Document Detail

Simulation as an additional tool for investigating the performance of standard operating procedures in anaesthesia.
MedLine Citation:
PMID:  17704088     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In medicine, the use of standard operating procedures (SOPs) is often evaluated using questionnaires (QUES). However, QUES can have limitations with regard to method, thus leading to errors. Simulation (SIM) offers another opportunity for evaluation. We hypothesized that medical errors in the evaluation of SOPs using QUES could be detected by SIM, and that SIM is better qualified to demonstrate applied medicine. METHODS: We investigated the use of SOPs in anaesthesia, rapid sequence induction (RSI), by means of a QUES (n=42) or SIM (n=42) among 84 anaesthesiologists. Seven measures for preventing aspiration during induction of anaesthesia were examined and evaluated according to a predetermined points system. RESULTS: The average number of times that precautionary measures to prevent aspiration were mentioned in the QUES [4.8 (0.9)] or performed during SIM [5.0 (1.1)] did not differ between the two groups. Pre-oxygenation was the most frequently described or performed measure (95% vs 93%). However, other measures, such as avoidance of positive pressure ventilation (45% vs 85%), differed significantly between the two groups. CONCLUSIONS: QUES and SIM are powerful instruments for evaluating the implementation of SOPs such as RSI. SIM demonstrates automated behaviours and thus more clearly represents behaviours used in clinical practice than is possible to demonstrate using QUES. Using a combination of these two instruments, method errors resulting from the individual instruments can be reduced.
Y A Zausig; Y Bayer; N Hacke; B Sinner; W Zink; C Grube; B M Graf
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-08-17
Journal Detail:
Title:  British journal of anaesthesia     Volume:  99     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-15     Completed Date:  2007-11-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  673-8     Citation Subset:  IM    
Department of Anaesthesiology, Emergency and Intensive Care Medicine, University of Goettingen, Robert-Koch-Strasse 40, 37075 Goettingen, Germany.
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MeSH Terms
Anesthesia / adverse effects,  standards*
Clinical Competence
Computer Simulation*
Critical Pathways / standards
Intubation, Intratracheal / adverse effects,  methods,  standards
Medical Errors / prevention & control*
Oxygen Inhalation Therapy
Patient Simulation
Pneumonia, Aspiration / prevention & control*
Positive-Pressure Respiration
Safety Management / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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