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L Quinzio

Publications and source records attributed to L Quinzio.

23 records · Page 2Linked to original sources

Data processing at the anesthesia workstation: from data entry to data presentation.

Main requirements for an Anesthesia Information Management System (AIMS) are the supply of additional information for the anesthesiologist at his workstation and complete documentation of the anesthetic procedure. With the implementation of an AIMS (NarkoData) and effective user support, the quality of documentation and the information flow at the anesthesia workstation could be increased. Today, more than 20,000 anesthesia procedures are annually recorded with the AIMS at 112 decentralized workstations. The network for data entry and the presentation and evaluation of data, statistics and results directly available at the clinical workstation was made operational.

Anesthesia↗

[Quality documentation with an Anaesthesia Information Management System (AIMS)].

OBJECTIVE: In 1994 the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University of Giessen decided to implement an Anaesthesia Information Management System (AIMS) to replace the previous hand-written documentation on paper. From 1997 until the end of 1998 the data sets of 41,393 anaesthesia procedures were recorded with the help of computers and imported into a data bank. Individual aspects and results of this data pool are presented under the aspect of how the system in its present form is able to guarantee documentation of quality according to the requirements of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI). METHODS: Since 1997 information on all anaesthesia procedures has been documented "online" with the anaesthesia documentation software NarkoData 4 (ProLogic GmbH, Erkrath). The data sets have been stored in a relational data bank (Oracle Corporation) and statistically processed with the help of the SQL-based program Voyant (Brossco Systems, Espoo, Finland). As an example of two adverse perioperative events (AVB) we compared incidences of "hypotension" and "nausea/vomiting", recorded by staff members into the AIMS, with the incidence of comparable events that were recorded with the help of online data during anaesthesia procedures, such as blood pressure and drug application. Since 1998 data recording has been revised constantly in department meetings; advanced training has been given. The results have been analysed critically. RESULTS: In 1997 the incidence of adverse perioperative events entered manually into the system was 3.6% (grade III and higher 0.9%) and increased during 1998 to 22.2% (grade III and higher 1.9%). The frequency of anaesthesia procedures with manually documented AVBs was significantly below the incidence (determined with the help of online data) of comparable events: "hypotension" (1.8% vs. 8.5%) and "nausea/vomiting" (4.9% vs. 8.3%). CONCLUSION: The current documentation of AVBs in almost any hospital is incomplete. In contrast to the hand-written procedure, the AIMS provides recorded data for evaluation and guarantees more detailed and complete quality documentation. In addition, the effort needed for documentation is reduced. Whether these data sets really describe and measure quality or not has to be evaluated. In addition it has to be considered whether different requirements (such as automatic AVB recognition for an AIMS) are advantageous for quality documentation regarding the data raster and the AVB recognition, with respect to different documentation procedures.

Anesthesia↗

[Statistics and evaluation of a graphic SQL user interface in an anesthesia information management system (AIMS)].

PURPOSE: Since 1997, the Anaesthesia Information Management Systems (AIMS) in our department has produced extensive data material (DGAI core data, vital sign parameters, respiratory parameters, material consumed, etc.) which is stored in a relational data bank. The processing of this data by means of SQL queries was restricted to a few persons with special knowledge only. It was the objective of the project to create an evaluation tool which enables each member of the department to enter queries concerning topics such as efficiency records, quality management, training and research at any time. The tool was also intended to present results in an adequate form. METHODS: Since 1997, the data of the performed anaesthesia procedures have been recorded using the online anaesthesia documentation software NarkoData Version 4 (ProLogic GmbH, Erkrath) within the AIMS. The recorded data sets have been imported into a relational Oracle data bank (Oracle Corporation). The commercial programme Voyant (Brossco Systems, Espoo, Finland) enables for the user to formulate SQL-requests (Structured Query Language) with the help of a graphic user interface and to present the results in a variety of graphics and tables. Repetition of the evaluation using the current data is possible at any time. RESULTS: During 1997 and the first quarter of 1998, the data of 26,030 anaesthesia procedures have been registered and stored in the anaesthesiological data base. 235 queries could be formulated with the SQL-capable graphic tool Voyant. They are available to each member of the department by the application of NarkoStatistik (IMS GmbH, Giessen) within the AIMS, together with the corresponding documentation (HTML pages). The query catalogue covers the main topics of efficiency, quality management, organisation, diagnoses and surgery, pre-, intra- and postoperative data and day-care unit. Even without much previous experience with the system it is possible to carry out evaluations with the current data at selected AIMS terminals. Queries concerning other subjects can be created and can be integrated into the existing query catalogue. CONCLUSION: With the described application we are able to establish an evaluation tool which fulfils our expectations regarding user friendliness and the subjects the queries can cover. Today it has a central position within the AIMS. In addition to the anaesthesia documentation software and the data bank structure, the efficiency of an AIMS is mainly influenced by the corresponding evaluation tool.

Anesthesiology↗

[Experiences fo three year's routine operation of an anesthesia information management system (AIMS) at a university clinic in Giessin].

PURPOSE: In 1994, the Department of Anaesthesiology and Intensive Care Medicine of the Justus Liebig University at Giessen decided to install an Anaesthesia Information Management System (AIMS). Individual aspects and results from routine operation are presented, demonstrating the quality of the documentation and the value of information at the anaesthesiological workstation. The paper discusses which adaptations are necessary according to the experience gathered. METHODS: For the installation of the system Apple Macintosh Clients (Apple Computer, Inc., Cupertino, California) and a File Server were integrated into the partially existing hospital network. The hospital network had to be enlarged during the project according to the Anaesthesiological requirements. The software of the Hospital Information System (HIS) and an HTML browser were installed at individual workstation computers in addition to the Anaesthesia documentation software NarkoData (ProLogic GmbH, Erkrath). The remote control software Timbuktu (Farallon, Alameda, USA) has been added to facilitate remote administration. The file administration programme FileWave (Wave Research, Berkeley, USA) is used for file distribution. Since 1995, all anaesthesia procedures have been documented with the system, either by online or postoperative recording. Since 1997, the recorded information has been stored in a relational Oracle 7 data bank (Oracle Corporation). RESULTS: From 1995 to 1997, 60,405 anaesthesiological procedures have been recorded with the help of this AIMS at 111 decentralised workstations. In 1997, 87.8% of the 21,130 performed anaesthesia procedures have been recorded online with the system and 12.2% postoperatively. From 1995 to 1997, the number of recorded procedures increased by 6.4% from 19,854 to 21,130. Because of lacking interfaces at some patient monitoring stations, the automatic recording of patient data could only be implemented at 69 workstations (62%). With the corresponding access rights, important patient information from the HIS (diagnoses, laboratory results, etc.), records of previous Anaesthesia procedures, numerous statistics, and the whole information from the hospital's intranet (including e-mail) are available at the anaesthesiological workstation at any time. CONCLUSION: The implementation of the AIMS and an effective user support have been able to increase significantly the quality of documentation, the flow of information at the anaesthesia workplace and the number of recorded Anaesthesia procedures. All recorded data can be analysed immediately The expansion of the automatic data transfer from the patient monitoring, interfaces to other computer subsystems of the hospital and a practicable evaluation programme are necessary for further enhancing the efficiency of the AIMS.

Anesthesiology↗