Abstract
Objective. The goal of this study was to determine whether the intraoperative vigilance of anesthesia residents is different when they keep a manual record than when an assistant performs the charting.Methods. A total of 9 anesthesia residents were studied during 36 general anesthesia cases on ASA class 1 or 2 patients. In half of the cases, the resident performed all record keeping. In the other half, the anesthesia record was kept by a human assistant. Vigilance was measured as detection rate and response time for the resident to detect a simulated abnormal value displayed on the physiologic monitor. For analysis, anesthesia cases were divided into stages of induction, maintenance, and emergence.Results. Response times and detection rates were not different when record keeping was performed by an assistant, rather than by the clinician. Shorter cases were associated with longer median response times (i.e., lower vigilance) during the maintenance phase, but only when record keeping was done manually.Conclusions. The results demonstrate that anesthesia residents are equally attentive to an experimental signal displayed on an electronic monitor while manually charting as they are when an assistant keeps the record. This brings into question the contention that eliminating the record-keeping task will result in a reduced level of vigilance.
Similar content being viewed by others
References
McDonald JS, Dzwonczyk R, Gupta B, Dahl M. A second time-study of the anaesthetist's intraoperative period. Br J Anaesth 1990;64:582–585
Kennedy PJ, Feingold A, Wiener EL, Hosek RS. Analysis of tasks and human factors in anesthesia for coronary-artery bypass. Anesth Analg 1976;55:374–377
Dallen L, Nguyen L, Zornow M, et al. Task analysis/workload of anesthetists performing general anesthesia. Anesthesiology 1990;73:A498 (Abstract)
Hamilton WK. The automated anesthetic record is inevitable and valuable. J Clin Monit 1990;6:333–334
Noel TA. Computerized anesthesia records may be dangerous (Letter). Anesthesiology 1986;64:300
Noel KR. Controversy in automated record keeping (Letter). J Clin Monit 1991;7:280
Loeb RG. A measure of intraoperative attention to monitor displays. Anesth Analg 1993;76:337–341
Pedhazur EJ. Multiple regression in behavioral research: Explanation and prediction, ed 2. New York: Holt, Rinehart, and Winston, 1982:334–337
Gravenstein JS, Weinger MB. Why investigate vigilance? J Clin Monit 1986;2:145–147
Cooper JO, Cullen BF. Observer reliability in detecting surreptitious random occlusions of the monaural esophageal stethoscope. J Clin Monit 1990;6:271–275
Weinger MB, Herndon OW, Zornow MH, et al. An objective methodology for task analysis and workload assessment in anesthesia providers. Anesthesiology 1994;80:77–92
Loeb RG. Monitor surveillance and vigilance of anesthesia residents. Anesthesiology 1994;80:(in press)
Yablok DO. Comparison of vigilance using automated versus hand written records (Abstract). Anesthesiology 1990;73:A416
Dzwonczyk R, Allard J, McDonald JS, et al. The effect of automatic record keeping on vigilance and record keeping time (Abstract). Anesth Analg 1992;74:S79
Sanders MS, McCormick EJ. Human factors in engineering and design, ed 6. New York: McGraw-Hill, 1987:57–68
Herndon OW, Weinger MB, Zornow MH, Gaba DM. The use of automated record keeping saves time in complicated anesthetic procedures (Abstract). Anesth Analg 1993;76:S140
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Loeb, R.G. Manual record keeping is not necessary for anesthesia vigilance. J Clin Monitor Comput 11, 9–13 (1995). https://doi.org/10.1007/BF01627413
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01627413