Independent sector and peri-operative cardiac arrest as reported to the 7th National Audit Project of the Royal College of Anaesthetists
© 2024 Association of Anaesthetists..
The 7th National Audit Project (NAP7) of the Royal College of Anaesthetists studied peri-operative cardiac arrest including those that occurred in the independent healthcare sector, which provides around 1 in 6 NHS-funded care episodes. In total, 174 (39%) of 442 independent hospitals contacted agreed to participate. A survey examining provider preparedness for cardiac arrest had a response rate of 23 (13%), preventing useful analysis. An activity survey with 1912 responses (from a maximum of 45% of participating hospitals) showed that, compared with the NHS caseload, the independent sector caseload was less comorbid, with fewer patients at the extremes of age or who were severely obese, and with a large proportion of elective orthopaedic surgery undertaken during weekday working hours. The survey suggested suboptimal compliance rates with monitoring recommendations. Seventeen reports of independent sector peri-operative cardiac arrest comprised 2% of NAP7 reports and underreporting is likely. These patients were lower risk than NHS cases, reflecting the sector's case mix, but included cases of haemorrhage, anaphylaxis, cardiac arrhythmia and pulmonary embolus. Good and poor quality care were seen, the latter including delayed recognition and treatment of patient deterioration, and poor care delivery. Independent sector outcomes were similar to those in the NHS, though due to the case mix, improved outcomes might be anticipated. Assessment of quality of care was less often favourable for independent sector reports than NHS reports, though assessments were often uncertain, reflecting poor quality reports. Overall, NAP7 is unable to determine whether peri-operative care relating to cardiac arrest is more, equally or less safe than in the NHS.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:79 |
|---|---|
| Enthalten in: |
Anaesthesia - 79(2024), 4 vom: 01. März, Seite 380-388 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cook, T M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anaesthesia |
|---|
| Anmerkungen: |
Date Completed 07.03.2024 Date Revised 07.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/anae.16175 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366639676 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366639676 | ||
| 003 | DE-627 | ||
| 005 | 20240307232153.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/anae.16175 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1319.xml |
| 035 | |a (DE-627)NLM366639676 | ||
| 035 | |a (NLM)38173350 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Cook, T M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Independent sector and peri-operative cardiac arrest as reported to the 7th National Audit Project of the Royal College of Anaesthetists |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.03.2024 | ||
| 500 | |a Date Revised 07.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 Association of Anaesthetists. | ||
| 520 | |a The 7th National Audit Project (NAP7) of the Royal College of Anaesthetists studied peri-operative cardiac arrest including those that occurred in the independent healthcare sector, which provides around 1 in 6 NHS-funded care episodes. In total, 174 (39%) of 442 independent hospitals contacted agreed to participate. A survey examining provider preparedness for cardiac arrest had a response rate of 23 (13%), preventing useful analysis. An activity survey with 1912 responses (from a maximum of 45% of participating hospitals) showed that, compared with the NHS caseload, the independent sector caseload was less comorbid, with fewer patients at the extremes of age or who were severely obese, and with a large proportion of elective orthopaedic surgery undertaken during weekday working hours. The survey suggested suboptimal compliance rates with monitoring recommendations. Seventeen reports of independent sector peri-operative cardiac arrest comprised 2% of NAP7 reports and underreporting is likely. These patients were lower risk than NHS cases, reflecting the sector's case mix, but included cases of haemorrhage, anaphylaxis, cardiac arrhythmia and pulmonary embolus. Good and poor quality care were seen, the latter including delayed recognition and treatment of patient deterioration, and poor care delivery. Independent sector outcomes were similar to those in the NHS, though due to the case mix, improved outcomes might be anticipated. Assessment of quality of care was less often favourable for independent sector reports than NHS reports, though assessments were often uncertain, reflecting poor quality reports. Overall, NAP7 is unable to determine whether peri-operative care relating to cardiac arrest is more, equally or less safe than in the NHS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anaesthesia | |
| 650 | 4 | |a cardiac arrest | |
| 650 | 4 | |a death | |
| 650 | 4 | |a independent sector | |
| 700 | 1 | |a Kane, A D |e verfasserin |4 aut | |
| 700 | 1 | |a Bouch, C |e verfasserin |4 aut | |
| 700 | 1 | |a Armstrong, R A |e verfasserin |4 aut | |
| 700 | 1 | |a Kursumovic, E |e verfasserin |4 aut | |
| 700 | 1 | |a Soar, J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Anaesthesia |d 1947 |g 79(2024), 4 vom: 01. März, Seite 380-388 |w (DE-627)NLM000046280 |x 1365-2044 |7 nnns |
| 773 | 1 | 8 | |g volume:79 |g year:2024 |g number:4 |g day:01 |g month:03 |g pages:380-388 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/anae.16175 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 79 |j 2024 |e 4 |b 01 |c 03 |h 380-388 | ||