{Reference Type}: Journal Article {Title}: A risk management audit: are we complying with the national guidelines for sedation by non-anaesthetists? {Author}: Nicol MF; {Journal}: J Accid Emerg Med {Volume}: 16 {Issue}: 2 {Year}: Mar 1999 暂无{DOI}: 10.1136/emj.16.2.120 {Abstract}: OBJECTIVE: To assess the effect of a preprinted form in ensuring an improved and sustained quality of documentation of clinical data in compliance with the national guidelines for sedation by non-anaesthetists.
METHODS: The process of retrospective case note audit was used to identify areas of poor performance, reiterate national guidelines, introduce a post-sedation advice sheet, and demonstrate improvement.
METHODS: Emergency Department, Musgrove Park Hospital, Taunton.
METHODS: Forty seven patients requiring sedation for relocation of a dislocated shoulder or manipulation of a Colles' fracture between July and October 1996 and July and October 1997.
METHODS: Evidence that the following items had been documented: consent for procedure, risk assessment, monitored observations, prophylactic use of supplementary oxygen, and discharging patients with printed advice. Case note review was performed before (n = 23) and after (n = 24) the introduction of a sedation audit form. Notes were analysed for the above outcome measures. The monitored observations analysed included: pulse oximetry, respiratory rate, pulse rate, blood pressure, electrocardiography, and conscious level.
RESULTS: Use of the form significantly improved documentation of most parameters measured.
CONCLUSIONS: Introduction of the form, together with staff education, resulted in enhanced documentation of data and improved conformity with national guidelines. A risk management approach to preempting critical incidents following sedation, can be adopted in this area of emergency medicine.