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Domain B: safety and quality Attribute 4: put into effect systems to protect patients and improve care Standards ➣➣ An anaesthetist must respond constructively to the outcome of audit, appraisals and performance reviews or assessments. ❏❏ An anaesthetist must participate in the annual appraisal process. ➣➣ An anaesthetist must take part in systems of quality assurance and quality improvement. ❏❏ An anaesthetist should co-operate with internal and external reviews. ➣➣ An anaesthetist must comply with risk management and clinical governance procedures. ❏❏ An anaesthetist should participate in relevant national reporting schemes. ❏❏ An anaesthetist must cooperate with legitimate requests for information from organisations monitoring public health. ➣➣ An anaesthetist must provide information for confidential enquiries and significant event reporting. ❏❏ An anaesthetist must report suspected adverse drug reactions. ➣➣ An anaesthetist must ensure arrangements are made for the continuing care of the patient where necessary. ❏❏ An anaesthetist should ensure that on-call teams have a range of skills sufficient to manage any reasonable predictable clinical eventuality. ❏❏ An anaesthetist must write clear instructions for post-operative care including pain relief, oxygen therapy and fluid management as necessary. ❏❏ An anaesthetist must ensure that there is continuous supervision of a patient receiving anaesthesia. If in exceptional circumstances you are required to leave the theatre, you must ensure that the patient is supervised by another anaesthetist or appropriately trained assistant following a handover in accordance with AAGBI guidelines.* ❏❏ An anaesthetist must ensure that recovering patients are observed on a one-to-one basis by an anaesthetist, recovery nurse or other properly trained member of staff in accordance with AAGBI guidelines** until they have regained airway control and cardiovascular stability and are able to communicate. Page 14 | The Good Anaesthetist | Standards of Practice for Career Grade Anaesthetists
Domain B: safety and quality Attribute 4: put into effect systems to protect patients and improve care Explanatory notes Anaesthetists have a duty of care in ensuring patient safety at all times. This duty applies at both systems and individual patient care levels. Taking part in data collection exercises and reporting significant events and complications are vital in developing an organisational culture whereby issues that could potentially affect patient safety can be systematically identified. The duty of care extends, whether you are on or off duty, to making sure that competent members of staff are involved in the provision of safe and continuous care of patients. Patient safety, including measures to foresee and prevent any adverse incidents that may arise, should be given due consideration in any service or performance review, including the annual appraisal. Related guidelines and sources of information The General Medical Council ›› Raising concerns about patient safety, 2008. The Royal College of Anaesthetists ›› Syringe labelling in critical care areas, 2004. The Association of Anaesthetists of Great Britain and Ireland ›› Controlled drugs in perioperative care, 2006. ›› Immediate postanaesthetic recovery, 2002.** ›› Interhospital transfer. AAGBI safety guideline, 2009. ›› Provision of anaesthetic services in magnetic resonance units, 2002. ›› Recommendations for standards of monitoring during anaesthesia and recovery (4th edition), 2007.* ›› Recommendations for the safe transfer of patients with brain injury, 2006. ›› Theatre efficiency: safety, quality of care and optimal use of resources, 2003. Prepared by the Joint Committee on Good Practice | Page 15
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Recommendations for the Safe Transf
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CONTENTS Section I Summary and Reco
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SECTION II - BACKGROUND In 1996 the
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SECTION IV - ORGANISATION AND COMMU
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SECTION V - STAFFING REQUIREMENTS A
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A p p ropriate re s p i ra t o ry s
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SECTION VII - THE TRANSFER The tran
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SECTION VIII - EQUIPMENT AND DRUGS
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SECTION IX - EDUCATION AND TRAINING
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SECTION X - RESOURCE IMPLICATIONS F
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APPENDIX I INDICATIONS FOR INTUBATI
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APPENDIX III ADDITIONAL INFORMATION
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AAGBI SAFETY GUIDELINE Suspected An
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GUIDELINES Suspected Anaphylactic R
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Suspected anaphylactic reactions as
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Storage of Drugs in Anaesthetic Roo
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Storage of Drugs in Anaesthetic Roo
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This guideline was originally publi
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Anaesthesia 2015 Checketts et al. |
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Anaesthesia 2016, 71, 1503 Correcti
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Membership of the working party Dr
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1. Summary 1.1 Safety, quality and
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3. Responsibility of anaesthetists
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3.4 The Trust - Medical Devices Man
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4. Standards 4.1 Medical Devices Di
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5. Responsibility of manufacturers
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6. Choosing and trialling equipment
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equipment officer is encouraged to
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EU procurement thresholds Threshold
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When negotiating a purchasing agree
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9. Shared equipment Many types of e
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Third party servicing is another op
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11. Replacement 11.1 Planned equipm
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number of re-uses (e.g. re-usable L
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Where new equipment is purchased th
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14. Incident reporting and investig
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available from www.hse.gov.uk 14.4
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DB DoH EBME EC EU FRCA HN HSE IEC I
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8. OPSI. Statutory Instrument 2006
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Eire Tel: 00353 1 676 4971 Website:
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Peri-operative management of the ob
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Guidelines Peri-operative managemen
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Recommendations 1 Every hospital sh
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35 30 25 Prevalance (%) 20 15 10 5
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is an increased incidence of prolon
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Figure 2 Relationship between total
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techniques, and when used with neur
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Table 5 The STOP-BANG screening que
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Intra-operative care Preparation of
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Figure 3 Ramping position for obese
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eturn of airway reflexes with desfl
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Table 6 Dosing schedule for thrombo
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A review and meta-analysis by the S
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numbers of staff are needed to roll
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Table 7 Equipment for managing obes
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11. Schneider HJ, Glaesmer H, Klots
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44. Edholm D, Kullberg J, Haenni A,
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75. McKay RE, Malhotra A, Cakmakkay
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21 Portland Place, London, W1B 1PY
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Anaesthesia 2015 Barker et al. | Gu
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Out of Hours Activity (Anaesthesia)
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Considerations for anaesthetists Th
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OAA / AAGBI Guidelines for Obstetri
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Contents 1. Key recommendations 2 2
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2. Introduction This is the third v
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Recommendations Medical staff The t
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appointed directly from other count
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Peripartum care Pre-operative asses
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Intravenous patient-controlled opio
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depression. In the absence of contr
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of clinical deterioration, as recom
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5. Training and education Each obst
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• Skills and drills training: ana
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• The midwife caring for a woman
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7. Support services, equipment, fac
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Equipment for PCA must be available
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8. The future The delivery of healt
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The following national guidelines s
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19. Obstetric Anaesthetists’ Asso
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At the first meeting held on 9 th M
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Methods to estimate/establish publi
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Recommendations The WP recommends:
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Anaesthesia, 2007, 62, pages 1199-1
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Anaesthesia, 2007, 62, pages 1199-1
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OPTION 3 - PRESUMED CONSENT. ‘Pre
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Power of Attorney) while requiring
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Needle-stick injury and HIV testing
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egain capacity, and the absence of
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treatment if it was understood that
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Management of hypertension before e
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AAGBI Safety Guideline Management o
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Malignant Hyperthermia Crisis Task
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MEMBERSHIP OF THE WORKING PARTY Dr
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Section 1 Recommendations 1. Transf
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Section 3 Introduction In 1997 it w
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This process may require many telep
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Section 6 Accompanying the patient
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Section 7 Monitoring, drugs and equ
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heavily congested areas, but not al
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APPENDIX 1 Departure checklist Do a
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The Association of Anaesthetists of
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