The online version of this article (doi:10.1186/s12871-017-0344-0) contains supplementary material, which is available to authorized users.
Several reports have shown that postoperative monitoring of general safety and quality issues, including pain treatment, after discharge from recovery is often non-systematic and inadequate. We suggest a new score with assessment of key recovery parameters, as a supportive tool for postoperative care and a call-out algorithm for need of extra help. The aim of this investigation was to validate the score.
After suggesting a prototype score from a pilot study in 182 postoperative patients, we performed a Delphi process by using international experts to create consensus on the final score contents and called the revised tool the Efficacy Safety Score (ESS). Then, we performed a prospective observational study with the ESS throughout the first 24 h postoperatively in 207 surgical in-patients. We compared ESS with Modified Early Warning Systems (MEWS), and postoperative journal information. We subsequently validated ESS by addressing recognized quality criteria for measurement of health status questionnaires.
A call-out value of ESS ≥10 correlated with MEWS > 0 values and journal information about postoperative concerns with a sensitivity of 94% and 92%, respectively. All serious safety issues were identified with the ESS ≥ 10, and a higher number of quality issues were identified than with routine care or MEWS. We obtained positive ratings for six out of seven tested criteria of questionnaire quality; one criterion had an indeterminate rating.
ESS fulfils suggested criteria for score quality validation and reflects the patient’s postoperative status adequately and with high sensitivity. Further clinical trials are warranted to evaluate the usefulness of ESS as a simple tool for assessment of the postoperative safety and quality of patients.
Benjamin (22) died after bone fracture, in VG. 2011: http://www.vg.no/helse/odelagt-i-helsevesenet/artikkel.php?artid=10093729 (01.12.2015).
Got to strong medications - Davoud (23) died, in Nettavisen. 2011: http://www.nettavisen.no/nyheter/article3257721.ece (01.12.2015).
Nearly died in the emergency room, in NRK. 2011: http://nrk.no/nyheter/norge/1.7629090 (01.12.2015).
AP, Overdose death at Seattle hospital not the first, in The Columbian. 2010: http://www.columbian.com/news/2010/sep/29/overdose-death-at-seattle-hospital-not-the-first/ (01.12.2015).
Warner M, et al. Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief 81. 2011. p. 1–8.
Kuklin V, Skraastad E, Ernst G, Berg P, Bjertnaes LJ, Raeder J. Kongsberg Satisfaction Score: A novel system for monitoring the status, efficacy and safety of the postoperative pain treatment after surgery, in Annual Meeting of the International Anesthesia Research Society. San Diego California, USA: Anesth Analg; 2013. p. S-295.
Skraastad E, Bjertnaes LJ, Ræder J, Kuklin V. 2013,26–4: Kongsberg Satisfaction Score - et verktøy for bedre postoperativ overvåkning og behandling, in NAForum. Dnlf: Tidsskrift for norsk anestesiologisk forening; 2013. p. 36–41.
Hsu C-C, Sandford BA. The Delphi technique: making sense of consensus. Practical assessment, research & evaluation. 2007;12(10):1–8.
White PF, Song D. New criteria for fast-tracking after outpatient anesthesia: a comparison with the modified Aldrete's scoring system. Anesth Analg. 1999;88(5):1069–72. PubMed
Hogue SL, et al. Assessing a tool to measure patient functional ability after outpatient surgery. Anesth Analg. 2000;91(1):97–106. PubMed
Holdgate A, et al. Comparison of a verbal numeric rating scale with the visual analogue scale for the measurement of acute pain. Emerg Med (Fremantle). 2003;15(5–6):441–6. CrossRef
- Development and validation of the Efficacy Safety Score (ESS), a novel tool for postoperative patient management
Lars J. Bjertnæs
- BioMed Central
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
Mail Icon II