Articles: checklist.
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Scand J Trauma Resus · Nov 2013
Developing templates for uniform data documentation and reporting in critical care using a modified nominal group technique.
Clinical practice in trauma and critical care is predominantly derived from quantitative observational cohort studies based on data retrospectively collected from medical records. Such data create uncontrolled bias and influence external and internal validity, thereby hindering systematic reviews. Templates or standards for uniform documenting and scientific reporting may result in high quality and internationally standardised data being collected on a regular basis, enhance large international multi-centre studies, and increase the quality of evidence. Templates or standards may be developed using multidisciplinary expert panel consensus methods.We present three consensus processes aimed at developing templates for documenting and scientific reporting. We discuss the advantages, limitations, and possible future improvements of our method. ⋯ Our modified NGT consensus method can successfully be used to establish templates for reporting trauma and critical care data. When used in a structured manner, the method uses recognised experts to achieve consensus, but based on our experiences, we recommend the consensus process to be followed by feasibility, reliability, and validity testing.
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Multicenter Study Observational Study
Compliance and use of the World Health Organization checklist in U.K. operating theatres.
The World Health Organization (WHO) Surgical Safety Checklist is reported to reduce surgical morbidity and mortality, and is mandatory in the U.K. National Health Service. Hospital audit data show high compliance rates, but direct observation suggests that actual performance may be suboptimal. ⋯ Meaningful compliance with the WHO Surgical Safety Checklist is much lower than indicated by administrative data. Sign-out compliance is generally poor, suggesting incompatibility with normal theatre work practices. There is variation between hospitals, but consistency across studied specialties, suggesting a need to address organizational culture issues.
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Pediatr Crit Care Me · Nov 2013
Observational StudySimulation training for pediatric residents on central venous catheter placement: a pilot study*.
To assess the effect of simulation training on pediatric residents' acquisition and retention of central venous catheter insertion skills. A secondary objective was to assess the effect of simulation training on self-confidence to perform the procedure. ⋯ Simulation training improved pediatric residents' central venous catheter insertion procedural skills. Decay in skills was found at 3-month follow-up. This suggests that simulation training for this procedure should occur in close temporal proximity to times when these skills would most likely be used clinically and that frequent refresher training might be beneficial to prevent skills decay.
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To improve our neonatal resuscitations we review video recordings of actual high-risk deliveries as an ongoing quality review process. In order to help identify and review errors that occurred during resuscitation we educated our resuscitation teams using crew resource management and in March 2009 developed a checklist to be used for potentially high-risk resuscitations. ⋯ The use of checklists during neonatal resuscitation was helpful in improving overall communication, and allowed for rapid identification of issues that need to be addressed by institutional leaders. There needs to be further evaluation of the utility and benefit of checklists for neonatal resuscitation. Based on our past and present experience we encourage the use of checklists for neonatal resuscitation teams.