Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia

The Physiological Profile Assessment : clinical validity of the postural sway measure and comparison of impairments by age

Background: The Physiological Profile Assessment (PPA) assesses falls risk in older adults by measuring impairments most associated with multiple falls. To date, no study has investigated the change in PPA impairment profile with age. Objective: To describe impairment profiles, by age and ability to complete the postural sway measure, of older adults fallers. Participants: We note that 885 older adults referred to multidisciplinary falls clinics located within two inner London boroughs (UK). Methods: Anonymised data was extracted from the PPA falls risk database. For comparisons, data was grouped by gender, age, and ability to complete the postural Sway test. Results: There were significant differences between all age groups in PPA falls risk, edge contrast sensitivity, quadriceps strength (Quad), postural sway and reported falls within the previous year (P < 0.01). The oldest age group (90+) had the highest PPA falls risk (P < 0.01), yet reported significantly less falls than the youngest age group (60 to 69; P < 0.05). There was significant variability in test results, with younger age groups displaying greater variability across PPA measures, and older age groups displaying more consistency (P < 0.05); 15.1% (n = 134) of patients that were able to perform the postural sway measure received a higher risk score for this test than those unable to complete the task. Conclusions: Greater variability in younger age groups indicates that specific impairments may provide the cause of falls, whereas widespread global reduction in function and frailty may provide the cause for falls in the older age groups. The postural sway scoring does not reflect ability to perform the test

WWW. Do not forget older people

Background: internet use continues to grow. It is often assumed that most users are younger or middle aged. We set out to establish how access to and use of the Internet varied with age.Methods: we surveyed a sample of patients attending urology outpatient clinics in a one week period.Results: use of the internet decreases with increasing age. However 75% of ages 65-69 and 55% of over 80's access the internet, with most doing so at least weekly. Whilst health-related information is very relevant, only 20% of patients had looked at the hospital departmental website prior to a visit.Conclusion: as health professionals we must ensure that we have relevant up-to-date information on our websites for patients to access of all age ranges. Departments should give consideration to courses or other novel methods (e.g. computers in GP surgeries, text to speech software, etc) to improve internet access in older people.</p

Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%–74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia