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• Problems:– Out of date files – Missing files– Inappropriate files

Results1

2

3

4

5

6

7

8

9

1

2

3

4

5

6

7

8

9

Red = Outdated

1

2

3

4

5

6

7

8

9

Red = Inappropriate

‘Inappropriate’

• Newton Valve cleaning

• Theatre Booking

• ADE valve

• MRSA circular

• Controlled drug circular

X = Missing1

2

3

4

5

6

7

8

9

x x x

x

xx

xxx

x

x

xx

‘Essential’ Files

• Advanced Life Support algorithm

• Anaphylaxis

• Local Anaesthetic Toxicity

• Child Protection

• Malignant Hyperthermia

1

2

3

4

5

6

7

8

9

Improvement Phase

• Generate List

• Put files in place

• Mechanism for maintenance

List of essential files

• 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

• 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?