Cabadas Avión R, Leal Ruiloba MS, Vázquez López S, Ojea Cendón M, Wi Hijazi I, Baluja González MA, Álvarez-Escudero J. A descriptive monitoring study of a non-anesthetist sedation quality program.
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2018;
111:55-62. [PMID:
30424678 DOI:
10.17235/reed.2018.5763/2018]
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Abstract
INTRODUCTION
sedation substantially improves the quality of digestive endoscopy procedures but may result in severe complications.
METHODS
a joint commission-based multidisciplinary protocol was used to define a protocol for sedation by non-anesthesiologists. ASA 4 patients were excluded, as well as patients with a difficult airway, complex procedures and deep sedation. Quality based on the analysis of 9 indicators were monitored. Incomplete procedures were also monitored in order to assess efficacy.
RESULTS
patient safety was established based on a very low incidence of complications and a rate of respiratory events of 1.07. Furthermore, a low rate of hypotension and bradycardia was found, as well as a low rate of pain, either during or after endoscopy and an incidence of unexpected admissions lower than 0.5%. The quality indicators measured reflect the evolution of the results of the program.
CONCLUSIONS
ongoing sedation program monitoring in endoscopy allows the control of different quality dimensions and the implementation of steps for process improvement.
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