Manual record keeping is not necessary for anesthesia vigilance

Loeb, Robert G.

doi:10.1007/bf01627413

Cited by 31 publications

(12 citation statements)

References 13 publications

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“…Weinger and Englund [55] called for automation, but with ''intelligence,'' in the form of alarms and visual alerts to call attention to deviation from normative values. Weinger and Loeb [13,15,57] attempted to directly study the vigilance of anesthesia residents through the use of a ''vigilance task'' and a second anesthesia provider to act as a scribe. Loeb's research was criticized by Woods et al [56], who indicated that a ''scribe'' was another human anesthesia provider who could participate in the delivery of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

Davis

Green

Colquhoun

et al. 2012

J Clin Monit Comput

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Anesthesia information management systems (AIMS) are rapidly gaining widespread acceptance. Aggressively promoted as an improvement to manual-entry recordkeeping systems (MERS) in the areas of accuracy, quality improvement, billing and vigilance, these systems record all patient vital signs and parameters, providing a legible hard copy and permanent electronic record. Concern exists that the practitioner may be less vigilant unless this data is recorded manually. This study's purpose was to determine if vigilance, as measured by the ability to recall important data, is influenced by the method of recordkeeping. This study analyzed differences in the accuracy of Certified Registered Nurse Anesthetists' (CRNAs) recall of specific patient variables during the course of an actual anesthetic case. CRNAs using AIMS were compared to CRNAs using MERS. Accuracy of recalled values of 10 patient variables was measured: highest and lowest values for heart rate, systolic blood pressure, inspiratory pressure, and end-tidal carbon dioxide levels, lowest oxygen saturation and total fluid volume. Four tertiary care facilities participated in this research; two of which used MERS, two utilized AIMS. A total of 214 subjects participated in this study; 106 in the computerized recordkeeping group, and 108 in the manual entry recordkeeping group. Demographic covariates were analyzed to ensure homogeneity between groups and facilities. No significant statistical differences were identified between the accuracy of recall among the groups. There was no difference in the accuracy of practitioners' recall of patient variables when using computerized or manual entry recordkeeping systems, suggesting little impact on vigilance.

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Section: Discussionmentioning

confidence: 99%

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

Davis

Green

Colquhoun

et al. 2012

J Clin Monit Comput

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show abstract

“…Previous work has demonstrated that AIMS use was associated with maintenance of practitioner vigilance, compared with manual records. 7,8 A study of intraoperative reading of printed material unrelated to the case revealed that such reading occurred during anesthesia maintenance in 35% of cases, but did not affect response time to a simulated alarm. 9 An investigation that characterized anesthesia activities demonstrated that 75% of intraoperative time was spent performing secondary or indirect activities rather than observing the physiological state of the patient.…”

Section: Discussionmentioning

confidence: 99%

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

2012

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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.

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“…Documenting while administering anesthesia is diffi cult, regardless of whether the record is kept manually or electronically [26]. Some procedures, including transesophageal echocardiography, have been associated with increased workload and decreased vigilance [10].…”

Section: Error Reduction and Patient Safetymentioning

confidence: 99%

The anesthesia information management system for electronic documentation: what are we waiting for?

Bloomfield

Feinglass

2008

J Anesth

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The anesthesia information management system (AIMS) will be part of the future of healthcare. An electronic medical records system or AIMS will provide clear and concise information and have the potential to integrate information across the entire hospital system, improve quality of care, reduce errors, decrease risks, and improve revenue capture. The practice of anesthesia requires a medical record system that can capture data in real time. In this article, we describe challenges that must be overcome to establish an efficient electronic medical record system for anesthesiology.

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Manual record keeping is not necessary for anesthesia vigilance

Cited by 31 publications

References 13 publications

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

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

The anesthesia information management system for electronic documentation: what are we waiting for?

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