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Abstract: Anaesthesia preadmission assessment: a new approach through use of a screening questionnaire.

Authors:

Badner NH, Craen RA, Paul TL, Doyle JA.

Institution:

Department of Anaesthesia, University Campus, London Health Sciences Centre, Ontario, Canada.

Source:

Can J Anaesth. 1998 Jan;45(1):87-92.

Abstract:

PURPOSE: The preadmission assessment of patients one to two weeks preoperatively has become the standard across North America. We have devised a new approach that utilises a preoperative screening questionnaire, and this study attempted to determine the effectiveness of this technique. METHODS: Over six weeks, the attending anaesthetist for each patient undergoing non-cardiac surgery processed through the preadmission clinic (PAC) completed a study survey. This survey questioned if the assessment was appropriate with reasons, the consequences of no assessment, and if time was saved/lost on the day of surgery. RESULTS: Three hundred and seventy patients were processed (243 same-day (SD), 111 outpatient (O/P), and 16 inpatients (I/P)). Of these, 224 were assessed in the PAC (101 by medicine, 84 by anaesthesia and 39 by both): 42% (94) based on the questionnaire, 12% (26) due to consultation, and 46% (104) due to positive questionnaires and consultation. The physician assessments were appropriate 184/219 (84%) times, inappropriate in 35 (16%), while there was no answer for five. Assessments were inappropriate because 25/35 (71%) were unnecessary, while in nine (26%) the patient was not optimised. Of the patients not assessed in the PAC only 9/145 (6%) should have been assessed. CONCLUSION: The use of our screening tool in combination with direct referrals appropriately determines assessment needs of patients and allows for more efficient use of medical personnel in the PAC.

Keywords:

Complications Preassessment Questionnaire