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Anesthesia Documentation of Intraoperative Temperature:

Anesthesia Documentation of Intraoperative Temperature: Strategy to Decrease Surgical Sites Infection. 6 th year medical students (group 5B) Supervised by: Dr.Maha Alawi Patient safety module - 2012 King Abdulaziz University Hospital – Jeddah, Saudi Arabia. Introduction. Introduction.

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Anesthesia Documentation of Intraoperative Temperature:

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  1. Anesthesia Documentation of Intraoperative Temperature: Strategy to Decrease Surgical Sites Infection 6th year medical students (group 5B) Supervised by: Dr.Maha Alawi Patient safety module - 2012 King Abdulaziz University Hospital – Jeddah, Saudi Arabia

  2. Introduction

  3. Introduction • International guidelines recommended that measures should be implemented to keep patients normothermic during surgeries for that intraoperative normothermia should be strictly maintained in patient undergoing operative procedure that last more than 30 minutes. • Anesthesia compliance with measures that keeps patient normothermic during surgeries such the use of warming blanket intraoperative and iv fluids warmers.

  4. hypothermia vasoconstriction P O2 impaired the neutrophil's phagocytosis impaired immunity Surgical site infection rates

  5. Aim and objectives

  6. Aim of the audit Reduce the surgical site infection rate related to hypothermia intra-operatively and post-operatively.

  7. Objectives • To asses the anesthetists’ compliance with the intra-operative temperature documentation. • To evaluate the current measures and if they are adequate to keep patients in KAUH normothermic intra-operatively and in the recovery area.

  8. Materials and Methods

  9. Materials and Methods Phase 4 Phase 3 Phase 2 Phase 1 Interventions Data analysis Data entry Data collection

  10. Phase I Phase I: Chart reviews adopted as the method for the data collection process. Information regarding: • Demographic data (age and gender) • MRN number • Type of Anesthesia • Type of Procedure • Temperature before the surgery • Temperature during every 30 minutes of the surgery • Temperature after the surgery • Methods used to keep the patient warm (blanket or other utilities)

  11. Data collection sheet • The data was collected from the medical records in the recovery area post-operation. (data collection sheet

  12. Phase II and III Phase II: The data was systemically entered and analyzed using the Microsoft office excel software. Phase III: After analyzing the data (by Dr. Maha Alawi) , a clinical audit report was written. The collection of data and analysis gave proof to the lack of intra-operative temperature documentation. Also, results showed the need for providing better warming methods.

  13. Phase IV (Intervention) Phase IV: Advocacy and emphasis on documentation of the intra-operative temperatures, began as part of the awareness. This was done by signs and posters hung in the pre-operation area along with the recovery area. In the operating room , thermometers were put in the file to remind the anesthesia department. Meeting arranged with Dr. Abdullah M. Kaki. (Chairman)

  14. Results

  15. Results

  16. Results Most common surgeries associated with hypothermia

  17. Results • The rate of intra-operative documentations is suboptimal. • 65.38% of the intra-operative notes are lacking intra-operative temperature documentation, only the temperatures before the surgery, and the temperature in the recovery area were available. • The most common surgery that lacks intra-operative documentation is Laparoscopic Cholecystectomy 17%. • The warming blankets were not effective in keeping our patients warm which is another issue to tackle. -

  18. Recommendations &Summary

  19. Recommendations 1- Dr. Kaki promised to enforce the documentation of temperatures intra-operatively and post-operatively. 2- To assess the need to implement additional methods to keep patients warm such thick socks ,booties and hats. 3- Another audit will be conducted at March 2013 to assess the compliance with the intra-operative documentations and measures to keep patients normothermic.

  20. Intervention

  21. Intervention

  22. Summary The rate of intra-operative documentations of the temperature is suboptimal which lead us to believe that more patients were hypothermic intra-operatively; however the report only detected 18% due to lack of documentations. Also, the warming blankets were not effective in keeping our patients warm which is another issue to tackle. The results and tactics are all important in keeping patients normothermic intra-operatively correlating highly with the subsequent development of surgical site infections.

  23. Acknowledgments Dr. Maha Alawi Dr. Abdullah M. Kaki The Nurses and staff of the OR recovery room

  24. Source • http://www.saferhealthcarenow.ca/EN/Interventions/SSI/Pages/measurement.aspx

  25. Thank you Prevent hypothermia

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