Pre-operative parent information and attitudes towards general anaesthetic induction technique in paediatric patients: An audit

Introduction It is a standard practice at our hospital to allow a parent to be present during induction of anaesthesia. Parents demonstrate a high degree of anxiety prior to their child's surgery. A struggling, crying child who then goes limp is emotionally upsetting to the parents ( 1 ). An anxious parent may increase the child's anxiety leading to various complications at induction. Adequate pre‐operative information regarding problems encountered during anaesthetic induction would help parents cope with this stress ( 2 ). The best practice would be that all the parents should be told about the preferred induction technique, intravenous or gas, an alternative technique if this fails and complications related to both. All parents should find the induction experience ‘better than’ or ‘as expected’ and be able to discuss their worries afterwards with a proficient member of the staff. The aim of this audit was to find out whether we gave adequate pre‐operative information to parents regarding anaesthetic induction and what were their attitudes towards this. Methods We designed a questionnaire which had two parts. Part A was filled in by the anaesthetist and part B by the parent who attended the induction. Results 50 patients were audited over a period of 3 months. Only 40% were told about both gas and intravenous induction. Only 58% were told why either technique was chosen. 10% of the parents found the induction experience to be ‘worse than expected’. 16% of the parents felt that the information given was ‘too little’. 12% were not able to discuss their worries afterwards with a proficient member of the staff. Conclusion Overall, the level of satisfaction was high with 90% of the parents finding the induction experience ‘better than’ or ‘as expected’. We fell short of the standards that we set up at the beginning of the audit. To improve parental satisfaction, adequate pre‐operative information is a must. Hence, considering a preoperative educational programme seems appropriate to improve our standards. We therefore make the following recommendations:

• 1 Detailed explanation by the anaesthetist to the parent regarding the general anaesthetic induction technique.
• 2 Use of audio‐visual aids, video‐tapes showing an anaesthetic induction.
• 3 Parental visit to the induction room to familiarise themselves with the environment.
• 4 Distribution of information leaflets to the parents explaining what to expect at anaesthetic induction.

Our next step is to design an information leaflet, put it on trial and then re‐audit.