71.
Grant MC, Sommer PM, He C, Li S, Page AJ, Stone AB, Hobson D, Wick E, Wu CL. Preserved analgesia with reduction in opioids through the use of an acute pain protocol in enhanced recovery after surgery for open hepatectomy. Reg Anesth Pain Med. 2017;42(4):451–7.
Bohringer C, Astorga C, Liu H. The benefits of opioid free anesthesia and the precautions necessary when employing it. Transl Perioper Pain Med. 2020;7(1):152–7.
Carroll NV, Miederhoff PA, Cox FM, Hirsch JD. Costs incurred by outpatient surgical centers in managing postoperative nausea and vomiting. J Clin Anesth. 1994;6(5):364–9.
Hodge SD Jr. Should you think twice before having a procedure done at an ambulatory surgical center. Quinnipiac L Rev. 2019;38:1.
Anesthesia Patient Safety Foundation. HydrALAZINE Hydrochloride, Phenylephrine HCI Injection [Image on the internet]. 2021 [updated 2021 Aug 23; cited 2022 Feb 21]. https://www.apsf.org/look-alike-drugs/.
Sameera V, Bindra A, Rath GP. Human errors and their prevention in healthcare. J Anaesthesiol Clin Pharmacol. 2021;37(3):328.
Wahr JA, Abernathy JH III, Lazarra EH, Keebler JR, Wall MH, Lynch I, Wolfe R, Cooper RL. Medication safety in the operating room: literature and expert-based recommendations. Br J Anaesth. 2017;118(1):32–43.
Nanji KC, Patel A, Shaikh S, Seger DL, Bates DW. Evaluation of perioperative medication errors and adverse drug events. Anesthesiology. 2016;124(1):25–34.
Mulac A, Hagesaether E, Granas AG. Medication dose calculation errors and other numeracy mishaps in hospitals: analysis of the nature and enablers of incident reports. J Adv Nurs. 2022;78(1):224–38.
Kuperman GJ, Teich JM, Gandhi TK, Bates DW. Patient safety and computerized medication ordering at Brigham and Women’s Hospital. Jt Comm J Qual Improv. 2001;27(10):509–21.
Odom-Forren J. A culture of safety—whose responsibility? J Perianesth Nurs. 2019;34(2):223–5.
Dhawan I, Tewari A, Sehgal S, Sinha AC. Medication errors in anesthesia: unacceptable or unavoidable? Rev Bras Anestesiol. 2017;67:184–92.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Jha, S.“., Adams, J., Ehrenfeld, J. (2023). Patient Safety in Anesthesia. In: Agrawal, A., Bhatt, J. (eds) Patient Safety. Springer, Cham. https://doi.org/10.1007/978-3-031-35933-0_19
Download citation
DOI: https://doi.org/10.1007/978-3-031-35933-0_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-35932-3
Online ISBN: 978-3-031-35933-0
eBook Packages: MedicineMedicine (R0)