A risk management audit: are we complying with the national guidelines for sedation by non-anaesthetists?

Improving documentation of procedural sedation in an adult emergency department

“…They suggested an interdisciplinary, formalized anesthetic preoperative record be introduced. Introduction of preprinted forms in EDs have shown similar magnitudes of improvement in documentation as this study for asthma management [17], general documentation [18], procedural sedation [8], and wound care [19].…”

“…Guidelines have been written by many professional organizations to ensure that PS is performed with optimal safety for the patient and to diminish risks for the physician [1][2][3][4][5][6]. Adherence to these guidelines by practitioners has not been well studied in any discipline [7,8] and despite recommendations for standardization of documentation [9,10], only minimal research has been published which addresses the adequacy of documentation of PS in EDs [11].…”

Establishing the Evidence Base for Trauma Quality Improvement: A Collaborative WHO‐IATSIC Review

“…Documentation of certain items, such as consent, vital signs, and use of oxygen, were monitored before and after the introduction of a sedation audit form used with patients requiring sedation for orthopedic maneuvers. Parameters that showed significant improvement in documentation included risk assessment, supplementary oxygen use, pulse oximetry reading, blood pressure, pulse, and level of consciousness [31]. In Yorkshire, U.K., a problem with the standard of trauma documentation revealed through an audit led to the introduction of trauma charts in a large teaching hospital.…”

“…Quality improvement measures to improve patient care documentation were addressed in seven articles, all of which involved introduction of a structured form, pre‐printed order sheets, or other documentation template (Table 8). Several of these took place in the emergency department, evaluating the introduction of structured documentation forms for common emergency conditions or procedures [30–32, 35]. One example is given in the article by Nicol, who assessed the effect of a pre‐printed form in improving quality of documentation of sedation by non‐anesthetists.…”

Evaluation of the impact of a paediatric procedural sedation credentialing programme on quality of care

“…in a formal evaluation of the use of a hospital wide structured model to reduce sedation‐ related adverse events 15 . A number of case series report the use of a quality assurance tool to measure adverse events and adherence to guidelines 16,17 and another measures the beneficial effect of introducing a preprinted audit form for completion by staff performing PPS 18 …”