United Kingdom: Recent Advances in the Safety and Prevention of Regional Anesthesia Complications
The National Institute of Academic Anesthesia’s Health Services Research Centre (HSRC) was formed in 2011 and coordinates national audit, quality improvement and research activity investigating the influence of perioperative care, anesthesia, and critical care on patient morbidity and safety. The National Patient Safety Alerting System alerts health personnel of drug- or device-related risks.
Complications that are the focus of UK regional anesthesia include inadvertent intravenous injection of local anesthetic, wrong site blocks, efficacy and side effects of central neuraxial blocks, and regional anesthesia for hip fracture surgery.
In 2014, the HSRC conducted a national survey of 260 UK hospitals in order to provide a national benchmark for patient satisfaction and patient-reported awareness after anesthesia against which hospitals could measure their own performance.
KeywordsAnesthesia Regional Morbidity Local anesthetic Audit Quality improvement Epidural Thoracic
Association of Anaesthetists of Great Britain and Ireland
Anaesthesia Sprint Audit of Practice
Central Neuraxial Block
Health Services Research Centre
National Audit Project
National Patient Safety Alerting System
National Health Service
National Institute of Academic Anesthesia
National Patient Safety Agency
National Reporting and Learning System
Royal College of Anaesthetists
Safe Anaesthesia Liaison Group
Sprint National Anesthesia Project
- 1.Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office; 2013.Google Scholar
- 2.Cabinet Office Prime Minister’s Office, 10 Downing Street and The Rt Hon David Cameron MP. Francis Report: PM statement on Mid Staffs Public Inquiry. London: Crown Copyright; 6 Feb 2013.Google Scholar
- 3.National Advisory Group on the Safety of Patients in England. A promise to learn—a commitment to act: improving the safety of patients in England. London: Crown Copyright; 2013.Google Scholar
- 4.Crone J. NHS doctor in the dock over caesarean death of primary school teacher ‘Mrs Coffee’ while police continue to seek his colleague. Daily Mail. 2015.Google Scholar
- 5.Corporate Manslaughter and Corporate Homicide Act 2007. 2007 c. 19. 6 Apr 2008.Google Scholar
- 6.NHS National Patient Safety Agency. NRLS reporting. https://report.nrls.nhs.uk/nrlsreporting/Default.aspx (2014).
- 7.NHS England Patient Safety Domain. An introduction to the NHS England patient safety alerting system. London: NHS England; 31 Jan 2014.Google Scholar
- 8.NHS National Patient Safety Agency. Epidural injections and infusions. London: National Patient Safety Agency; 2007.Google Scholar
- 9.NHS National Patient Safety Agency. Safer spinal (intrathecal), epidural and regional devices—part B. London: National Patient Safety Agency; 24 Nov 2009.Google Scholar
- 10.NHS National Patient Safety Agency. Safer spinal (intrathecal), epidural and regional devices—part A. London: National Patient Safety Agency; 27 Jan 2011.Google Scholar
- 11.ISO 80369-6 Small bore connectors for liquids and gases in healthcare applications—part 6: connectors for neuraxial applications. Geneva: International Organization for Standardization; 2016.Google Scholar
- 15.Department of Health, Chief Medical Officer. Annual report of the Chief Medical Officer 2002. London: UK Department of Health Publications; 3 July 2003.Google Scholar
- 17.NHS England Patient Safety Domain. Never events list 2015/16. London: NHS England; 27 Mar 2015.Google Scholar
- 18.World Alliance for Patient Safety. WHO surgical safety checklist. Geneva: World Health Organization; 2008.Google Scholar
- 19.NHS Safe Anaesthesia Liaison Group. Wrong site blocks during surgery. London: National Patient Safety Agency; 2010.Google Scholar
- 20.Safe Anaesthesia Liaison Group. Stop Before You Block Campaign. Nottingham: Nottingham University Hospitals NHS Trust; 2011.Google Scholar
- 23.Faculty of Pain Medicine, The Royal College of Anaesthetists. Best practice in the management of epidural analgesia in the hospital setting. London: The Royal College of Anaesthetists; 2015.Google Scholar
- 24.HSRC: Health Services Research Centre. https://rayzume.com/NIAA/HSRC_home (2015). Accessed 7 Mar 2016.
- 25.NIAA: National Institute of Academic Anaesthesia. www.niaa.org.uk (2015). Accessed 7 Mar 2016.
- 26.Health Services Research Centre. SNAP1, Sprint National Anaesthesia Project. London: Royal College of Anaesthetists; 2014.Google Scholar
- 27.Royal College of Physicians. The National Hip Fracture Database Anaesthetic Sprint Audit of Practice (ASAP). London: Association of Anaesthetists of Great Britain and Ireland; 2014.Google Scholar
- 28.Griffiths R, White SM, Moppett IK, Parker MJ, Chesser TJ, Costa ML, Johansen A, Wilson H, Timperley AJ. Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture 2015: Association of Anaesthetists of Great Britain and Ireland British Orthopaedic Association British Geriatric Society. Anaesthesia. 2015;70:623–6.CrossRefPubMedGoogle Scholar