Articles: checklist.
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Information loss can occur during all phases of care. The transfer of care (handoff) from the operating room to the postoperative anesthesia care unit (PACU) is an especially susceptible time. Information loss can lead to an increase in medication errors, sentinel events, and poor patient outcomes. ⋯ As the healthcare industry becomes more complex, it is in the interest of patient safety to develop, validate, and use similar objective procedures as those used in high-reliability organizations. The purpose of this research was to determine if the utilization of a formulated checklist with objective measures during the handoff from the operating room to the PACU decreased information loss, the need for information clarification, and anesthesia providers' time spent in transfer of care, with improved adequacy of the handoff. Specific metrics were monitored before and after implementation to assess for information loss, information clarification, anesthesia providers' time, and to rate the adequacy of the report.
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Applying human factors principles to the design of clinical emergency guidelines is important. The UK Civil Aviation Authority uses a Checklist Assessment Tool for evaluating the content and usability of emergency drills before introduction into service on aircraft. We hypothesised that this model could be used to develop a generic medical tool. ⋯ Internal consistency, as assessed by Cronbach's alpha, was 0.74, 0.96 and 0.72 for the tool's three constituent domains of physical characteristics, content and layout/format, respectively. Inter-rater reliability, as assessed by Cohen's kappa, ranged from 0.33 to 0.72. The adoption of our tool has the potential to improve the usability of medical emergency guidelines.
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A Preprocedural Checklist Improves the Safety of Emergency Department Intubation of Trauma Patients.
Endotracheal intubation of trauma patients is a vital and high-risk procedure in the emergency department (ED). The hypothesis was that implementation of a standardized, preprocedural checklist would improve the safety of this procedure. ⋯ Implementation of a preintubation checklist for ED intubation of trauma patients was associated with a reduction in intubation-related complications, decreased paralysis-to-intubation time, and improved adherence to recognized safety measures.
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To determine if a knot-tying checklist can provide a valid score and if the checklist can be used by novice surgeons in a reliable manner. ⋯ The knot-tying checklist provides a valid score for basic surgical knot-tying and can be used by novice and experienced raters. Its use supports peer assessment of performance in a surgical skills laboratory setting.