Authors (including presenting author) :
Tse KC (1), Cheng HK (1), Ngai YY (1), Wong SH (1)
Affiliation :
Department of Anaesthesia and Operating Services, Tseung Kwan O Hospital
Introduction :
For decades, advanced analgesic modalities provided by anaesthetists have helped to provide satisfactory pain relief for postoperative and other patients with significant pain. Conventional modalities include intravenous patient-controlled analgesia (IVPCA), epidural analgesia (EA), regional analgesia (RA), while newer modalities were introduced in our hospital, including multimodal oral analgesia (with oxycodone - mainly for Enhanced Recovery After Surgery cases) and IV lignocaine. Paper records have all along been used electronic platform has recently been introduced to replace the paper records in a stepwise way.
Objectives :
1. Enabling electronic documentation – reducing paper records 2. Enhancing safety features that are unique on an electronic interface e.g. pop-up messages on medication precaution 3. Aligning with aim of Smart Hospital – pain ward round with iPad 4. Facilitating audit / research processes
Methodology :
Traditionally, acute pain service records consist of anaesthetist copy (which inform anaesthetist and pain nurse to follow up the patient) and ward copy (which guide patient observation in ward) as paper records. In collaboration with a third party information technology developer, an electronic platform was developed. In the new system, the anaesthetist copy is faded out, being replaced by an electronic list of patients receiving acute pain service to facilitate follow-up. The system also allows simultaneous use of 2 modalities, namely IV lignocaine + IVPCA, and IV lignocaine + multimodal oral analgesia. At present documentation in the system does not replace IPMOE prescription. In future potential integration with IPMOE system may be facilitated by order templates already in place. Prescription of analgesics and documentation in the APS electronic platform can be done in one goal. These order templates are especially helping in more complicated analgesic regimes, such as multimodal oral analgesic therapy. The ward copy may also integrate in the auto-charting system of vital sign observations and can be replaced as well.
Result & Outcome :
The early results are encouraging as the system is gaining popularity among anaesthetic colleagues. Compliance rate with the new system is 100%. Rate of missing entry of postoperative follow-up data also shows a decreasing trend (from around 10% to <5%). Incidents of missing follow-up by forgetting to put the anaesthetist paper copy in the follow-up folders are reduced from around 1% to 0%. Medication safety is also reinforced with the help of the prompting messages. The future outlook will be potentially bright with the enhancement features mentioned above.
Co-location with:
