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- Anesthesia Nursing
- Structured Hand-offs
Journal Article > Review
Mackay E, Jennings J, Webber S. BJA Education. 2019;19:151-157.
Human factors affect medication delivery in the operating room. This review highlights the role of the anesthesiologist in safe medication administration and recommends strategies to reduce opportunities for error at each stage of medication administration, such as preoperative time-outs, preparation of medicines with color-coded syringe labels, patient identification prior to medication administration, and review of medications at handovers after administration.
Cases & Commentaries
- Web M&M
Lina Bergman, RN, MSc, and Wendy Chaboyer, RN, PhD; February 2019
Following surgery under general anesthesia, a boy was extubated and brought to postanesthesia care unit (PACU). Due to the patient's age and length of the surgery, the PACU anesthesiologist ordered continuous pulse-oximetry monitoring for 24 hours. Deemed stable to leave the PACU, the boy was transported to the regular floor. When the nurse went to place the patient on pulse oximetry, she realized he was markedly hypoxic. She administered oxygen by face mask, but he became bradycardic and hypotensive and a code blue was called.
Cierniak KH, Gaunt MJ, Grissinger M. PA-PSRS. Patient Saf Advis. 2018;15(4).
The operating room environment harbors particular patient safety hazards. Drawing from 1137 perioperative medication error reports submitted over a 1-year period, this analysis found that more than half of the recorded incidents reached the patient and the majority of those stemmed from communication breakdowns during transitions or handoffs. The authors provide recommendations to reduce risks of error, including using barcode medication administration, standardizing handoff procedures, and stocking prefilled syringes.