SummaryLarge-scale audit and research projects demand robust, efficient systems for accurate data collection, handling and analysis. We utilised a multiplatform 'bring your own device' (BYOD) electronic data collection app to capture observational audit data on theatre efficiency across seven hospital Trusts in South Yorkshire in June-August 2013. None of the participating hospitals had a dedicated information governance policy for bring your own device. Data were collected by 17 investigators for 392 individual theatre lists, capturing 14 148 individual data points, 12 852 (91%) of which were transmitted to a central database on the day of collection without any loss of data. BYOD technology enabled accurate collection of a large volume of secure data across multiple NHS organisations over a short period of time. Bring your own device technology provides a method for collecting real-time audit, research and quality improvement data within healthcare systems without compromising patient data protection.
birthchoiceuk.com). The duty obstetric anaesthetist at each unit was telephoned and asked the following questions: (i) Do you routinely use neuraxial opioids for caesarean section and, if so, which opioids do you use? (ii) Do you have departmental guidelines for postoperative monitoring of patients? (iii) Are you aware of NICE guidelines for monitoring after neuraxial opioids have been published? and (iv) Have you witnessed a case of respiratory depression following neuraxial opioids in obstetrics?
ResultsWe were able to contact 213 of the 223 (97%) consultantled units listed. Ten units (5%) did not administer neuraxial diamorphine or morphine for caesarean section because they were unable to monitor patients adequately afterwards. Of the remaining 203 units, 183 (90%) used neuraxial diamorphine and 20 (10%) used neuraxial morphine for caesarean section. One hundred and fourteen (56%) of these units had departmental guidelines for postoperative monitoring of patients, but in only 34 of these (30%) were the guidelines compliant with the NICE recommendations. Only 40 (18%) telephone respondents were aware of the existence of the NICE guidelines. None had witnessed a case of respiratory depression following neuraxial opioids in obstetrics.
DiscussionNeuraxial opioids improve analgesia following caesarean section but may rarely cause respiratory depression [1]. Diamorphine is the most commonly used opioid for providing analgesia following caesarean section in the UK. In order to detect respiratory depression, NICE suggests that women are monitored hourly for 2 and 12 h after epidural and intrathecal diamorphine administration respectively [2]. Our survey has produced results that may raise considerable concern: only 18% of respondents were aware of the NICE guidelines; 44% of maternity units in the UK do not have guidelines for monitoring women who have received neuraxial opioids for caesarean section; and of those that do, only 30% are compliant with the NICE recommendations. We hope our survey increases awareness of the existence of these guidelines. . This audit was designed to evaluate suction equipment availability and assess its readiness for immediate use with the aim of reducing resuscitation delays and improving patient safety.
MethodsWe developed simple criteria and standards from the available guidance [1]: (i) criterion: suction equipment should be complete and functional; (ii) standards: 100% of suction units should have a Yankauer tip; 100% of suction units should have correct tubing; 100% of suction units should be properly connected; and 100% of suction equipment should work. Audit approval was received at each of the six hospitals and data collection was standardised using a guide and proforma to ensure comparability. The audit was conducted as a spot check with the consent of the nurse in charge of each area. Minor faults were corrected where possible and reported to the appropriate member of the ward staff. In addition, major faults were reported to medical engineering and the resuscitation office...
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