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Vol. 35. Issue 3.
Pages 149-157 (May - June 2020)
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Vol. 35. Issue 3.
Pages 149-157 (May - June 2020)
Original Article
DOI: 10.1016/j.jhqr.2020.03.005
Online survey about anesthesia-related practice and patient safety in Indian hospitals
Encuesta online relacionada con la práctica anestésica y la seguridad del paciente en los hospitales de India
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M. Sinha, M. Kumar, H.M.R. Karim
Corresponding author
drhabibkarim@gmail.com

Corresponding author.
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India
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Tables (5)
Table 1. Number and percentage distribution of responders, availability and practice of standard and essential monitoring and pre-anesthetic preparations in the cohort.
Table 2. Pre anesthetic preparations sub-grouped as per working set-ups and compared using Fisher's exact test, taking ATI as standard.
Table 3. Availability of different equipment, medications and systems for patient safety among the entire cohort.
Table 4. Availability and practice of standard and essential monitoring sub-grouped as per working set-ups and compared using Fisher's exact test, taking ATI as standard.
Table 5. Availability of different equipment, medications and systems for patient safety among the different working set-ups and compared using Fisher's exact test, taking ATI as standard.
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Abstract
Background

Patient safety is a global concern, and anaesthesiologists are critically involved in patient safety-related measures and practices. Although anesthesia service has improved a lot over the last few decades, the information on the anesthesia practice and patient safety in India is lacking. The present survey was aimed to get the information on these aspects.

Methods

A cross-sectional, questionnaire-based survey including both postgraduate trainees and anaesthesiologists, working across the different hospitals of India was conducted during February–May 2019. Google form was used as the survey; responses were directly downloaded as an Excel file and calculated in absolute numbers and percentages. Autonomous teaching institutes (ATI) were taken as standard, and Fisher's exact test was used for comparisons; P<0.05 was considered significant.

Results

Six-hundred (86.1%) responses were included for analysis. Pulse oximetry and non-invasive blood pressure (NIBP) were available in nearly 99% set-ups, but end-tidal carbon-di-oxide (EtCO2), temperature, oxygen, and anesthesia gas analyzer were lacking. ATI and corporate teaching hospitals were having almost all standard monitoring, but patient safety-related advanced equipment and medications were not present in many of the hospitals. The lack was highest in both public and private non-teaching hospitals (P<0.0001).

Conclusion

Patient safety and anesthesia-related services in India are unsatisfactory. Except for pulse oximetry and NIBP, the public and private sector non-teaching hospitals were lacking even the standard monitoring. Referral and top-level corporate and public sector institutes also have scope for improvement.

Keywords:
Anesthesia
Patient safety
Preventive health services
Quality of health care
Hospitals
India
Resumen
Antecedentes

La seguridad del paciente es una cuestión de preocupación global, y los anestesiólogos están seriamente involucrados en las medidas y las prácticas relacionadas con la seguridad. Aunque el servicio de anestesia ha mejorado mucho en los últimos decenios, India carece de información acerca de la práctica anestésica y la seguridad del paciente. El objetivo de esta encuesta fue obtener información relativa a estos aspectos.

Métodos

Encuesta transversal basada en un cuestionario que incluyó a estudiantes de posgrado y anestesiólogos que trabajaban en diferentes hospitales de India, realizada de febrero a mayo de 2019. Se utilizó un formulario Google® como encuesta, descargándose directamente las respuestas en forma de archivo Excel®, respuestas que se calcularon como cifras absolutas y porcentajes. Se tomaron como estándar las instituciones autónomas docentes (IAD), utilizándose la prueba exacta de Fisher para realizar las comparaciones. Se consideró significativo el valor p<0,05.

Resultados

Se incluyeron para análisis 600 respuestas (86,1%). Se disponía de pulsioximetría y presión arterial no invasiva (PANI) en cerca del 99% de los centros, pero se carecía de dióxido de carbono espiratorio final (EtCO2), temperatura, oxígeno y analizador de gases anestésicos. Las IAD y los hospitales docentes corporativos contaban con casi todos los sistemas estándar de monitorización, pero los equipos avanzados y medicaciones relacionados con la seguridad del paciente no estaban presentes en muchos hospitales. Esta carencia fue mayor en los hospitales públicos y los hospitales privados no docentes (p<0,0001).

Conclusión

La seguridad del paciente y los servicios relacionados con la anestesia en India son insatisfactorios. Excepto en lo relacionado con la pulsioximetría y la PANI, los hospitales públicos y privados no docentes carecían incluso de monitorización estándar. Los institutos de referencia y los institutos corporativos de alto nivel y del sector público son también susceptibles de mejora.

Palabras clave:
Anestesia
Seguridad del paciente
Servicios sanitarios de prevención
Calidad de la atención sanitaria
Hospitales
India

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