Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2016.07.008
Brazilian Journal of Anesthesiology
Scientific Article

The practice of postanesthesia visits - a questionnaire study

A prática de visitas pós-anestésicas - estudo de um questionário

Tobias Fink; Hauke Rensing; Thomas Volk; Ragnar Huhn; Alexander M. Mathes

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Abstract

Abstract Background and objective Regular postanesthesia visits allow the detection of anesthesia related complications and increase patient satisfaction. Consequently, the performance of postanesthesia visits has been recommended after certain types of anesthesia. However, no data is available concerning the current practice of postanesthesia visits. Therefore, this study was designed to investigate quantity, organization, contents, significance and problems of postanesthesia visits in Germany. Methods For this prospective closed-design survey, a questionnaire, consisting of 13 questions, was designed and tested for objectivity, reliability and validity. Subsequently, 3955 registered anesthesiologists were contacted via email to answer this survey. Results Return rate was 31.4%; 958 questionnaires were included in the study. Only a small portion of patients was estimated to receive a postanesthesia visit (median: 20.0%). In hospitals with a specific postanesthesia visit service, this number was significantly higher (median: 65.0%, p < 0.001) vs. no postanesthesia visit service. Postanesthesia visits usually lasted less than 5 minutes (60.0%), and were typically conducted on the day of surgery (48.0%), after regular working hours (55.0%). 38.0% of the respondents reported to detect perioperative complications intermittently during their visits. While 98.0% of all respondents believe that postanesthesia visits improve the quality of their own work, 86.0% of the participants complain a lack of time for this task. Conclusions Our survey indicates that current working conditions prevent a regular postanesthesia visit routine. Considering the high appreciation of postanesthesia visits by anesthesiologists, as well as the relevant incidence of postoperative complications detected during these visits, it seems desirable to consider organizational improvements for postanesthesia care.

Keywords

Postanesthesia visit, Anesthesia, Complication, Questionnaire

Resumo

Resumo Justificativa e objetivo As visitas regulares pós-anestesia (VPA) permitem detectar complicações relacionadas à anestesia e aumentar a satisfação do paciente. Portanto, a VPA é recomendada após certos tipos de anestesia. Porém, não há dados disponíveis sobre a prática atual de VPA. Logo, este estudo foi projetado para investigar a quantidade, a organização, o conteúdo, a significância e os problemas da VPA na Alemanha. Método Para esta pesquisa de natureza fechada e prospectiva, um questionário com 13 perguntas foi criado e testado para identificar a objetividade, confiabilidade e validade. Posteriormente, 3.955 anestesiologistas registrados foram contatados via e-mail para responder a pesquisa. Resultados A taxa de retorno foi de 31,4%; 958 questionários foram incluídos no estudo. Apenas uma pequena parte dos pacientes foi designada para receber uma VPA (mediana: 20%). Em hospitais com serviço específico de VPA, esse número foi significativamente maior (mediana: 65%, p < 0,001) vs. ausência de serviço de VPA. As VPA normalmente duraram menos de cinco minutos (60%) e foram tipicamente conduzidas no dia da cirurgia (48%), após o turno normal de trabalho (55%). Dentre os que responderam o questionário, 38% relataram detectar complicações perioperatórias de forma intermitente durante as visitas. Enquanto 98% dos entrevistados acreditam que as VPA melhoram a qualidade de seu próprio trabalho, 86% se queixam de falta de tempo para essa tarefa. Conclusões Nossa pesquisa indica que as condições atuais de trabalho impedem a feitura rotineira de VPA. Considerando a alta valorização das VPA por anestesiologistas, bem como a incidência relevante de complicações no pós-operatório detectadas durante essas visitas, parece desejável considerar melhorias organizacionais para a assistência após a anestesia.

Palavras-chave

Visita pós-anestésica, Anestesia, Complicação, Questionário

References

Hesse F, Lendle L, Schoen R. Allgemeinnarkose und örtliche Betäubung. Zusammenfassende Darstellung für die Praxis auf pharmakologischer und klinischer Grundlage. 1934.

Witte W. Premedication, preoperaive and postoperative visits. Importance as reflected in anaesthesiology textbooks. Anaesthesist. 2007;56:1252-6.

Dahmen KG, Albert DM. An approach to quality management in anaesthesia: a focus on periopertive care and outcome. Eur J Anaesthesiol Suppl. 2001;23:4-9.

Capuzzo M, Gilli G, Paparella L. Factors predictive of patient satisfaction with anesthesia. Anesth Analg. 2007;105:435-42.

Bothner U, Schwilk B, Steffen P. Perioperative monitoring of the course of anesthesia, the postanesthesia visit and inquiry of patient satisfaction. A prospective study of parameters in process and outcome quality in anesthesia. Anasthesiol Intensivmed Notfallmed Schmerzther. 1996;31:608-14.

Bauer M, Böhrer H, Aichele G. Measuring patient satisfaction with anaesthesia: perioperative questionnaire versus standardised face-to-face interview. Acta Anaesthesiol Scand. 2001;45:65-72.

Zvara DA, Nelson JM, Brooker RF. The importance of the postoperative anesthetic visit: do repeated visits improve patient satisfaction or physician recognition?. Anesth Analg. 1996;83:793-7.

Gebremedhn EG, Chekol WB, Amberbir WD. Patient satisfaction with anaesthesia services and associated factors at the University of Gondar Hospital, 2013: a cross-sectional study. BMC Res Notes. 2015;8:377.

Saal D, Heidegger T, Nuebling M. Does a postoperative visit increase patient satisfaction with anaesthesia care?. Br J Anaesth. 2011;107:703-9.

Bajwa SJS, Takrouri MSM. Post-operative anesthesia rounds: need of the hour. Anesth Essays Res. 2013;7:291-3.

Schiff JH, Fornaschon AS, Frankenhauser S. The Heidelberg peri-anaesthetic questionnaire-development of a new refined psychometric questionnaire. Anaesthesia. 2008;63:1096-104.

Auquier P, Pernoud N, Bruder N. Development and validation of a perioperative satisfaction questionnaire. Anesthesiology. 2005;102:1116-23.

Caljouw MA, van Beuzekom M, Boer F. Patient's satisfaction with perioperative care: development, validation, and application of a questionnaire. Br J Anaesth. 2008;100:637-44.

Capuzzo M, Landi F, Bassani A. Emotional and interpersonal factors are most important for patient satisfaction with anaesthesia. Acta Anaesthesiol Scand. 2005;49:735-42.

Hisom A, Sorgatz H. Durchführung von Analgesie- und Anästhesie in der Geburtshilfe. Entschließungen - Empfehlungen - Vereinbarungen: Ein Beitrag zur Qualitätssicherung in der Anästhesiologie. 2011:183-90.

Schneider G. Intraoperative awareness. Anästhesiol Intensivmed Notfallmed Schmerther. 2003;38:75-84.

Hisom A, Sorgatz H. Vereinbarung über die Zusammenarbeit bei der operativen Patientenversorgung des Berufsverbandes Deutscher Anästhesisten und des Berufsverbandes der Deutschen Chirurgen. Entschließungen - Empfehlungen - Vereinbarungen: Ein Beitrag zur Qualitätssicherung in der Anästhesiologie. 2011:9-12.

Hisom A, Sorgatz H. Vereinbarung über die Zusammenarbeit in der Gynäkologie und Geburtshilfe. Entschließungen - Empfehlungen - Vereinbarungen: Ein Beitrag zur Qualitätssicherung in der Anästhesiologie. 2011:19-24.

Hisom A, Sorgatz H. Vereinbarung über die Zusammenarbeit bei der operativen Patientenversorgung des Berufsverbandes Deutscher Anästhesisten und des Berufsverbandes der Ärzte für Orthopädie. Entschließungen - Empfehlungen - Vereinbarungen: Ein Beitrag zur Qualitätssicherung in der Anästhesiologie. 2011:31-6.

Hisom A, Sorgatz H. Vereinbarung über die Zusammenarbeit in der HNO-Heilkunde. Entschließungen - Empfehlungen - Vereinbarungen: Ein Beitrag zur Qualitätssicherung in der Anästhesiologie. 2011:25-6.

Guidelines for patient care in anesthesiology. 2011:1-4.

Simpson DK, Walburn B. Post-operative care. Raising the Standard: a compendium of audit recipes. 2012:128-9.

Klock PA, Roizen MF. More or better - educating the patient about the anaesthesiologist's role as perioperative physician. Anesth Analg. 1996;83:793-7.

Foss NB, Christensen DS, Krasheninnikoff M. Post-operative rounds by anaesthesiologists after hip fracture surgery: a pilot study. Acta Anaesthesiol Scand. 2006;50:437-42.

Nulty DD. The adequacy of response rates to online and paper surveys: what can be done?. Assess Eval High Educ. 2008:301-14.

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