Intraoperative Non–Record-keeping Usage of Anesthesia Information Management System Workstations and Associated Hemodynamic Variability and Aberrancies

Abstract

Background: Anesthesia information management system workstations in the anesthesia workspace that allow usage of non-record-keeping applications could lead to distraction from patient care. We evaluated whether non-record-keeping usage of the computer workstation was associated with hemodynamic variability and aberrancies. Methods: Auditing data were collected on eight anesthesia information management system workstations and linked to their corresponding electronic anesthesia records to identify which application was active at any given time during the case. For each case, the periods spent using the anesthesia information management system record-keeping module were separated from those spent using non-recordkeeping applications. The variability of heart rate and blood pressure were also calculated, as were the incidence of hypotension, hypertension, and tachycardia. Analysis was performed to identify whether non-record-keeping activity was a significant predictor of these hemodynamic outcomes. Results: Data were analyzed for 1,061 cases performed by 171 clinicians. Median (interquartile range) non-recordkeeping activity time was 14 (1, 38) min, representing 16 (3, 33) % of a median 80 (39, 143) min of procedure time. Variables associated with greater non-record-keeping activity included attending anesthesiologists working unassisted, longer case duration, lower American Society of Anesthesiologists status, and general anesthesia. Overall, there was no independent association between non-record-keeping workstation use and hemodynamic variability or aberrancies during anesthesia either between cases or within cases. Conclusion: Anesthesia providers spent sizable portions of case time performing non-record-keeping applications on anesthesia information management system workstations. This use, however, was not independently associated with greater hemodynamic variability or aberrancies in patients during maintenance of general anesthesia for predominantly general surgical and gynecologic procedures.

Internet use among anaesthesiologists: A cross-sectional survey

“…However, one study exploring the effect of non-record keeping activity during anaesthesia, including access to the internet, did not find significant haemodynamic variability or aberrancies from such practice. [ 4 ]…”

Smartphone use habits of anesthesia providers during anesthetized patient care: a survey from Turkey

“…In a similar study, the impact of the use of non-record-keeping Anesthesia Information Management System workstations on hemodynamic variability and aberrancies was explored. Anesthesia providers spent a significant proportion of their time using non-record-keeping Anesthesia Information Management System workstations, but that did not cause any significant hemodynamic variability or aberrancy in anesthetized patients during general surgery or gynecological procedures [ 21 ].…”

Distraction Implications for the Practice of Anesthesia

“…For each case, time spent accessing the internet through the anesthesia workstation was compared with data about each patient on variability of heart rate, blood pressure, the incidence of hypotension or hypertension, and tachycardia. 18 The authors were unable to find an association between internet use and hemodynamic outcomes. Some variables were associated with longer internet use including attending anesthesiologists working unassisted, longer case duration, lower ASA Physical Status, and administration of general anesthesia.…”