Anesthesiology's journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
Read the article by Haller et al. entitled “Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients” on page 1121 of this issue.
Review the questions and other required information for CME program completion (published in both the print and online journal).
When ready, go to the CME Web site: http://www.asahq.org/journal-cme. Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.
The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.
The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA's Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.
Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives: After reading this article, participants should have a better understanding of what unplanned admission to an intensive care unit can tell us about the process of care and health care safety in patients having surgery.
Authors –Guy Haller, M.D., Paul S. Myles, M.B.B.S., M.P.H., M.D., F.C.A.R.C.S.I., F.A.N.Z.C.A., Rory Wolfe, B.Sc., Ph.D., Anthony M. Weeks, M.B.B.S., F.A.N.Z.C.A., Johannes Stoelwinder, M.B.B.S., M.D., F.R.C.A.M.A., F.A.C.H.S.E., F.F.P.H.M., and John McNeil, M.B.B.S., Ph.D., F.R.A.C.P.
Grants or research support: Supported by the Swiss National Science Foundation, Bern, Switzerland; the Count Eugenio Litta Foundation, Vaduz, Liechtenstein; a Monash University Postgraduate Research Scholarship, Melbourne, Australia (to Dr. Haller); and an Australian National Health and Medical Research Council Practitioner's Fellowship, Canberra, Australia (to Dr. Myles).
Consultantships or honoraria: None
Question Writer –Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Based on the article by Haller et al. entitled “Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=103&issue=6&spage=1121&part=fulltext in the December issue of Anesthesiology, choose the one correct answer for each question:
1. Which of the following is least likely to provide useful information concerning the process of care when patients suffer an adverse outcome?
A. Critical incident analysis techniques
B. Monitoring mortality rates
C. Organizational safety culture assessment
D. Incident reporting
2. A “near miss” is an incident where an act of commission or omission could have harmed a patient but did not. Which of the following is least likely to explain why a potentially harmful incident results only in a near miss?
A. Chance alone prevented harm from being caused.
B. Steps were taken to prevent harm.
C. Steps were taken to reduce any harm.
D. Other more serious outcomes rendered the near miss irrelevant.
3. Which of the following statements concerning the analysis of patient care when unintended admission to an intensive care unit occurs after surgery is most likely true?
A. It can provide specific information on the safety of patient care.
B. It requires the use of risk-adjusted models.
C. Peer review is necessary in order to properly determine a relationship between adverse outcomes and a safety issue.
D. An electronic information system is necessary for proper analysis.
4. Which of the following is least likely to be associated with increased risk of an unplanned intensive care unit admission after surgery?
A. Duration of surgery
B. Time of day of surgery
C. Female gender
5. Which of the following statements concerning patients who experience an unplanned intensive care unit admission after surgery is least likely true?
A. Overall, they will experience a significant increase in mortality.
B. They frequently (50% of the time) will have had an intraoperative near miss.
C. The impact of the unplanned intensive care unit admission will be most negligible for patients who had minor surgery.
D. For patients undergoing most surgeries, the hospital length of stay increases significantly.
6. Unplanned intensive care unit admission after surgery is least likely to involve which of the following?
A. Complications of vascular line insertion
D. Uncontrolled hypertension