Patient Safety in Veterinary Anaesthesia. What can we learn from human anaesthesia?
In veterinary medicine, patient safety culture is in its infancy with very few peer reviewed publications published. Little is actually known about safety in veterinary anaesthesia and historically, studies have focused on reporting mortality rates and associated risk factors such as patient age, health status and anaesthetic techniques used. While advancements in veterinary anaesthetic technology, techniques and pharmacology have seen the anaesthetic related mortality rates in dogs and cats improve over time, the reported fatality rate remains much higher than that reported in the developed and developing worlds in human anaesthesia (Brodbelt et al. 2008; Bainbridge et al. 2012). Recently, Hofmeister et al (2014) provided compelling evidence that implementation of four simple interventions significantly improved patient safety and decreased the number of anaesthetic incidents in a university teaching hospital.
While it is important to continue to improve our veterinary anaesthetic practices with regards to technology and pharmacology, it is likely that our most significant improvements will be made via innovations regarding a patient safety culture. To paraphrase Weller & Merry (2013), the pursuit of patient safety involves reducing the gap between best practice and that care that is actually delivered to patients. Therefore, understanding how to reliably deliver best practice care using established anaesthetic techniques may be more important than seeking new ones.
Dr. Santos is a Lecturer in Veterinary Anaesthesia, Adelaide University School of Animal and Veterinary Sciences Adelaide, South Australia.
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Bainbridge D, Martin J, Arango M et al. (2012) Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet 380, p.1075-1081.
Brodbelt DC, Blissitt KJ, Hammond RA et al. (2008) The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaesth Analg 35, p.365-373.
Hofmeister EH, Quandt J, Braun C et al. (2014) Development, implementation and impact of simple patient safety interventions in a university teaching hospital. Vet Anaesth Analg 41, p.243-248.
Weller JM & Merry AF (2013) Best practice and patient safety in anaesthesia, BJA: British Journal of Anaesthesia, 110, 5, p.671–673.