Qualität und sichere Anästhesie für alle Kinder

Purpose of reviewThe aim of this study was to review the evolution of safety and outcomes in paediatric anaesthesia, identify gaps in quality and how these gaps may influence outcomes, and to propose a plan to address these challenges through the creation of universal outcome standards and a paediatric anaesthesia designation programme.Recent findingsTremendous advancements in the quality and safety of paediatric anaesthesia care have occurred since the 1950 s, resulting in a near absence of documented mortality in children undergoing general anaesthesia. However, the majority of data we have on paediatric anaesthesia outcomes come from specialized academic institutions, whereas most children are being anaesthetized outside of free-standing children's hospitals.SummaryAlthough the literature supports dramatic improvements in patient safety during anaesthesia, there are still gaps, particularly in where a child receives anaesthesia care and in quality outcomes beyond mortality. Our goal is to increase equity in care, create standardized outcome measures in paediatric anaesthesia and build a verification system to ensure that these targets are accomplished. The time has come to benchmark paediatric anaesthesia care and increase quality received by all children with universal measures that go beyond simply mortality.

Section: Gaps and Challenges In Quality In Paediatric Anaesthesia Carementioning

confidence: 99%

Beyond mortality: definitions and benchmarks of outcome standards in paediatric anaesthesiology

Olbrecht

Engelhardt²,

Tobias

2023

“…However, anaesthesia-related complications in children are common and some authors estimate a 10-fold higher complication rate than in adults resulting an increased mortality [2]. Children who experience anaesthesia-related complications are often healthy [3,4,5 ▪▪ ,6–8,9 ▪▪ ,10]. The reasons for this increased morbidity and mortality are numerous and frequently discussed in the literature [2,11–15].…”

Section: Introductionmentioning

confidence: 99%

Quality and safe anaesthesia for all children

Machotta

Hansen

Weiß

2023

Self Cite

Purpose of reviewIn 1989, the United Nations passed the ‘Convention on the Rights of the Child’ (UNCRC) and, among others claimed the highest attainable standard of health for children and consequently the highest level of safety and quality in paediatric anaesthesia. SAFETOTS (Safe Anesthesia For Every Tot, www.safetots.org), an initiative of international active paediatric anaesthetists, has derived 10 rights, the ‘10 R’ of children undergoing anaesthesia care, which are critical for the well being of the child.Recent findingsThe current situation in paediatric anaesthesia care in Europe does not always meet the requirements demanded by the UNCRC. Anaesthesia-related complications in children are still persistent. Anaesthesiologists are frequently asked to provide care for newborns, infants and small children without having sufficient child-specific expertise, resulting in an increased morbidity and mortality.SummaryThis article will explain these statutes of children's rights and their implications for everyday paediatric anaesthesia. Furthermore, it will also express the institutional and political changes that are needed to guarantee children their right to enjoy the highest attainable standard of health.

“…The cause of allocating procedural sedation along different specialists is variation in clinical structures, and although it may be useful for optimising the use of personnel resources, the highest safety and quality for children and their caregivers should be guaranteed, regardless of sedation provider [3]. Standards for equipment, monitoring and peri-procedural management are part of the framework for the well tolerated conduct of procedural sedation.…”

Section: Introductionmentioning

confidence: 99%

Safety and quality in paediatric procedural sedation: what really matters?

Röher

Becke‐Jakob

Eich

2023

Purpose of reviewThis review gives an overview of the safety aspects for paediatric procedural sedation and a discussion of possibilities for optimizing structure, processes and outcomes.Recent findingsProcedural sedation in paediatric patients is performed by providers of different specialties and compliance with safety standards is a basic requirement regardless of provider specialty. This includes preprocedural evaluation, monitoring, equipment and profound expertise of sedation teams. The choice of sedative medications and the possibility of incorporating nonpharmacological methods play an important role for optimal outcome. In addition, an ideal outcome from the patient's perspective includes optimized processes and clear and empathetic communication.SummaryInstitutions providing paediatric procedural sedation must ensure the comprehensive training of sedations teams. Furthermore, institutional standards for equipment, processes and optimal choice of medication depending on performed procedure and comorbidities of the patient must be established. At the same time, organizational and communication aspects should be considered.