Implementierung anästhesiologischer Qualitätsindikatoren in Deutschland

Ziemann, Sebastian; Coburn, Mark; Rossaint, Rolf; Waesberghe, Julia Van; Bürkle, Hartmut; Fries, Michael; Henrich, Michael; Henzler, Dietrich; Karst, Jörg; Kunitz, Oliver; Löb, Rainer; Meißner, Winfried; Meybohm, Patrick; Mierke, B.; Pabst, F.; Schaelte, G.; Schiff, Jan-Henrik; Soehle, Martin; Winterhalter, Michael; Kowark, Ana

doi:10.1007/s00101-020-00775-w

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Nevertheless, “lack of compliance” with failure to adhere to the standardized protocol could not be excluded as reason for fluid overload. In the anesthesia setting, implementation of quality indicators was confronted with poor employee compliance [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery

Krüger,

Flo Forner,

Ender

et al. 2023

JCDD

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Optimal fluid therapy during perioperative care as part of enhanced recovery after cardiac surgery (ERACS) should improve the outcome. Our objective was finding out the effects of fluid overload on outcome and mortality within a well-established ERACS program. All consecutive patients undergoing cardiac surgery between January 2020 and December 2021 were enrolled. According to ROC curve analysis, a cut-off of ≥7 kg (group M, n = 1198) and <7 kg (group L, n = 1015) was defined. A moderate correlation was shown between weight gain and fluid balance r = 0.4, and a simple linear regression was significant p < 0.0001, R2 = 0.16. Propensity score matching showed that increased weight gain was associated with a longer hospital length of stay (LOS) (L 8 [3] d vs. M 9 [6] d, p < 0.0001), an increased number of patients who received pRBCs (L 311 (36%) vs. M 429 (50%), p < 0.0001), and a higher incidence of postoperative acute kidney injury (AKI) (L 84 (9.8%) vs. M 165 (19.2%), p < 0.0001). Weight gain can easily represent fluid overload. Fluid overload after cardiac surgery is common and is associated with prolonged hospital LOS and increases the incidence of AKI.

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Section: Discussionmentioning

confidence: 99%

Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery

Krüger,

Flo Forner,

Ender

et al. 2023

JCDD

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Patient satisfaction with divided anesthesia care

Koster

Björklund²,

Fenner³

et al. 2022

Anaesthesiologie

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Background Up to now, no prospective cohort study using a validated questionnaire has assessed patients’ expectation and perception of divided anesthesia care and its influence on patient satisfaction. Objective We assessed patient satisfaction with divided anesthesia care in a district general hospital in Switzerland. We hypothesized that patient expectations, combined with their perceptions of the (un)importance of continuous anesthesia care would influence patient satisfaction. Material and methods A total of 484 eligible in-patients receiving anesthesia from October 2019 to February 2020 were included and received preoperative information about divided care via a brochure and face-to-face. The primary outcome was the assessment of patient satisfaction with divided anesthesia care using a validated questionnaire. In group 1 continuity of care was considered important but not performed. In group 2 continuity was ensured. In group 3 continuity was regarded as not important and was not performed. In group 4 patients could not remember or did not answer. A psychometrically developed validated questionnaire was sent to patients at home after discharge. Results A total of 484 completed questionnaires (response rate 81%) were analyzed. In group 1 (n = 110) the mean total dissatisfaction score was 25% (95% confidence interval [CI] 21.8–28.1), in group 2 (n = 61) 6.8% (95% CI 4.8–8.7), in group 3 (n = 223) 12.1% (95% CI 10.7–13.4), and in group 4 (n = 90) 15% (95% CI 11–18); ANOVA: p < 0.001, η = 0.43. Of the patients 286 (59%) considered continuity of care by the same anesthetist relatively unimportant (34%) or not important at all (25%). The other 40% considered it important (22%) or very important (18%). Conclusion Despite receiving comprehensive preoperative information about divided anesthesia care, 40% of patients still considered continuity of care by the same anesthetist important. We recommend further research evaluating whether and how patient expectations can be modified towards the common practice of divided care and patient satisfaction can be increased.

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Interventions Triggered During Routine Use of NIRS Cerebral Oxygenation Monitoring in Cardiac Surgical Patients

Bochmann

Meineri

Ender

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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Implementierung anästhesiologischer Qualitätsindikatoren in Deutschland

Cited by 3 publications

References 13 publications

Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery

Postoperative Weight Gain within Enhanced Recovery after Cardiac Surgery

Patient satisfaction with divided anesthesia care

Interventions Triggered During Routine Use of NIRS Cerebral Oxygenation Monitoring in Cardiac Surgical Patients

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