Documentation and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records
In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AI...
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| Veröffentlicht in: | Journal of medical systems 2017-05, Vol.41 (5), p.86-86, Article 86 |
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| creator | Shear, Torin D. Deshur, Mark Lapin, Brittany Greenberg, Steven B. Murphy, Glenn S. Szokol, Joseph Ujiki, Michael Newmark, Rebecca Benson, Jessica Koress, Cody Dwyer, Connor Vender, Jeffery |
| description | In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AIMS. We hypothesized that the type of anesthetic record (paper or AIMS) would lead to differences in the documentation and management of hypotension. Consecutive patients who underwent esophageal surgery between 2009 and 2014 by a single surgeon were eligible for the study. Patients were grouped in to ‘paper’ or ‘AIMS’ based on the type of anesthetic record identified in the chart. Pertinent patient identifiers were removed and data collated after collection. Predetermined preoperative and intraoperative data variables were reviewed. Consecutive esophageal surgery patients (
N
= 189) between 2009 and 2014 were evaluated. 92 patients had an anesthetic record documented on paper and 97 using AIMS. The median number of unique blood pressure recordings was lower in the AIMS group (median (Q1,Q3) AIMS 30.0 (24.0, 39.0) vs. Paper 35.0 (28.5, 43.5),
p
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| doi_str_mv | 10.1007/s10916-017-0737-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1887054866</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4321603161</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-d30d2f9b035c5feccb95c559a9514ffd5a0742d9515d2c3cc6534a14995b73ea3</originalsourceid><addsrcrecordid>eNp1kUtLxDAUhYMoOj5-gBsJuHFTvWmapnEnvkFQZAR3IZPeamUmGZNW9N-bMqOI6Cav852TC4eQXQaHDEAeRQaKlRkwmYHkaVkhIyYkz8pKPa6SEbCiyoRQ1QbZjPEFAFRZynWykVcFMK7kiLyfedvP0HWma72jxtV0HNB0wxP1Db12XTB-jiHpb0ivPua-QxcTe0zPp2i74F1r6YnD2D1jbA29R-tDHekbhthHemeS-Q99m6w1ZhpxZ7lvkYeL8_HpVXZze3l9enKTWS7zLqs51HmjJsCFFQ1aO1HpIJRRghVNUwsDssjrdBN1brm1peCFYYVSYiI5Gr5FDha58-Bf-zSFnrXR4nRqHPo-alZVEkRRlWVC93-hL74PLk03UGWeC6gGii0oG3yMARs9D-3MhA_NQA-16EUtOtWih1o0JM_eMrmfzLD-dnz1kIB8AcQkuScMP77-N_UTfMmZ0A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1886225086</pqid></control><display><type>article</type><title>Documentation and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Shear, Torin D. ; Deshur, Mark ; Lapin, Brittany ; Greenberg, Steven B. ; Murphy, Glenn S. ; Szokol, Joseph ; Ujiki, Michael ; Newmark, Rebecca ; Benson, Jessica ; Koress, Cody ; Dwyer, Connor ; Vender, Jeffery</creator><creatorcontrib>Shear, Torin D. ; Deshur, Mark ; Lapin, Brittany ; Greenberg, Steven B. ; Murphy, Glenn S. ; Szokol, Joseph ; Ujiki, Michael ; Newmark, Rebecca ; Benson, Jessica ; Koress, Cody ; Dwyer, Connor ; Vender, Jeffery</creatorcontrib><description>In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AIMS. We hypothesized that the type of anesthetic record (paper or AIMS) would lead to differences in the documentation and management of hypotension. Consecutive patients who underwent esophageal surgery between 2009 and 2014 by a single surgeon were eligible for the study. Patients were grouped in to ‘paper’ or ‘AIMS’ based on the type of anesthetic record identified in the chart. Pertinent patient identifiers were removed and data collated after collection. Predetermined preoperative and intraoperative data variables were reviewed. Consecutive esophageal surgery patients (
N
= 189) between 2009 and 2014 were evaluated. 92 patients had an anesthetic record documented on paper and 97 using AIMS. The median number of unique blood pressure recordings was lower in the AIMS group (median (Q1,Q3) AIMS 30.0 (24.0, 39.0) vs. Paper 35.0 (28.5, 43.5),
p
< 0.01). However, the median number of hypotensive events (HTEs) was higher in the AIMS group (median (Q1,Q3) 8.0 (4.0, 18.0) vs. 4.0 (1.0, 10.5),
p
< 0.001), and the percentage of HTEs per blood pressure recording was higher in the AIMS group (30.4 ((Q1, Q3) (9.5, 60.9)% vs. 12.5 (2.4, 27.5)%),
p
< 0.01). Multivariable regression analysis identified independent predictors of HTEs. The incidence of HTEs was found to increase with AIMS (IRR = 1.88,
p
< 0.01). Preoperative systolic blood pressure, increased blood loss, and phenylephrine. A phenylephrine infusion was negatively associated with hypotensive events (IRR = 0.99,
p
= 0.03). We noted an increased incidence of HTEs associated with the institution of an AIMS. Despite this increase, no change in medical therapy for hypotension was seen. AIMS did not appear to have an effect on the management of intraoperative hypotension in this patient population.</description><identifier>ISSN: 0148-5598</identifier><identifier>EISSN: 1573-689X</identifier><identifier>DOI: 10.1007/s10916-017-0737-0</identifier><identifier>PMID: 28401397</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anesthesia ; Blood Pressure ; Documentation ; Electronic health records ; Health Informatics ; Health Sciences ; Humans ; Hypotension ; Intraoperative Care ; Medicine ; Medicine & Public Health ; Monitoring, Intraoperative ; Statistics for Life Sciences ; Surgery ; Systems-Level Quality Improvement</subject><ispartof>Journal of medical systems, 2017-05, Vol.41 (5), p.86-86, Article 86</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Journal of Medical Systems is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-d30d2f9b035c5feccb95c559a9514ffd5a0742d9515d2c3cc6534a14995b73ea3</citedby><cites>FETCH-LOGICAL-c372t-d30d2f9b035c5feccb95c559a9514ffd5a0742d9515d2c3cc6534a14995b73ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10916-017-0737-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10916-017-0737-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28401397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shear, Torin D.</creatorcontrib><creatorcontrib>Deshur, Mark</creatorcontrib><creatorcontrib>Lapin, Brittany</creatorcontrib><creatorcontrib>Greenberg, Steven B.</creatorcontrib><creatorcontrib>Murphy, Glenn S.</creatorcontrib><creatorcontrib>Szokol, Joseph</creatorcontrib><creatorcontrib>Ujiki, Michael</creatorcontrib><creatorcontrib>Newmark, Rebecca</creatorcontrib><creatorcontrib>Benson, Jessica</creatorcontrib><creatorcontrib>Koress, Cody</creatorcontrib><creatorcontrib>Dwyer, Connor</creatorcontrib><creatorcontrib>Vender, Jeffery</creatorcontrib><title>Documentation and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records</title><title>Journal of medical systems</title><addtitle>J Med Syst</addtitle><addtitle>J Med Syst</addtitle><description>In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AIMS. We hypothesized that the type of anesthetic record (paper or AIMS) would lead to differences in the documentation and management of hypotension. Consecutive patients who underwent esophageal surgery between 2009 and 2014 by a single surgeon were eligible for the study. Patients were grouped in to ‘paper’ or ‘AIMS’ based on the type of anesthetic record identified in the chart. Pertinent patient identifiers were removed and data collated after collection. Predetermined preoperative and intraoperative data variables were reviewed. Consecutive esophageal surgery patients (
N
= 189) between 2009 and 2014 were evaluated. 92 patients had an anesthetic record documented on paper and 97 using AIMS. The median number of unique blood pressure recordings was lower in the AIMS group (median (Q1,Q3) AIMS 30.0 (24.0, 39.0) vs. Paper 35.0 (28.5, 43.5),
p
< 0.01). However, the median number of hypotensive events (HTEs) was higher in the AIMS group (median (Q1,Q3) 8.0 (4.0, 18.0) vs. 4.0 (1.0, 10.5),
p
< 0.001), and the percentage of HTEs per blood pressure recording was higher in the AIMS group (30.4 ((Q1, Q3) (9.5, 60.9)% vs. 12.5 (2.4, 27.5)%),
p
< 0.01). Multivariable regression analysis identified independent predictors of HTEs. The incidence of HTEs was found to increase with AIMS (IRR = 1.88,
p
< 0.01). Preoperative systolic blood pressure, increased blood loss, and phenylephrine. A phenylephrine infusion was negatively associated with hypotensive events (IRR = 0.99,
p
= 0.03). We noted an increased incidence of HTEs associated with the institution of an AIMS. Despite this increase, no change in medical therapy for hypotension was seen. AIMS did not appear to have an effect on the management of intraoperative hypotension in this patient population.</description><subject>Anesthesia</subject><subject>Blood Pressure</subject><subject>Documentation</subject><subject>Electronic health records</subject><subject>Health Informatics</subject><subject>Health Sciences</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Intraoperative Care</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monitoring, Intraoperative</subject><subject>Statistics for Life Sciences</subject><subject>Surgery</subject><subject>Systems-Level Quality 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and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records</title><author>Shear, Torin D. ; Deshur, Mark ; Lapin, Brittany ; Greenberg, Steven B. ; Murphy, Glenn S. ; Szokol, Joseph ; Ujiki, Michael ; Newmark, Rebecca ; Benson, Jessica ; Koress, Cody ; Dwyer, Connor ; Vender, Jeffery</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-d30d2f9b035c5feccb95c559a9514ffd5a0742d9515d2c3cc6534a14995b73ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anesthesia</topic><topic>Blood Pressure</topic><topic>Documentation</topic><topic>Electronic health records</topic><topic>Health Informatics</topic><topic>Health Sciences</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Intraoperative Care</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monitoring, Intraoperative</topic><topic>Statistics 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Syst</addtitle><date>2017-05-01</date><risdate>2017</risdate><volume>41</volume><issue>5</issue><spage>86</spage><epage>86</epage><pages>86-86</pages><artnum>86</artnum><issn>0148-5598</issn><eissn>1573-689X</eissn><abstract>In this study, we examined anesthetic records before and after the implementation of an electronic anesthetic record documentation (AIMS) in a single surgical population. The purpose of this study was to identify any inconsistencies in anesthetic care based on handwritten documentation (paper) or AIMS. We hypothesized that the type of anesthetic record (paper or AIMS) would lead to differences in the documentation and management of hypotension. Consecutive patients who underwent esophageal surgery between 2009 and 2014 by a single surgeon were eligible for the study. Patients were grouped in to ‘paper’ or ‘AIMS’ based on the type of anesthetic record identified in the chart. Pertinent patient identifiers were removed and data collated after collection. Predetermined preoperative and intraoperative data variables were reviewed. Consecutive esophageal surgery patients (
N
= 189) between 2009 and 2014 were evaluated. 92 patients had an anesthetic record documented on paper and 97 using AIMS. The median number of unique blood pressure recordings was lower in the AIMS group (median (Q1,Q3) AIMS 30.0 (24.0, 39.0) vs. Paper 35.0 (28.5, 43.5),
p
< 0.01). However, the median number of hypotensive events (HTEs) was higher in the AIMS group (median (Q1,Q3) 8.0 (4.0, 18.0) vs. 4.0 (1.0, 10.5),
p
< 0.001), and the percentage of HTEs per blood pressure recording was higher in the AIMS group (30.4 ((Q1, Q3) (9.5, 60.9)% vs. 12.5 (2.4, 27.5)%),
p
< 0.01). Multivariable regression analysis identified independent predictors of HTEs. The incidence of HTEs was found to increase with AIMS (IRR = 1.88,
p
< 0.01). Preoperative systolic blood pressure, increased blood loss, and phenylephrine. A phenylephrine infusion was negatively associated with hypotensive events (IRR = 0.99,
p
= 0.03). We noted an increased incidence of HTEs associated with the institution of an AIMS. Despite this increase, no change in medical therapy for hypotension was seen. AIMS did not appear to have an effect on the management of intraoperative hypotension in this patient population.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28401397</pmid><doi>10.1007/s10916-017-0737-0</doi><tpages>1</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Anesthesia Blood Pressure Documentation Electronic health records Health Informatics Health Sciences Humans Hypotension Intraoperative Care Medicine Medicine & Public Health Monitoring, Intraoperative Statistics for Life Sciences Surgery Systems-Level Quality Improvement |
| title | Documentation and Treatment of Intraoperative Hypotension: Electronic Anesthesia Records versus Paper Anesthesia Records |
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