059 Encouraging standardisation of documentation in anaesthetics using the intensive care framework of central lines
Published Date: 01st May 2020
Publication Authors: Mahambrey T
The Faculty of Intensive Care Medicine (ICM) produced a series of World Health Organization (WHO) style checklists, the Local Safety Standards for Invasive Procedures (LocSSIPs), based on a framework from NHS England's Safety Domain to ensure safe practice of invasive procedures and prevent a never event [1, 2]. In Whiston Hospital, the LocSSIPs are used extensively within the intensive care department; however, the anaesthetic department's use of this framework was sporadic and subsequent documentation was inadequate to meet patient safety standards.
Methods
A staff survey was distributed to assess perceived documentation practices within ICM and anaesthetics. We then performed a retrospective notes audit, to assess documentation for the month of June 2019. We audited standards as set by the Intensive Care Society as well as noting the directorate of the operator and the department it was inserted.
Results
From the survey, 100% of ICM responses stated they knew what LocSSIPs were compared with 90% of anaesthetists. Ninety per cent of ICM staff stated using it all the time, only 60% of anaesthetists did. Comparatively from the notes we audited, none of the lines inserted outside of the intensive care unit used a LocSSIP, and the documentation of these lines failed to meet the key documentation points audited. None of the lines inserted by anaesthesia staff in the month of June had a LocSSIP. Ninety‐three per cent of central lines inserted by ICM staff used a LocSSIP and the majority of these met all set standards.
Discussion
Our results demonstrated that the use of a LocSSIP has a positive impact on documentation standards, as well as its use for safety standards in real time. There appears to be a lack of understanding of the benefit of using a LocSSIP within the anaesthetic directorate and its role in preventing never events. Improving education and awareness of this widely available tool will help in risk reduction and improve the handover between anaesthetics and ICM, as well as improve documentation standards. Following these results, we are implementing a series of changes including training sessions, physical prompts on central line equipment located outside of the intensive care unit and encourage prompts in handover between the two specialities. We hope this will have a positive impact on patient safety and documentation standards.
Luyt, J; Buffery, C; Mahambrey, T. (2020). Encouraging standardisation of documentation in anaesthetics using the intensive care framework of central lines. Anaesthesia. 75 (S2), 38