Setting the scene for Perioperative Medicine in Ireland: a survey of the attitudes, beliefs and current practice of anaesthesiologists.
1.
Please select the grade at which you currently work?
Consultant
SAT 1-2
SAT 3-6
NCHD
Other (please specify)
2.
When do you think anaesthesiologist’s involvement in the care of the surgical patient should start? (Please mark all that apply)
When the patient is referred to the surgical outpatient clinic
When the decision to operate is made
At the preoperative assessment clinic
On the day of admission for surgery
In the anaesthetic room
Other (please specify)
3.
When do you think the anaesthesiologist’s involvement in the care of the surgical patient should end? (Please mark all that apply)
In the recovery room
At a fixed point after surgery (e.g. 24 hours, day 3 etc)
Once there are no acute clinical issues
Once the acute surgical issues are resolved
Once the patient is discharged from hospital
Other (please specify)
4.
What do you consider to be the key components of perioperative care? (Please mark all that apply)
Preoperative assessment
Quantification of perioperative risk
Identification of co-morbidity
Identification of geriatric syndromes (e.g. frailty, cognitive impairment)
Medical optimisation (e.g. treatment of anaemia, diabetes, heart failure)
Anaesthetic planning
Assessment of capacity to consent to procedure
Taking consent for anaesthesia
Taking consent for surgical procedure
Anaesthetising the patient
Management of postoperative medical complications
Discharge planning
Longer term post discharge follow-up of postoperative complications (e.g. delirium, acute kidney injury)
Other (please specify)
5.
Do you apply risk prediction scores during pre-operative assessment?
Always
Never
Sometimes – if so, what prompts this?
6.
If you use one, or more, risk prediction scores in practice, please specify below which tool(s) you use
7.
At the hospital where you currently work, do you have a clinical lead for preoperative assessment?
Yes
No
Not sure
8.
At the hospital where you currently work, what staff routinely works in the preoperative assessment clinic?
Nurse
Nurse and NCHD
NCHD only
NCHD and consultant anaesthesiologist
Nurse and consultant anaesthesiologist
Dedicated session for consultant anaesthesiologist
Not sure
Other (please specify)
9.
Who do you think should make up the team that delivers perioperative medicine? (Please mark all that apply)
Anaesthesiologist
Intensivist
Medicine for the Elderly specialist
Organ specific physicians
Nurse / Advanced Nurse Practitioner
Other (please specify)
10.
Do you consider yourself a perioperative medicine doctor?
Yes
No
11.
What speciality should have clinical governance over the perioperative medicine service?
Anaesthesiology
Critical Care Medicine
Acute Medicine (e.g on-call medical team)
Medicine for the Elderly
All of the above
Other (please specify)
12.
Anaesthesiologists are being asked to increase their input into perioperative services. We have listed some factors that may be seen as barriers to anaesthesiologists delivering a perioperative medicine service. Please select all that you feel apply.
Anaesthesiologists do not want to practice perioperative medicine
Increased input by anaesthesiologists into the perioperative pathway will not affect patient outcomes
Anaesthesiologists lack sufficient training to deliver perioperative medicine
Physicians are better placed to deliver perioperative medicine
Surgical teams are reluctant to allow increased input by anaesthesiologists into perioperative services
There are not enough anaesthesiologists to allow this additional job role
There is a lack of evidence to show that it improves patient outcomes
A perioperative medicine service could deskill surgical teams in the management of postoperative complications
13.
In your last week at work, how many times did you visit a postoperative patient (other than to advise on pain management issues)?
I didn’t see any postoperative patients on the ward in the last week
Once
2-4 times
5-7 times
7 or more times
14.
In your last week at work, if you visited a postoperative patient, please indicate why.
15.
Please indicate your current location of clinical practice.
South/South West Hospital Group
RCSI Hospital Group
Ireland East Hospital Group
Dublin Midlands Hospital Group
Children’s Hospital Group
Saolta Hospital Group
University of Limerick Hospital Group
Other (please specify)
