key: cord-0804901-2qrk6wxi
authors: Foley, E.; Whitehouse, K.; Roberts, K.
title: P.167 Digitalising patient information in obstetric anaesthesia during the COVID-19 pandemic
date: 2022-05-31
journal: International Journal of Obstetric Anesthesia
DOI: 10.1016/j.ijoa.2022.103463
sha: 923137f9ee71f185e45743899d33ee284f649927
doc_id: 804901
cord_uid: 2qrk6wxi

nan

patient's subjective assessment of the consent process, and their objective recall of potential procedure complications. Methods: Thirty-six patients who had undergone an AIO were identified from departmental follow up forms. A questionnaire was used to collect data over two months, at an average of 20 h after intervention. Results: 60% of women recalled seeing the LabourPains.com poster antenatally. However, none of the patients surveyed accessed the online information after this. Because of this, we were unable to assess whether this information had an impact on the women's consent process. Our findings did, however, support our previous work regarding the importance of written information and early consent. 33% of women received written information prior to AIO. Recall of average number of complications was significantly improved between women provided with written information (3.41 complications) versus those without (1.45, P = 0.046). A difference was also seen with consent before admission (2.5 complications) versus those consented immediately before procedure (1.44, P > 0.05). Discussion: As with our previous work, these data support the RCoA's recommendations regarding the provision of written information and early consent. Receiving written information was associated with a significant improvement in recall of anaesthetic complications. Unfortunately, the provision of information via poster adverts appeared to be ineffective. This may be due to 'poster fatigue' or the posters not being optimally located. Having information accessible via an online platform remains a beneficial source due to ease of updates, as well as the availability of different languages. An alternate method of improving access this information is via QR codes included in the antenatal packs provided to women. This is something we will implement with our maternity service.

P.167 Digitalising patient information in obstetric anaesthesia during the COVID-19 pandemic E. Foley, K. Whitehouse, K. Roberts

Introduction: Social distancing during the COVID-19 pandemic significantly impacted how we provide our patients with information about anaesthesia for childbirth. Face-to-face consultations in the obstetric anaesthesia clinic largely stopped, so we asked patients how satisfied they were with the information they received regarding their anaesthetic options, to subsequently improve our patient information service as we navigate our way out of the pandemic and beyond. Methods: We asked 50 patients on the postnatal suite at the Royal Victoria Infirmary who had undergone a first time elective caesarean section under spinal anaesthesia, or who had received a first time epidural in labour, about where they received their information about pain relief in labour. Ethics approval was not required for this project as advised by the clinical effectiveness department of the trust. Results: Twenty percent of patients said they received no information about spinal anaesthesia before the day of surgery and 35% learnt about spinal anaesthesia by word of mouth alone. Just 20% discussed spinals in clinic and five percent when visiting the delivery suite for other reasons. The remaining patients looked online (10%) and in leaflets (10%). Eighty-five percent of patients felt anxious about neuraxial procedures and 85% would have liked more information about what to expect from neuraxial procedures at an earlier stage. Fifty-five percent of patients receiving first time epidurals decided late in their labour to have an epidural, citing lack of knowledge as a reason for their late decision. Discussion: The information received about anaesthesia antenatally was inadequate for informed decision making. We have therefore created two online videos; one detailing a patient's journey through theatre for an elective caesarean section, and another for a patient undergoing an epidural in labour. Our intention is for these videos to provide reliable, hospital specific information to our patients about anaesthesia for childbirth in a format which can be accessed at any stage of pregnancy, in any location. We hope that by taking patient information online we will empower our patients to make more informed decisions about pain relief earlier in their pregnancy and bring our department into line with the vision of the NHS to digitalise patient information. 

Introduction: The Royal College of Anaesthetists (RCoA) strategy places increasing emphasis for simulation-based education to support training in obstetric anaesthesia [1] . We describe the development of a one-day obstetric anaesthesia course for novice anaesthetists. Methods: A canvas of novice anaesthetists revealed a demand for further obstetric anaesthetic training. Trainees felt hesitant progressing to the on-call obstetric rota citing reduced clinical experience, inability to complete assessments and a temporary cessation of mandatory multidisciplinary training days. Our objectives were to provide an efficient and effective one day course, mapped to the RCoA curriculum, aiming to improve confidence and skills and thereby improving obstetric patient safety. The day combined high-fidelity simulated obstetric anaesthetic emergencies and workshops with expert matter facilitators covering common clinical problems. Outcome measures were participant and faculty feedback. The course material, confidence scores and free text responses were collated and used to drive forward improvements for future delivery. Results: We have delivered two courses; February and November 2021 totalling 11 participants run by an experienced multidisciplinary faculty. 100% of participants would recommend the course and stated the educational content was good or excellent. 100% agreed the course increased their confidence in handling obstetric emergencies and 80% felt more confident starting obstetric on calls. 100% of trainees agreed the simulated scenarios helped achieve curriculum competencies. Qualitative feedback suggested this course should be delivered routinely to achieve the Initial Assessment of Competence in Obstetric Anaesthesia Certificate. Course modifications incorporated longer and more focused debriefs and faculty allocation of simulation scenarios to tailor trainee experience. Discussion: The course demonstrated an improved confidence in knowledge and skills required to perform safe obstetric anaesthetic care. It facilitated sign off of mandatory components of the RCoA curriculum and allowed opportunities to 'drill' rarer obstetric problems working as part of a wider multidisciplinary team.

International Journal of Obstetric Anesthesia 50S (2022)

Guidelines for the Provision of Anaesthesia Services for an Obstetric Population

AAGBI: Consent for anaesthesia 2017