Articles: checklist.
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Anaesth Intensive Care · Jul 2016
Successful introduction of a daily checklist to enhance compliance with accepted standards of care in the medical intensive care unit.
We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient. ⋯ There was a decrease in the incidence of missed elements of the bundle of care the longer the patient stayed in the ICU. Types of missed elements varied with the duration of the ICU stay. We found that the introduction of a simple checklist, developed in collaboration with the junior medical staff who would be using the checklist every day in the ICU, resulted in the detection and correction of missed elements of a bundle of care we had previously introduced in the ICU.
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The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. The association of the introduction of SSCs with 90-day mortality remains unclear. ⋯ The data cannot prove causality owing to the study design. The implementation of SSCs was associated with a 27% reduction of the adjusted risk for all-cause death within 90 days but not within 30 days. The adjusted length of stay was reduced after implementation of SSCs.
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Anaesth Intensive Care · Jul 2016
A site check prior to regional anaesthesia to prevent wrong-sided blocks.
This paper describes the implementation of the 'Stop Before You Block' (SB4YB) initiative in an Australian teaching hospital. This process, which began in the UK in 2010, is a pre-procedure pause to confirm the correct side of a regional anaesthetic block. A change in practice was implemented with the formal roll out of a SB4YB educational program. ⋯ We propose that Stop Before You Block or a block time-out should be performed prior to all unilateral nerve blocks. Success of this initiative requires education, and both cultural and systems changes to occur. We propose that a formal block time-out should become part of the surgical safety checklist and this activity should be endorsed and promoted by anaesthetic professional bodies.
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Veterinary surgery : VS · Jul 2016
Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist.
To examine whether the use of a surgical safety checklist (SSC) could reduce the incidence of complications after small animal surgery. ⋯ The frequency and severity of postoperative complications was significantly decreased after introduction of a surgical checklist. All veterinary hospitals should consider using a surgical checklist. Compliance with implementation of the checklist is important for success.
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In health care, most preventable adverse events occur in the operating room. Surgical safety checklists have become a standard of care for safe operating room practice, but there is conflicting evidence for the effectiveness of checklists to improve perioperative outcomes in some populations. Our objective was to determine whether surgical safety checklists are associated with a reduction in the proportion of children who had perioperative complications. ⋯ The implementation of surgical safety checklists for pediatric surgery in Ontario was not associated with a reduction in the proportion of children who had perioperative complications.