Transcript Emergency Information Files

Emergency Information Files
In RHSC anaesthetic rooms
John Glen
ST3
Introduction
• Emergency Information
– Flipboards
– Wallcharts
• Feeling that current system could be
improved
• Casual inspection confirms this
How to audit?
• Lack of explicit criteria
• RCOA
– List of essential files
– Essential files in place
– No ‘extra’ files
– Means of identifying/rectifying deficiency
– Mechanism for updating
Initial Audit Sweep
• March 2009
• 9 areas
• Heterogeneity:
– 27 document types
– Range of 4 to 15 documents per location
– Median 11
Initial audit sweep
• Problems:
– Out of date files
– Missing files
– Inappropriate files
Results
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9
Red = Outdated
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9
Red = Inappropriate
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9
‘Inappropriate’
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Newton Valve cleaning
Theatre Booking
ADE valve
MRSA circular
Controlled drug circular
X = Missing
1
2
x
x
x
x
3
x
x
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x
x
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x
x
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x
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x
9
x
‘Essential’ Files
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•
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Advanced Life Support algorithm
Anaphylaxis
Local Anaesthetic Toxicity
Child Protection
Malignant Hyperthermia
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2
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5
6
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9
Improvement Phase
• Generate List
• Put files in place
• Mechanism for maintenance
List of essential files
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By ‘consensus’
List too large
Flowcharts in suspension files
Booklets etc. in folder
‘Folder Items’
• Trainee Handbook
• Guidelines for:
– Pain, blood, asthma, endocarditis, latex,
hickman line access
• Full child protection booklet
Improvement Phase
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•
•
•
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Files now in place
Identical layout in all anaesthetic rooms
Master file kept separately
Consultant will be ongoing ‘lead’
Plan for regular review
Future Project
• Roll out scheme to other areas
– Cardiology, CT, recovery
– ?A&E, ?ITU
• Decide what should be on wall
Worthwhile?
• Access to emergency info crucial
– Anaesthesia
– Paediatrics
• Rotating trainees
– Unfamiliar with paediatrics
– Unfamiliar with hospital
• Useful resource
Discussion
• Are you surprised at the initial results?
• Are these files a good idea?
• What should be in them?