Documentation of spinal anaesthesia technique and block level at caesarean section

dc.contributor.advisorvan Dyk, Dominique
dc.contributor.advisorDyer, Robert A
dc.contributor.authorDu Toit, Michiel Adriaan
dc.date.accessioned2022-02-18T06:25:36Z
dc.date.available2022-02-18T06:25:36Z
dc.date.issued2021
dc.date.updated2022-02-10T09:40:00Z
dc.description.abstractBackground The ease of administration and relative safety of spinal anaesthesia has made this the preferred technique for elective and many emergency caesarean sections. Complications include incomplete sensory block, resulting in intraoperative breakthrough pain, which is commonly associated with a successful medicolegal claim. If documentation of spinal anaesthesia technique was found to be inadequate in the course of such medicolegal proceedings, it is likely that the decision would be against the anaesthetist. The purpose of this study was to evaluate documentation by anaesthetists relating to the establishment of surgical anaesthesia utilizing subarachnoid block. Methods A retrospective folder analysis was conducted at Mowbray Maternity Hospital in Cape Town, South Africa. One hundred consecutive spinal anaesthesia charts, each completed by a different anaesthetist, either a registrar or specialist, were analysed, starting December 31st, 2018, and proceeding retrospectively in time until the sample size was achieved. Results Of the 100 cases of spinal anaesthesia for caesarean section analysed, 68 were emergency and 32 elective operations. After literature review, 12 variables were identified requiring documentation, so that adequate information would be available in the event of medicolegal action. In 23% and 32% of patients respectively, 7 or 8/12 were recorded. Ninety percent of anaesthesia charts had inadequate documentation, defined as information on fewer than 10 of the specified variables. Conclusion The quality of documentation of procedure and block level during spinal anaesthesia for caesarean section was inadequate. National guidelines should be drafted and standardised to improve the quality of these records, both for quality of care and medicolegal purposes.
dc.identifier.apacitationDu Toit, M. A. (2021). <i>Documentation of spinal anaesthesia technique and block level at caesarean section</i>. (). ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. Retrieved from http://hdl.handle.net/11427/35719en_ZA
dc.identifier.chicagocitationDu Toit, Michiel Adriaan. <i>"Documentation of spinal anaesthesia technique and block level at caesarean section."</i> ., ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021. http://hdl.handle.net/11427/35719en_ZA
dc.identifier.citationDu Toit, M.A. 2021. Documentation of spinal anaesthesia technique and block level at caesarean section. . ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine. http://hdl.handle.net/11427/35719en_ZA
dc.identifier.ris TY - Master Thesis AU - Du Toit, Michiel Adriaan AB - Background The ease of administration and relative safety of spinal anaesthesia has made this the preferred technique for elective and many emergency caesarean sections. Complications include incomplete sensory block, resulting in intraoperative breakthrough pain, which is commonly associated with a successful medicolegal claim. If documentation of spinal anaesthesia technique was found to be inadequate in the course of such medicolegal proceedings, it is likely that the decision would be against the anaesthetist. The purpose of this study was to evaluate documentation by anaesthetists relating to the establishment of surgical anaesthesia utilizing subarachnoid block. Methods A retrospective folder analysis was conducted at Mowbray Maternity Hospital in Cape Town, South Africa. One hundred consecutive spinal anaesthesia charts, each completed by a different anaesthetist, either a registrar or specialist, were analysed, starting December 31st, 2018, and proceeding retrospectively in time until the sample size was achieved. Results Of the 100 cases of spinal anaesthesia for caesarean section analysed, 68 were emergency and 32 elective operations. After literature review, 12 variables were identified requiring documentation, so that adequate information would be available in the event of medicolegal action. In 23% and 32% of patients respectively, 7 or 8/12 were recorded. Ninety percent of anaesthesia charts had inadequate documentation, defined as information on fewer than 10 of the specified variables. Conclusion The quality of documentation of procedure and block level during spinal anaesthesia for caesarean section was inadequate. National guidelines should be drafted and standardised to improve the quality of these records, both for quality of care and medicolegal purposes. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Anaesthesiology LK - https://open.uct.ac.za PY - 2021 T1 - Documentation of spinal anaesthesia technique and block level at caesarean section TI - Documentation of spinal anaesthesia technique and block level at caesarean section UR - http://hdl.handle.net/11427/35719 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35719
dc.identifier.vancouvercitationDu Toit MA. Documentation of spinal anaesthesia technique and block level at caesarean section. []. ,Faculty of Health Sciences ,Department of Anaesthesia and Perioperative Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35719en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Anaesthesia and Perioperative Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectAnaesthesiology
dc.titleDocumentation of spinal anaesthesia technique and block level at caesarean section
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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