VAOIG Inspection of San Juan VA

Healthcare Inspection Alleged Anesthesia Staffing and Quality of Care Issues VA Caribbean Healthcare System, San Juan, Puerto Rico 04/16/09. The purpose of this review was to evaluate the validity of allegations regarding insufficient anesthesiologist staffing and inadequate intra-operative and post-operative patient monitoring by anesthesiologists at the San Juan VA Medical Center in San Juan, Puerto Rico. We did not substantiate the allegation of insufficient anesthesiologist staffing. Although Certified Registered Nurse Anesthetist vacancies existed, we identified no negative impact on patient outcomes as a result. We also did not substantiate the allegation that surgical patients were not monitored appropriately before, during, and after the administration of anesthesia. We found, however, that anesthesia staff failed to properly document the identity of the practitioner who administered medications during a procedure. We recommended that managers ensure that anesthesia staff properly document medication administration in the anesthesia record. VAOIG