One year on from NAP3: dissemination and clinical changes after the Third National Audit Project of the Royal College of Anaesthetists

Background. The Third National Audit Project of the Royal College of Anaesthetists (NAP3) in 2009 reported the number of central neuraxial blocks (CNBs) performed annually in the UK National Health Service and the incidence of associated major complications. Various methodologies were used to disseminate the results. Methods. This national survey using an electronic questionnaire, performed 1 yr after publication of the report, examines the effectiveness of dissemination of the report results to local reporters and departments of anaesthesia. It also explores whether the project led to changes in organizational or individual practices. Results. The response rate was 75.3%. More than 98% of respondents were aware of the project and its results. Respondents had been made aware of results by multiple methods, with publication in the British Journal of Anaesthesia and departmental presentation being the most frequent. The majority (82%) considered dissemination of results had been satisfactory. The project results had led to change in information given to patients, regarding risk of CNB, in half of hospitals and by two-thirds of individual respondents. The practice of management and supervision of CNB or investigation of possible complications had been changed in 20-28% of hospitals and by 16-25% of individual respondents. Conclusions. The results of the NAP3 report have been disseminated to the vast majority of UK anaesthetic departments and to the individual anaesthetists supervising the project in those hospitals. NAP3 has led to changes in practice by the majority of hospitals and by many of the anaesthetists surveyed.