A Survey of Perioperative Monitoring Capacity of Major Referral Hospitals in Kenya
Abstract
Background: Monitoring in anaesthesia entails checking the physiologic progress and status
of patients over time. This is important in predicting, preventing, and mitigating adverse
perioperative events, hence a certain level of minimum standard of monitoring is
recommended by various professional medical organizations.
Main Objective: To determine the capacity for recommended minimum monitoring of
patients in anaesthesia in major referral hospitals in Kenya.
Methodology: This was a descriptive, cross-sectional, observational study carried out in
surgical operating suites, procedural sedation areas, and post-anaesthesia care unit beds in 16
major referral hospitals in Kenya. The availability of recommended monitoring devices was
evaluated using an in-person audit checklist adapted from the 2015 Association of
Anaesthetists of Great Britain and Ireland (AAGBI) monitoring guidelines.
Results: We evaluated 103 operating suites, 96 post anaesthesia care unit beds, and 16 areas
where procedural sedation was administered in 16 major referral hospitals in Kenya. The
average availability of intraoperative minimum monitoring devices as recommended by the
AAGBI was 70.2%. Only one hospital (6.25%) had all of the recommended devices.
Capnography was available in 62.5% of hospitals. All the recommended monitoring devices
were present in 12.5% of the procedural sedation areas and 2.1% of the post anaesthesia care
unit beds. Advanced monitoring devices such as invasive arterial blood pressure were
available in only 25% of the institutions audited. Portable multi-parameter devices for
monitoring patients during transfer were present in 5 (31.25%) of the hospitals.
Conclusions: The majority of referral hospitals in Kenya do not meet the minimum
requirements for intraoperative and peri-procedural monitoring. We recommend that these
data be used to effect advocated policy change and safety profile
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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