Ethical issues in anesthesia: the need for a more practical and contextual approach in teaching

Subramanian, Hariharan

doi:10.1007/s00540-009-0776-x

Cited by 10 publications

(4 citation statements)

References 14 publications

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“…This finding is in agreement with previous research which suggests that both educational efforts and electronic prompting are effective in causing behavior change [1-4,13]. It is also in agreement with studies that suggest that behavior change is more likely when a practical application is included within the educational framework [14-16]. To our knowledge, however, this is the first study to demonstrate these effects within the context of an APS.…”

Section: Discussionsupporting

confidence: 92%

A Multi-faceted Educational Approach for Pain Metric Recording Prior to Knee and Hip Arthroplasty: Effects on Documentation by an Acute Pain Service

Ardon

Warrick

Wickas

2019

Cureus

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Background Despite the increased use of electronic medical records (EMRs) in past years, the recording of clinically useful baseline pain information may still be lacking. An educational effort targeted at the acute pain service and reinforced by electronic prompting may be an effective way to promote electronic documentation of relevant pain metrics. The objective of this study was to assess whether an educational effort with electronic prompting in the EMR promotes the documentation of baseline pain scores and preoperative opioid use by an acute pain service (APS). Methods A total of 98 patients were included in this study: 49 in the study group and 49 in the control group. The study group consisted of patients who underwent knee and hip arthroplasties after the institution of a multimodal analgesia educational program that also incorporated an electronic prompt to promote behavior change. Primary outcomes were the frequency of documentation of baseline pain scores and preoperative opioid use. Results After the implementation of the education initiative, 67% of the patients had baseline pain scores recorded in the preoperative APS documentation, compared to 20% in the control group ( p = 0.0001). Preoperative opioid use was recorded in 24% of APS documentation within the control group, but this increased to 73% after the educational intervention ( p = 0.0001). Documentation of resting pain scores on the day of surgery also increased from 59% to 87% ( p = 0.0014). Conclusions The introduction of a multi-dimensional educational effort focused on baseline pain metric recording within the context of an analgesic change of practice increased assessment of both baseline pain and preoperative opioid use by APS. These results can be applied to other settings in which a focused change of practice is required and an electronic medical record already utilized.

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Section: Discussionsupporting

confidence: 92%

A Multi-faceted Educational Approach for Pain Metric Recording Prior to Knee and Hip Arthroplasty: Effects on Documentation by an Acute Pain Service

Ardon

Warrick

Wickas

2019

Cureus

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Section: Discussionmentioning

confidence: 99%

Constructing Recognition of the Others State of Surrendering- A Grounded Theory

Liebenhagen¹,

Forsberg²

2016

J Perioper Crit Intensive Care Nurs

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Objective: The intraoperative setting is a complex environment, where nurse anaesthetists' are required to handle an intense flow of information. Apart from intraoperative time constraints and pressure to perform, little is known about nurse anesthetists' concerns prior to administering anaesthesia. Therefore, the aim of this study is to answer the key questions; what are nurse anaesthetists' main concerns prior to and during anaesthesia induction and how do they cope with them? Methods: Constructivist grounded theory was used to illuminate the context and specific conditions under which the informants performed anaesthesia nursing. Fifteen nurse anaesthetists were interviewed using an open-ended method. Results: The common denominator for the informants was their active efforts to construct grounds for recognition of the other's state of surrendering associated with anaesthesia induction. The core category; constructing recognition of the Other's state of surrendering, is supported by three main categories; Creating a trusting relationship, Working with the technology and Establishing recognition. Conclusion: The act of recognition highlights the healthcare organisation's obligation to provide sufficient time for the ethical practice of anaesthesia, which presupposes awareness on the part of anaesthesia staff of their own professional approach.

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“…This would help those applicants who lack the necessary qualities to discover and follow other professional paths [23]. The patient's modesty and possible diffidence when entering the operating theatre demand an empathic and respectful approach on the part of the NA [24]. D. Clinical: The rapid pace of work and time constraints of the operating schedule undermine the NA's professional obligation to assume true ethical responsibility [3,4].…”

Section: Discussionmentioning

confidence: 99%

Constructing Recognition of the Others State of Surrendering- A Grounded Theory

Liebenhagen¹,

Forsberg²

2016

J Perioper Crit Intensive Care Nurs

View full text Add to dashboard Cite

Objective: The intraoperative setting is a complex environment, where nurse anaesthetists' are required to handle an intense flow of information. Apart from intraoperative time constraints and pressure to perform, little is known about nurse anesthetists' concerns prior to administering anaesthesia. Therefore, the aim of this study is to answer the key questions; what are nurse anaesthetists' main concerns prior to and during anaesthesia induction and how do they cope with them?Methods: Constructivist grounded theory was used to illuminate the context and specific conditions under which the informants performed anaesthesia nursing. Fifteen nurse anaesthetists were interviewed using an open-ended method. Results:The common denominator for the informants was their active efforts to construct grounds for recognition of the other's state of surrendering associated with anaesthesia induction. The core category; constructing recognition of the Other's state of surrendering, is supported by three main categories; Creating a trusting relationship, Working with the technology and Establishing recognition. Conclusion:The act of recognition highlights the healthcare organisation's obligation to provide sufficient time for the ethical practice of anaesthesia, which presupposes awareness on the part of anaesthesia staff of their own professional approach.

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Ethical issues in anesthesia: the need for a more practical and contextual approach in teaching

Cited by 10 publications

References 14 publications

A Multi-faceted Educational Approach for Pain Metric Recording Prior to Knee and Hip Arthroplasty: Effects on Documentation by an Acute Pain Service

A Multi-faceted Educational Approach for Pain Metric Recording Prior to Knee and Hip Arthroplasty: Effects on Documentation by an Acute Pain Service

Constructing Recognition of the Others State of Surrendering- A Grounded Theory

Constructing Recognition of the Others State of Surrendering- A Grounded Theory

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