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The Influence of a Consultant Anaesthetist in a Nurse-led Anaesthetic service
Abstract
Aim - Non-physician anaesthesia providers are commonly engaged in our subregion. The objective of the paper is to
highlight what input a part time consultant can make in anaesthetic service provided by nurses.
Method – A retrospective study of anaesthetic service covering 15 months before and 15 months after the engagement
of a consultant anaesthetist in a General Hospital. Results – There were 4 nurse anaesthetists, no preoperative review by anaesthetists, no intraoperative documentation and no recovery room in the first 15 months. The anaesthetic technique was total intravenous anaesthesia (TIVA) using
ketamine in 86.9%, regional anaesthesia 0.2% and field block 12.9% of cases. After the engagement of the consultant, pre-anaesthetic review and intraoperative charts were prepared and used, patient monitors were provided as well as a recovery room. Anaesthetic techniques in this period expanded to include 67.5% TIVA, 9.6% inhalational, 4.5% relaxant, 10.1% regional and 8.3% field block.
Conclusion – Consultant anaesthetists should be engaged in secondary health care facilities in our subregion on parttime
basis to assist in raising the standard of anaesthetic service.
Recommendations – More consultants should seek outreach positions in nurse-led anaesthetic services, refresher courses should be organized periodically for nurse anaesthetists , hospital linkages should be established within and outside the subregion, friends and hospitals in developed countries should “adopt a hospital” to provide them with a lifeline.
Key words- consultant anaesthetists, Nurse anaesthetists, anaesthetic service, developing countries
highlight what input a part time consultant can make in anaesthetic service provided by nurses.
Method – A retrospective study of anaesthetic service covering 15 months before and 15 months after the engagement
of a consultant anaesthetist in a General Hospital. Results – There were 4 nurse anaesthetists, no preoperative review by anaesthetists, no intraoperative documentation and no recovery room in the first 15 months. The anaesthetic technique was total intravenous anaesthesia (TIVA) using
ketamine in 86.9%, regional anaesthesia 0.2% and field block 12.9% of cases. After the engagement of the consultant, pre-anaesthetic review and intraoperative charts were prepared and used, patient monitors were provided as well as a recovery room. Anaesthetic techniques in this period expanded to include 67.5% TIVA, 9.6% inhalational, 4.5% relaxant, 10.1% regional and 8.3% field block.
Conclusion – Consultant anaesthetists should be engaged in secondary health care facilities in our subregion on parttime
basis to assist in raising the standard of anaesthetic service.
Recommendations – More consultants should seek outreach positions in nurse-led anaesthetic services, refresher courses should be organized periodically for nurse anaesthetists , hospital linkages should be established within and outside the subregion, friends and hospitals in developed countries should “adopt a hospital” to provide them with a lifeline.
Key words- consultant anaesthetists, Nurse anaesthetists, anaesthetic service, developing countries
