250 likes | 263 Views
NAP4 is a national audit determining the incidence of major complications of airway management in UK anaesthetic practice, aiming to learn from adverse events and improve patient safety. The study consists of two phases, collecting data over a 2-week snapshot and one year. It includes criteria for inclusion of complications and aims to identify themes for improvement.
E N D
What is NAP4? A national audit of major complications of airway management in the UK
Why? To determine the incidence of serious complications of airway management in UK anaesthetic practice To look for themes and to learn from adverse events
Incidence? Number of Complications _________________________________________________________________________________ Number of Airway Interventions Within a given time period
How many anaesthetics are performed per year in the UK? Not known No data = No denominator Snapshot of current practice needed
Phase 1 A snapshot of practice Over a 2 week period During September 2008 Provides denominator Phase 2 Study of complications Over one year 01/09/2008 - 31/08/2009 Provides numerator NAP4 needs two phases Number of complications _________________________________________________________________________________ Number of Airway Interventions
Phase 1 A snapshot of practice Over a 2 week period During September 2008 Provides denominator Phase 2 Study of complications Over one year 01/09/2008 - 31/08/2009 Provides numerator NAP4 needs two phases Number of complications _________________________________________________________________________________ Number of Airway Interventions
Phase 1- The Snapshot Data Collection • All anaesthetics in a hospital • Over the same 2 week period • Submit data on clinical activity • Number of general or regional anaesthetics • Airway management of cases under GA • All hospitals in the UK • Co-ordinated by the Local Reporter
Local Reporters Used for NAP3 – Central neuraxial blockade • Have an essential central role • Disseminate information • Collect data - snapshot • Support local anaesthetists • Aid reporting of adverse airway events in phase 2
Phase 2 –Airway Complications Data Collection • Starts 1st September 2008 • Runs for 1 year • Notify RCoA /Tim Cook by email • Online data submission
What sort of Complications? Inclusion Criteria • Death • Brain damage • Emergency surgical airway • ICU admission resulting from an airway management complication
Emergency Surgical Airway Includes • Emergency Cricothyroidotomy • Needle • Cannula • Emergency surgical airway • Cricothyroidotomy • Tracheostomy
ICU Admission Resulting from an Airway Management Complication Example cases for inclusion • Post extubation stridor requiring re-intubation and ICU admission • Elective ventilation following hypoxic cardiac arrest due to an airway problem during anaesthesia • ICU admission following aspiration of gastric contents during an operation
ICU Admission Resulting from an Airway Management Complication Example of cases for exclusion • ICU Admission for unrelated reasons • ICU Admission because HDU was full • HDU admission following aspiration of gastric contents with complete resolution
When does it start? • Snapshot of current practice • 2 week period September/October 2008 • One year data collection process • 01/09/2008 to 30/08/2009
Airway Problems ElsewhereMeeting Inclusion Criteria Intensive Care Unit – Inform NAP4 Emergency Department – Inform NAP4 Hospital wards - Do not inform NAP4 Pre-hospital care - Do not inform NAP4 If an anaesthetic is involved Anywhere in the hospital – Inform NAP4
Notification of Events • Anyone may inform the college of events • Inform the RCoA lead • Tim Cook tcook@rcoa.ac.uk • A username will be issued to enable on-line data submission via the DAS web-site • Data submission is required to be anonymous
All you need to remember is.. • If you know of an airway problem resulting in: • Death • Brain damage • Emergency surgical airway • ICU admissionresulting from an airway management complication • Inform Tim Cook tcook@rcoa.ac.uk • Send no patient details
Approval The process has been approved by • NRES National Research Ethics Service • PIAG Patient Information Advisory Group • CMO UK Chief Medical Officers
Royal College of Anaesthetists Difficult Airway Society National Patient Safety Agency Association of Anaesthetists of Great Britain and Ireland, Association for Peri-Operative Practice Association of Paediatric Anaesthetists College of Emergency Medicine College of Operating Department Practitioners Intensive Care Society Intensive Care National Audit and Research Centre Obstetric Anaesthetists Association Paediatric Intensive Care Society Paediatric Intensive Care network All Chief Medical Officers Medical Defence organisations Supported by
More Information RCoA Bulletin September 2008 Anaesthesia News September 2008
More Information - Posters • Appearing soon! • Anaesthesia departments • Intensive Care Units • Emergency departments
Thanks for your support The End