Abstract
To record, tabulate and report problems associated with anaesthesia, we have developedan information collection system and computer software to follow all patients attended by an anaesthetist at a teaching hospital in Canada. For the last 15 mo, data for 17,000 patients have been collected and the system is ongoing. Data collection is from three sources: carbonless copies of the handwritten Operating Room (OR) and Post Anaesthetic Care Unit (PACU) records, other hospital databases, and postoperative visits. Adverse events (observations which differ from specific physiological variables, or require an intervention and do not normally occur during the routine conduct of anaesthesia), are defined directly on each OR and PA CU record. These events are recorded when they occur by the attending anaesthetist or the PACU nurse. All data are verified by a research nurse and an anaesthetist. Computer software, developed from DBase IV, is used to track 95 individual items on preoperative status and anaesthetic technique and another possible 1,450 selections for drugs, physicians, airways, surgical procedures and events for each patient. Data are analyzed with SAS software and reports generated to link the casemix and process with outcome. Comparison of data entered into the computer programme to a retrospective chart review revealed discrepancies of less than 0.5%. Collection, verification and computer entry takes five minutes per patient and the on-going cost is estimated at $4 per patient record. Analysis of the information collected in this database has been useful for research of adverse outcome following anaesthesia, resident expertise profiles, and the administrative management of an anaesthesia department.
Résumé
Nous avons mis au point un système de recueil de l’information et développé à partir de dBASE IV un logiciel servant à compiler et classifier les incidents associés à l’anesthésie. La collection des donnees se réalise à partir de trois sources: 1) le dossier anesthésique original et de celui de la salle de réveil, 2) les banques de données hospitalières, 3) les visites post-anesthésiques. Le logiciel est conçu pour détecter 95 éléments isolés se rapportant à l’état pré-opératoire et à la technique anesthésique ainsi que 1450 autres choix comme la médication, les médecins intervenants, les gestes chirurgicaux, les techniques appliquées au maintien des voies respiratoires, les événements survenus. Les incidents notés sont vérifiés par un anesthésiste ou une infirmière associée de recherche puis analysés par le logiciel SAS de façon à établir une relation entre les différentes variables et l’issue clinique. La durée totale de collection, de vérification et d’enregistrement des données de chacun des 17 000 dossiers pendant les 16 derniers mois est évaluée à cinq minutes et le coût total à 4$ par patient. Une comparaison des données introduites dans le programme informatique avec une etude retrospective des dossiers a démontré une divergence inférieure à 0,4%.
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Supported in part by the PSI Foundation, St. Michael’s Hospital Research Society, and a National Health Scholar Award (Health & Welfare Canada) to Dr. Cohen.
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Rose, D.K., Cohen, M.M., Wigglesworth, D.F. et al. Development of a computerized database for the study of anaesthesia care. Can J Anaesth 39, 716–723 (1992). https://doi.org/10.1007/BF03008236
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DOI: https://doi.org/10.1007/BF03008236