ASA Standards & APSF Recommendations Survey

Patient Safety & Monitoring Survey

This survey has been sent to doctors, nurses, hospital administrators, and other healthcare providers. Your reply to this survey is very much appreciated by midnight ET, Friday, September 9, 2011.

To qualify for a chance to win an iPad 2 and to receive a copy of the survey report, please provide your contact information at the bottom of the survey. (The winner will be chosen randomly from those who complete the survey and the contact information form below.)

Physician-Patient Alliance for Health & Safety (PPAHS) is an advocacy group devoted to improving patient health and safety. Our website is http://ppahs.wordpress.com/

The ASA recently updated its Standards for Basic Anesthetic Monitoring to read: “During moderate or deep sedation the adequacy of ventilation shall be evaluated by continual observation of qualitative clinical signs and monitoring of the presence of exhaled carbon dioxide unless precluded or invalidated by the nature of the patient, procedure, or equipment.” The ASA Standards were issued October 2010 for implementation July 1, 2011.

Moreover, the Anesthesia Patient Safety Foundation (APSF) recently issued recommendations and conclusions on electronic monitoring strategies to detect drug-induced postoperative respiratory depression. Among other things, the APSF Recommendations provide, “Continuous electronic monitoring of oxygenation and ventilation should be available and considered for all patients and would reduce the likelihood of unrecognized clinically significant opioid-induced depression of ventilation in the postoperative period.” For more on these recommendations, please see the release at http://wp.me/p1JikT-2L

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* 1. Please identify your principal role:

Doctor; please specify practice area below

Nurse; please specify practice area below

Other healthcare provider; please specify below

Healthcare Administrator

Patient or Advocate

Please briefly describe your medical practice (e.g. anesthesiology, critical care, GI, surgery, pulmonology, CRNA)

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* 2. As of July 1, 2011, I would describe the medical practices, of which I am aware, to be in accord with ASA Standards as:

Completely

Mostly

Partially

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* 3. To improve compliance with ASA Standards, I believe that it would help to have (check all that apply):

Safety checklists that include ASA Standards.

Recommendations on the equipment to be used to meet ASA Standards.

Training or certification on ASA Standards.

Other (please specify)

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* 4. Do you believe that clinically significant drug-induced respiratory depression (oxygenation and/or ventilation) in the postoperative period remains a serious patient safety risk that continues to be associated with significant morbidity and mortality?

Yes

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* 5. Do you believe that intermittent “spot checks” of oxygenation (pulse oximetry) and ventilation (nursing assessment) are adequate for reliably recognizing clinically significant evolving drug-induced respiratory depression in the postoperative period.

Yes

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* 6. Do you agree or disagree with the following statement -- Continuous electronic monitoring of oxygenation and ventilation should be available and considered for all patients and would reduce the likelihood of unrecognized clinically significant opioid-induced depression of ventilation in the postoperative period:

Agree

Disagree

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* 7. Impediments to continuous electronic monitoring of oxygenation and ventilation (selected or all patients) in the postoperative period are (please check all that apply):

Initial investment cost in instituting existing technology

Existing technology is not practical

Absence of evidence-based data to support value of electronic monitoring

Failure of caregivers to recognize (inadequate education) the true risk of drug-induced depression of ventilation

Safety checklists that include APSF Recommendations.

Recommendations on the equipment to be used to meet APSF Recommendations.

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* 8. (optional) If you’d like to be entered into a lottery draw for an iPad 2 or would like to receive a copy of a report on this survey, please complete the following:

Name