Post on 13-Jan-2016
Emergency Information Files
In RHSC anaesthetic rooms
John Glen ST3
Introduction
• Emergency Information– Flipboards– Wallcharts
• Feeling that current system could be improved
• Casual inspection confirms this
How to audit?
• Lack of explicit criteria
• RCOA – List of essential files– Essential files in place– No ‘extra’ files– Means of identifying/rectifying deficiency– Mechanism for updating
Initial Audit Sweep
• March 2009
• 9 areas
• Heterogeneity:– 27 document types– Range of 4 to 15 documents per location– Median 11
Initial audit sweep
• Problems:– Out of date files – Missing files– Inappropriate files
Results1
2
3
4
5
6
7
8
9
1
2
3
4
5
6
7
8
9
Red = Outdated
1
2
3
4
5
6
7
8
9
Red = Inappropriate
‘Inappropriate’
• Newton Valve cleaning
• Theatre Booking
• ADE valve
• MRSA circular
• Controlled drug circular
X = Missing1
2
3
4
5
6
7
8
9
x x x
x
xx
xxx
x
x
xx
‘Essential’ Files
• Advanced Life Support algorithm
• Anaphylaxis
• Local Anaesthetic Toxicity
• Child Protection
• Malignant Hyperthermia
1
2
3
4
5
6
7
8
9
Improvement Phase
• Generate List
• Put files in place
• Mechanism for maintenance
List of essential files
• By ‘consensus’
• List too large
• Flowcharts in suspension files
• Booklets etc. in folder
‘Folder Items’
• Trainee Handbook
• Guidelines for:– Pain, blood, asthma, endocarditis, latex,
hickman line access
• Full child protection booklet
Improvement Phase
• Files now in place
• Identical layout in all anaesthetic rooms
• Master file kept separately
• Consultant will be ongoing ‘lead’
• Plan for regular review
Future Project
• Roll out scheme to other areas– Cardiology, CT, recovery– ?A&E, ?ITU
• Decide what should be on wall
Worthwhile?
• Access to emergency info crucial– Anaesthesia– Paediatrics
• Rotating trainees– Unfamiliar with paediatrics– Unfamiliar with hospital
• Useful resource
Discussion
• Are you surprised at the initial results?
• Are these files a good idea?
• What should be in them?