Kontakt 2020, 22(3):183-192 | DOI: 10.32725/kont.2020.011

Adverse events in anaesthesia careNursing - Review

Petra Bejvančická1,2,*, Iva Brabcová1
1 University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, České Budějovice, Czech Republic
2 University of West Bohemia, Faculty of Health Care Studies, Plzeň, Czech Republic

The goal of this review study was to summarize research conclusions on reported adverse events in anaesthesia care regarding paediatric and adult patients in the last 10 years.

Methods: Relevant sources were found in scientific databases EBSCO, PubMed, Science Direct, Wiley and Scopus. We used the following keywords: adverse events/incident/malpractice, anaesthesia, report. Other criteria for the inclusion of studies were: full-text, English language, publications that were no older than 10 years (2009-2019) and human related. In the end, we included 15 studies.

Results: The studies (analytical, prospective, retrospective, cohort, observational, systematic revisions and meta-analyses) mostly specify the areas and frequencies of reported adverse events and deal with the efficiency of report procedures and their implementation in clinical practice. The most frequent adverse events that occurred in anaesthesia care were respiration and cardiovascular problems and medical errors. The level of their occurrence varied by the patients' age.

Conclusions: The monitoring and assessment of adverse events is an effective instrument for the improvement of quality and safety in anaesthesia practical care. The main problem is the unwillingness of medical workers to participate in reporting adverse events and the incompatibility of adverse event databases in anaesthesia care.

Keywords: Adverse event; Anaesthesia; Patient safety; Perioperative care; Report

Received: January 10, 2020; Revised: January 10, 2020; Accepted: March 30, 2020; Prepublished online: April 16, 2020; Published: August 28, 2020  Show citation

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Bejvančická P, Brabcová I. Adverse events in anaesthesia care. Kontakt. 2020;22(3):183-192. doi: 10.32725/kont.2020.011.
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    References

    1. Bellolio MF, Gilani WI, Barrionuevo P, Murad MH, Erwin PJ, Anderson JR, Miner JR, Hess EP (2016a). Incidence of adverse events in adults undergoing procedural sedation in the emergency department: a systematic review and meta-analysis. Acad Emerg Med 23(2): 119-134. DOI: 10.1111/acem.12875. Go to original source... Go to PubMed...
    2. Bellolio MF, Puls HA, Anderson JL, Gilani WI, Murad MH, Barrionuevo P, et al. (2016b). Incidence of adverse events in paediatric procedural sedation in the emergency department: a systematic review and meta-analysis. BMJ Open 6(6): e011384. DOI: 10.1136/bmjopen-2016011384. Go to original source... Go to PubMed...
    3. Choy CY (2008). Critical incident monitoring in anaesthesia. Curr Opin Anaesthesiol 21(2): 183-186. DOI: 10.1097/ACO.0b013e3282f33592. Go to original source... Go to PubMed...
    4. ČSARIM (2017). Zásady bezpečné anesteziologické péče. Doporučený postup. [online] [cit. 2019-06-15]. Available from: https://www.csarim.cz/content/uploads/2018/11/doporuceny-postup-zasady-bezpecne-anesteziologicke-pece-2017.pdf
    5. D'Angelo R, Smiley RM, Riley ET, Segal S (2014). Serious Complications Related to Obstetric AnesthesiaThe Serious Complication Repository Project of the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 120(6): 1505-12. DOI: 10.1097/ALN.0000000000000253. Go to original source... Go to PubMed...
    6. De Graaff JC, Sarfo MC, Van Wolfswinkel L, van der Werff DB, Schouten AN (2015). Anesthesia-related critical incidents in the perioperative period in children; a proposal for an anesthesia-related reporting system for critical incidents in children. Paediatr Anaesth 25(6): 621-629. DOI:10.1111/pan.12623. Go to original source... Go to PubMed...
    7. de Santana Lemos C, de Brito Poveda V (2019). Adverse Events in Anesthesia: An Integrative Review. J Perianesth Nurs 34(5): 978-981. DOI: 10.1016/j.jopan.2019.02.005. Go to original source... Go to PubMed...
    8. Dias R, Dave N, Chiluveru S, Garasia M (2016). Critical incidents in paediatric anaesthesia: A prospective analysis over a 1 year period. Indian J Anaesth 60(11): 801. DOI: 10.4103/0019-5049.193658. Go to original source... Go to PubMed...
    9. Gaba D (2000). Anaesthesiology as a model for patient safety in health care. BMJ 320(7237): 785-788. DOI: 10.1136/bmj.320.7237.785. Go to original source... Go to PubMed...
    10. Gupta S, Naithani U, Brajesh SK, Pathania VS, Gupta A (2009). Critical incident reporting in anaesthesia: a prospective internal audit. Indian J Anaesth 53(4): 425. Go to PubMed...
    11. Habre W, Disma N, Virag K, Becke K, Hansen TG, Jöhr M, et al. (2017). Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observationalstudy in 261 hospitals in Europe. Lancet Respir Med 5(5): 412-425. DOI: 10.1016/S2213-2600(17)30116-9. Go to original source... Go to PubMed...
    12. Kurth CD, Tyler D, Heitmiller E, Tosone SR, Martin L, Deshpande JK (2014). National pediatric anesthesia safety quality improvement program in the United States. Anesth Analg 119(1): 112-121. DOI: 10.1213/ANE.0000000000000040. Go to original source... Go to PubMed...
    13. Levinson DR (2010). Adverse Events In Hospitals: National Incidence Among Medicare Beneficiaries. Office of Inspector General, U.S. Department of Health and Human Services. [online] [cit. 2019-05-13]. Available from: https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf
    14. MacLennan AI, Smith AF (2011). An analysis of critical incidents relevant to pediatric anesthesia reported to the UK National Reporting and Learning System, 2006-2008. Paediatr Anaesth 21(8): 841-847. DOI: 10.1111/j.1460-9592.2010.03421.x. Go to original source... Go to PubMed...
    15. Mahajan RP (2010). Critical incident reporting and learning. Br J Anaesth 105(1): 69-75. DOI: 10.1093/bja/aeq133. Go to original source... Go to PubMed...
    16. Mellin-Olsen J, Staender S, Whitaker DK, Smith AF (2010). Helsinki Declaration for Patient Safety in Anaesthesiology. Eur J Anaesthesiol 27(7): 592-597. DOI: 10.1097/EJA.0b013e32833b1adf. Go to original source... Go to PubMed...
    17. Mir Ghassemi A, Neira V, Ufholz LA, Barrowman N, Mulla J, Bradbury CL, Bould MD (2015). A systematic review and meta-analysis of acute severe complications of pediatric anesthesia. Paediatr Anaesth 25(11): 1093-1102. DOI: 10.1111/pan.12751. Go to original source... Go to PubMed...
    18. Munting KE, van Zaane B, Schouten AN, van Wolfswinkel L, de Graaff JC (2015). Reporting critical incidents in a tertiary hospital: a historical cohort study of 110,310 procedures. Can J Anaesth 62(12): 1248-1258. DOI: 10.1007/s12630-015-0492-y. Go to original source... Go to PubMed...
    19. Narasethkamol A, Charuluxananan S, Kyokong O, Premsamran P, Kundej S (2011). Study of model of anesthesia related adverse event by incident report at King Chulalongkorn Memorial Hospital. J Med Assoc Thai 94(1): 78-88. PMID: 21425732. Go to PubMed...
    20. Pokorná A, Mužík J, Štrombachová V (2018). Nežádoucí události při poskytování zdravotních služeb a jejich sledování na národní/centrální úrovni. Management rizik ve zdravotnictví 2(1): 16-21.
    21. Smith AF, Mahajan RP (2009). National critical incident reporting: improving patient safety. Br J Anaesth 103(5): 623-625. DOI: 10.1093/bja/aep273. Go to original source... Go to PubMed...
    22. Vlayen A, Verelst S, Bekkering GE, Schrooten W, Hellings J, Claes N (2012). Incidence and preventability of adverse events requiring intensive care admission: a systematic review.
    23. J Eval Clin Pract 18(2): 485-497. DOI: 10.1111/j.1365-2753.2010.01612.x. Go to original source... Go to PubMed...
    24. Williams GD, Muffly MK, Mendoza JM, Wixson N, Leong K, Claure RE (2017). Reporting of perioperative adverse events
    25. Wan S, Siow YN, Lee SM, Ng A (2013). Audits and critical incident reporting in paediatric anaesthesia: lessons from 75,331 anaesthetics. Singapore Med J 54(2): 69-74. DOI: 10.11622/smedj.2013027. Go to original source... Go to PubMed...
    26. by pediatric anesthesiologists at a tertiary children's hospital: targeted interventions to increase the rate of reporting. Anesth Analg 125(5): 1515-1523. DOI: 10.1111/j.1365-2753.2010.01612.x. Go to original source... Go to PubMed...

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