ESRA Academy. Kukreja Y. Sep 8, 2016; 138580; 0456 Topic: Safety of Regional Anaesthesia - Complications - General Aspects
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Dr. Yuvraj Kukreja
Dr. Yuvraj Kukreja

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Background and Aims:

The Association of Anaesthetists of Great Britain & Ireland (AAGBI) recommends documentation of invasive procedures with significant risks . The Royal College of Anaesthetists (RCOA) recommends audit to achieve 100% compliance with this target.

A departmental audit on written risk disclosure for upper limb nerve blocks in 2013 revealed poor compliance and suggested use of printed risk disclosure stickers on the anaesthetic consent chart to improve practice. We aimed to evaluate the effectiveness of these recommendations by performing a re-audit.


After obtaining local audit committee approval, retrospective analysis of risk disclosure on anaesthetic consent forms from 50 patients who had upper limb blocks between November and December 2015.



A significant improvement in documentation to perform a block was noted, 92% v 46% previously. However documentation of type of block or the risks remained poor (Table 1)

Forty-eight percent clinicians used printed stickers. Where stickers were not used documentation of risk was worse than in the initial audit (Table 2)


Our audit demonstrated failure to achieve 100% compliance as recommended by RCOA.   

Documentation of a plan to perform a block improved significantly since 2013. It appears that use of the stickers encouraged written risk disclosure for upper limb blocks. We recommend incorporating the information on the sticker into the anaesthetic chart to encourage use by all anaesthetists. A re-audit after this intervention is planned to close the audit loop. 

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