Clinical Audit on Current Practice of Anesthesia Machine Check and Equipment Preparedness Before Use in Debre Berhan Comprehensive Specialized Hospital, North Shewa, Ethiopia, 2020

Abstract

Background: Assessing the quality assurance of providing work-ready anesthesia equipment in operating rooms is so vital. Most of the anesthesia-related adverse events are preventable by the identification and correction of anesthesia machine errors and equipment preparation in the pre-induction period. This paper aimed to keep a high-quality environment for workers and patients in the surgical operating theater. Materials and Methods: Data were collected after ethical clearance obtained from the institutional ethical review board, and daily observations of pre-induction anesthesia preparation were done in all surgical rooms at the start of each day and continuously before the next cases with a prepared anesthesia machine checklist. Descriptive statistical analysis and crosstabulation of each checklist with the type of anesthesia and urgency of surgery were done to determine the degree of staff compliance with daily preparations using SPSS version 22, and finally, results were presented by texts and graphs. Results: In this study, a total of 61 checking events with 19 items were involved during the study period. There were 893 (77.1%) fully met checking events, 205 (17.7%) not-met checking events(sodalime) 61 (5.3%) not available in anesthesia machine check and equipment preparation before use. Among 19 checklists, only three (power source plugged in, power source switched on, and functionality of monitoring) were perfectly completed; however, the rest sixteen checklists are in bad practice among them seven checklists (presence of functional self-inflating bag, automatic machine check, power source backup battery, anti-hypoxic device, ventilator, difficult airway equipment and scavenging systems) were checked below 90%. Conclusions and Recommendations: This study concludes there is poor compliance among anesthetists in pre-induction preparation and underperformed since all anesthesia machine checklists have zero tolerance for errors. . This paper recommends that every responsible anesthetist perform anesthesia machine check and equipment preparation regardless of the type of anesthesia and type of surgery and avoid professional negligence.

Assessment of pre-anesthesia machine check and airway equipment preparedness: A cross-sectional study

“…This result showed that anesthesia machine check and equipment preparation is more or less similar to the clinical audit done by Samuel Debasu and his colleagues at Debre Birhan referral hospital but, the Debre Birhan study was conducted among 61 machine checks. Whereas, our study was conducted among 202 checking events [ 20 ]. However, this study is under practiced when compared with most standards [ 18 , 31 , 32 ].…”

“…Therefore, according to the national audit project (NAP4) report the most contributing factors for poor outcomes regarding airway management were deficiencies in judgment and inadequate equipment preparedness. As evidence recommends, machine checks and airway equipment be performed on daily basis [ 10 , 14 , [18] , [19] , [20] , [21] ]. Furthermore, The properly labeled equipment container provides the right equipment, in the right amount, in the right place, at the right time [ 22 , 23 ].…”