• Daryl S Henshaw, James D Turner, Sean W Dobson, Douglas JaffeJonathanJDepartment of Anesthesiology, Section on Regional Anesthesia and Acute Pain Management, Wake Forest School of Medicine, Winston Salem, North Carolina, USA., John Wells Reynolds, Christopher J Edwards, and Robert S Weller.
• Department of Anesthesiology, Section on Regional Anesthesia and Acute Pain Management, Wake Forest School of Medicine, Winston Salem, North Carolina, USA dhenshaw@wakehealth.edu.
• Reg Anesth Pain Med. 2019 Jan 13.

BackgroundThe term "Wrong-Site Surgery (WSS)" is commonly associated with surgical procedures; however, The Joint Commission (TJC) considers any invasive procedure, not just a surgical procedure, performed on the wrong side, at the wrong site, or on the wrong patient to be a WSS. For anesthesia providers, this means that a wrong-site nerve block (WSNB) also constitutes a WSS and would be considered a sentinel event by TJC. In an attempt to combat WSNB, the American Society of Regional Anesthesia and Pain Medicine published guidelines in 2014 recommending the use of a preprocedural checklist before performing regional blocks. The effectiveness of such a checklist, however, to reduce the occurrence of WSNB has not yet been demonstrated. We hypothesized that the introduction of a preprocedural checklist specific for regional anesthesia would be associated with a lower rate of WSNB procedures.MethodsA retrospective review was performed to compare the incidence of WSNB 2  years before, to 6  years after the implementation of a preprocedural checklist specific to regional anesthesia.ResultsPrior to checklist implementation, 4 WSNB events occurred during 10 123 procedures (3.95 per 10 000 (95% CI 1.26 to 9.53). Following implementation, WSNB events occurred during 35 890 procedures (0 per 10 000 (95% CI 0 to 0.84)); p=0.0023.ConclusionsImplementation of a regional anesthesia specific preprocedural checklist was associated with a significantly lower incidence of WSNB procedures. While prospective controlled studies would be required to demonstrate causation, this study suggests that for regional anesthesia procedures, a preprocedural checklist may positively impact patient safety.© American Society of Regional Anesthesia & Pain Medicine 2018. No commercial re-use. See rights and permissions. Published by BMJ.

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