The Thai anesthesia incidents study (THAI study) of anesthetic adverse outcomes

Charuluxananan, S.; Punjasawadwong, Yodying; Suraseranivongse, Suwannee; Srisawasdi, Sureerat; Kyokong, Oranuch; Chinachoti, Thitima

doi:10.1097/00003643-200606001-00901

Cited by 20 publications

(29 citation statements)

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“…Forty-two percents of respondents stated that more than half of their patients were firstly evaluated just before providing anesthesia. This result was similar to the rate of pre-anesthetic visit of 38% in the THAI Study [6]. The rate of preanesthetic evaluation for difficult airway in this survey (88%) was higher than that of the Thai Study (70%) in 2005 [6].…”

Section: Discussionsupporting

confidence: 81%

“…However, patient safety is not only monitored by measurement of mortality rates. The rates of anesthesia complication remains elevated [7,9]. Moreover, anesthesia can still be responsible for severe adverse events resulting in permanent damage or for unplanned ICU admission [19].…”

Section: Discussionmentioning

confidence: 99%

“…In 2004, the RCAT initiated the Thai Anesthesia Incidents Study (THAI Study) [6,7] with more than 30-substudies of specific anesthesia adverse events. RCAT started the registry of anesthesia services in 20 hospitals, and expanded the study sites to 51 hospitals across Thailand, namely the Thai Anesthesia Incidents Monitoring Study (Thai AIMS) [8,9].…”

Section: Objectives Mcintosh and Macariomentioning

confidence: 99%

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Quality and patient safety in anesthesia service: Thai survey

et al. 2010

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Background:The Royal College of Anesthesiologists of Thailand (RCAT) performed large-scale epidemiologic study of anesthesia-related complications and national incidents study in 2004 and 2007, respectively. Objectives: Evaluate the anesthesia service in Thailand with regard to status of quality and patient safety. Material and methods: A pre-planned structured questionnaire regarding demographic, administrative, preanesthetic, intraoperative postanesthetic variables and complications were requested to be filled in by nurse anesthetists attending the refresher course lecture of RCAT in February 2008. Descriptive statistics was used. Results: Three hundred fifty questionnaires were given and 341 respondents (97%) returned the questionnaires. Most of the respondents (90%) worked in government section. Thirty percent of respondents practiced in hospital without medical doctor anesthesiologist and 58% of nurse anesthetists worked in hospitals that have been accredited. Forty-six percent of respondents reported unavailability of a 24-hour recovery room. The questionnaires revealed of inadequacy of anesthesia personnel (64%), inadequate supervision during emergency condition (53%), inadequacy of patient information regarding anesthesia (57-69%), and low opportunity for patient to choose choice of anesthesia (19%). The commonly used monitoring were pulse oximeter (92% of respondents) and electrocardiography (63%). One-third (32%) of respondents had to provide of anesthesia for patients with insufficient NPO (non per oral) time. Common problems that the respondents experienced were miscommunication (49%), intraoperative cardiac arrest during the past year (35%), error related to infusion pump (24%) and medication error (8%). Fifty-five percent of respondents had to monitor at least one patient per month receiving spinal anesthesia. Conclusion: Suggested strategies for quality and patient safety improvement in anesthesia service are increasing personnel, increasing 24-hour recovery room, improvement of supervision, improvement of communication, compliance to guidelines and improvement of nurse anesthetist's training regarding monitoring patient receiving spinal anesthesia and cardiopulmonary resuscitation.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Objectives Mcintosh and Macariomentioning

confidence: 99%

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Quality and patient safety in anesthesia service: Thai survey

et al. 2010

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“…The most common type of incident we found in our study was airway and respiratory events which is similar to some studies [11] [21] [22] although others have found cardiovascular incidents to be more common [18], this is likely due to differences in patient population and lack of standardization in types of incidents.…”

Section: Characteristics Of Incidentssupporting

confidence: 88%

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Zeng¹,

Ng²,

Thong³

2016

IJCM

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Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported incidents in a tertiary hospital over a 4-year period. Results: A total of 441 incidents were reported out of 98,502 anesthetics performed during the study period. Of these incidents, 67 resulted in no harm caused, 116 with unanticipated ICU admissions and 20 mortalities. The odds of having a critical incident increased with ASA status: from an odds ratio of 2.08 (95% CI: 1.58 to 2.74) for ASA 2 patients compared to ASA1, to OR of 13.70 (5.91 to 31.74) in ASA 5 compared to ASA 1. Critical incidents also have higher odds occurring out of hours (OR 1.7 (1.45 to 2.23) compared to daytime hours (08:00-17:00). They occurred most commonly in maintenance phase (142, 32.7%), followed by induction (120, 27.6%). The most common types of incidents include airway and respiratory (110, 24.9%) followed by drug related incidents (67, 15.2%). Human error was attributed as a significant contributing factor in 276 incidents (61.5%) followed by patient factors in 112 incidents (25.4%). Mitigating factors such as vigilance by staff involved were significant in 136 incidents (30.3%). Conclusion: Higher ASA status appears to be the most important factor associated with actual or potential patient harm in our study. Also significant, was time of incident, with incidents more likely out of hours. Critical incident reporting is a valuable part of quality assurance. We should continue to invest in incident reporting, incident analysis and improvement plans.

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“…To provide additional insight into the interpretation of our results, we compared hospital statistics on surgery and anesthesia from Vietnam with those reported from other East Asian, Southeast Asian, and non-Asian countries (Table 4). Two reports from Italy-one in which classic medical indicators were used [22] and another in which more comprehensive assessment tools were applied, including patient satisfaction and staff mental state [3]-and one each from Hong Kong [11], Thailand [23,24], and Japan [25] are reported. The proportion of major surgical cases at UMC was approximately the same as that in Italy.…”

Section: Clinical Assessments and International Comparisonmentioning

confidence: 99%

Perception of anesthesia safety and postoperative symptoms of surgery patients in Ho Chi Minh City, Vietnam: a pioneering trial of postoperative care assessment in a developing nation

Soejima

Goto

et al. 2010

Environ Health Prev Med

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Objectives Vietnamese patients' views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients' impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patientcentered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24 h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting the patients' perceptions of anesthesia safety, postoperative symptoms, and pain was examined using multiple logistic regression analysis.Results The perception of a low level of anesthesia safety by 105 patients (59%) was associated with a low satisfaction in terms of preoperative anesthesia education [odds ratio (OR) 15.03], poor interaction with family (OR 21.80), and absence of perioperative adverse effects (OR 6.10). The occurrence of three or more postoperative symptoms (59%) was associated with a surgery C3 h (OR 2.00). Severe pain at 2 h (25%) post-surgery was associated with male gender (OR 2.08) and open surgery (OR 3.30), no reduction in pain at 24 h (51%) was associated with female gender (OR 2.08), and experiencing as much or more pain than expected (46%) was associated with blood loss C100 ml (OR 1.04) and low satisfaction with staff communication (OR 1.90). Conclusion Our results suggest that facilitating patients' communication with staff and families and paying attention to gender differences in pain management are important factors to take into consideration when the aim is to improve perioperative care in the rapidly developing healthcare environment of Vietnam.

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The Thai anesthesia incidents study (THAI study) of anesthetic adverse outcomes

Cited by 20 publications

References 0 publications

Quality and patient safety in anesthesia service: Thai survey

Quality and patient safety in anesthesia service: Thai survey

Analysis of Critical Incidents during Anesthesia in a Tertiary Hospital

Perception of anesthesia safety and postoperative symptoms of surgery patients in Ho Chi Minh City, Vietnam: a pioneering trial of postoperative care assessment in a developing nation

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