ESRA Academy. Aggarwal A. Sep 8, 2016; 138567; 0441 Topic: Safety of Regional Anaesthesia - Complications - General Aspects
Dr. Amitabh Aggarwal
Dr. Amitabh Aggarwal

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Background and Aims:

The ‘STOP before you block’ process, designed by the Safe Anaesthesia Liaison Group and Regional Anaesthesia UK, is an important National Patient Safety Initiative aimed at decreasing the incidence of wrong sided nerve blocks which is a ‘Never Event’ classified by NHS Improvement Agency. The aim of the audit was to establish how frequently the ‘STOP before you block’ process was being followed in our hospital and to explore necessary remedial changes to improve patient safety. 


Data was collected prospectively over a period of one month on all patients having nerve blocks in theatres. The parameters recorded were ‘STOP before you block’- pre-block pause and documentation, completion of WHO checklist and documentation of block on the Anaesthetic charts.


Data was collected for 36 nerve blocks over a month. ‘STOP before you block’- pause was done in 52.8% of cases with documentation of it in 84% cases. The WHO checklist was completed in 94.4% of cases and block documentation on Anaesthetic chart in 97.2% cases.


The audit revealed that the ‘STOP before you block’ process was being followed in only half of the cases. Non-compliance with this important safety process increases the risk of an inadvertent wrong sided nerve block and has the potential to cause patient harm. To improve the compliance we recommend displaying ‘STOP before you block’ posters more prominently in the Anaesthetic rooms and on the nerve block equipment. We also suggest active staff education for anyone involved with the process of administering nerve blocks.

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