SNACC

Society for Neuroscience in Anesthesiology and Critical Care

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EVD Quality and Safety

Are you interested in collecting data on quality and safety regarding EVDs? SNACC has created a list of electronic clinical quality metrics that you can start implementing at your hospital.

External Ventricular Drain (EVD) Safety Campaign
Perioperative Quality and Safety Metrics

A)  Preoperative assessment of patients with EVDs
Documentation of EVD-specific clinical information
Numerator: Percentage of patients with documentation of EVD setting, average CSF output, and an average ICP value
Denominator: All patients with indwelling EVDs who undergo preoperative assessment
Data source: Pre-anesthesia assessment notes

B) Intrahospital transport
ICP monitoring during intrahospital transport
Numerator: Percentage of patients with ICP monitoring during intrahospital transport
Denominator: All patients with indwelling EVDs who undergo intrahospital transport
Data source: Anesthesia records, electronic medical records

C) Intraoperative care of EVD
Intraoperative documentation of intracranial res

  1. Intraoperative EVD output (q 15 min- q 1 hr.)
  2. Intraoperative ICP values (q 15 min- q 1 hr.)
  3. Documentation of adverse events
    1. Disconnection of EVD system
    2. Inadvertent injection in the EVD collecting system
    3. Intracranial pressure elevation during intrahospital transport

Numerator:

  1. Number of patients with intraoperative EVD output documentation
  2. Number of patients with intraoperative ICP documentation

Denominator: Number of patients with indwelling EVDs who have an anesthetic encounter

Data source: Electronic medical records, Anesthesia records

D)  EVD-associated infection
Numerator: Cerebrospinal fluid (CSF) infection related to an EVD. Definition: positive CSF culture
Denominator: External ventricular drain days
Data source: Infection control / ICU QI

E) EVD-associated hemorrhagic complication
Numerator: Intracerebral hemorrhage associated with placement of EVDs.
Denominator: All patients with EVDs placed at your institution
Data source: Post-EVD-placement computerized tomography of the head.

Abbreviations:
ICP: Intracranial pressure, CSF: cerebrospinal fluid