Perioperative care given before and after surgery covers a broader landscape nowadays. It takes place in hospitals, in surgical centers attached to hospitals, in freestanding surgical centers and in various health care providers’ offices.
International Standards for a Safe Practice of Anesthesia
These Standards of Care are recommended to anesthesia specialists throughout the world. For some, these Standards will represent a future goal, while for others they may already have been implemented and be regarded as mandatory.
The Standards were developed by the International Task Force on Anesthesia Safety and adopted by the World Federation of Societies of Anesthesiologists on June 13, 1992. As the practice and technology evolve, these standards will need revision. Click here to review the Standards of Care.
Post Anesthesia Patient Handoffs
Anesthesia providers participate in patient handoffs for each patient under their care and each handoff has the potential for poor communication that may jeopardize patient safety. The ASA defines the standard as the patient to be re-evaluated and a verbal report given by a member of the anesthesia care team who accompanies the patient to the responsible receiving nurse. The quality and quantity of information exchanged can still be variable, so it is important to be thorough.
In efforts to standardize the Post Anesthesia Care Unit (PACU) handoff, some institutions have adopted standardized handoff checklists. A succinct checklist could expedite the handoff process while increasing meaningful communication between the anesthesia specialist and PACU nurse.
ERAS and Pain Management
The opioid epidemic that has spread across the United States as a result of the misuse, abuse, and diversion of prescribed opioid medications has left hospitals, clinicians, anesthesia medical groups and health systems with the responsibility of finding solutions, particularly alternatives to opioid administration for perioperative pain management.
Enhanced Recovery After Surgery (ERAS) initiatives are important in helping build safety and increase patient satisfaction in hospital systems. ERAS protocols provide transformative plans for minimizing pain, expediting patient recovery, and decreasing perioperative complications and hospital length of stay. In addition to improving patient outcomes, ERAS care maps and standardization have resulted in dramatic declines in opioid usage in surgical patients.
An essential component of all ERAS protocols is multimodal pain management. Unlike traditional opioid-centered regimens, comprehensive ERAS multimodal pain management focuses on the use of two or more non-opioid analgesic medications or techniques to minimize or negate the perioperative use of opioid medications. These protocols can be a safe and effective strategy to improve pain control while minimizing opioid side effects and addiction.
ASA, ASPF and the Patient Safety Movement
The American Society of Anesthesiologists (ASA) and Anesthesia Patient Safety Foundation (APSF) jointly support the Patient Safety Movement Foundation’s (PSMF) mission to eliminate preventable patient deaths by the year 2020. The two organizations will encourage physician anesthesia specialists to lead their organizations to implement patient safety improvements.
“The APSF (an ASA related organization launched in 1985) was established to continually work to improve patient safety during anesthesia care through safety, research, education, safety programs and campaigns, and the exchange of information with anesthesia specialists around the world,” said Mark A. Warner, M.D., APSF president.
A 2020 Patient Safety Curriculum Award will be awarded to an anesthesia education investigator for the purpose of modifying the Patient Safety Movement Foundation’s Patient Safety Curriculum to specifically address perioperative patient safety. Applications are due by December 31, 2019. Click to Learn More
International Standards for a Safe Practice of Anesthesia. apsf.org
Improving Post Anesthesia Care Unit (PACU) Handoff by Implementing a Succinct Checklist. apsf.org
ERAS: Roadmap for a Safe Perioperative Journey. apsf.org