ORIGINAL ARTICLEObstetric recovery practice: a survey of UK obstetric anaesthetists
Introduction
In September 1998 the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in conjunction with the Obstetric Anaesthetists’ Association (OAA) issued guidelines for obstetric anaesthesia services. Within this document it was stated that “the postoperative care of the obstetric patient should be in accordance with the care of any postoperative patient ” and that “midwifery staff deputed to look after postoperative patients should be specifically trained in monitoring, care of the airway and resuscitative procedures.”1
The objective of this survey was to compare the existing standards of obstetric recovery services with the recommended standards of recovery, as documented in the AAGBI guidelines.[2], [3]
Section snippets
Methods
A questionnaire (Appendix) that had been approved and partly modified by the audit subcommittee of the OAA was sent out to the lead anaesthetists of 251 obstetric units within the United Kingdom. The list was supplied by the OAA secretariat. The questionnaire was designed to investigate recovery room facilities, recovery room staffing and the level of background training. A letter accompanying the questionnaire explained that answers should be based on unit policies and not individual practice.
Results
Of the 251 questionnaires sent, 195 (78%) were returned. One unit on the mailing list had closed, and four other hospitals had amalgamated into two. Some respondents didn’t complete all parts of the questionnaire and consequently the denominator varies in the analysis of the results.
The demographic data from the first part of the questionnaire are shown in Table 1. The annual delivery rate was not significantly correlated with the caesarean section rate, percentage of caesarean sections
Discussion
A fully equipped and staffed recovery area is paramount to the safety of patients recovering from the immediate effects of anaesthesia. In addition, it provides the ideal setting for detection and treatment of early postoperative complications. In accordance with the guidelines for obstetric anaesthesia services published by the Association of Anaesthetists of Great Britain and Ireland in September 1998, obstetric patients should receive the same standard of postoperative care as that of the
Conclusion
Our results have demonstrated that at the time the survey was conducted, the standards of obstetric recovery services did not always match those recommended by the AAGBI guidelines. Shortfalls in the provision of obstetric recovery areas, together with inappropriate staffing and often inadequate background training have been identified as the key areas for concern. Ideally, the provision of dedicated recovery staff or a cohort of specifically trained midwifery staff would help to improve
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MBRRACE-UK: Saving Lives, Improving Mothers' Care - Implications for anaesthetists
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2009, Anesthesia and AnalgesiaCitation Excerpt :In a 1991 survey of Michigan hospitals,28 67% of responders rated the level of patient care in their obstetric PACU as “cause for concern.” A 2005 survey conducted in the United Kingdom concluded there was often a disparity between obstetric recovery practice and the recommended guidelines published by the Association of Anesthetists of Great Britain and Ireland (AAGBI).29 For example, although AAGBI guidelines state that all recovery staff should be trained in BLS, only 54% of nondedicated recovery staff were certified in BLS.29
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