Articles: checklist.
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Ambulatory surgery centers (ASCs) are being asked to use a safe surgical checklist in 2012 and to report that it has been used in 2013. Checklists should focus on communication and safe surgery practices in each of 3 perioperative periods: (1) before administration of anesthesia, (2) before skin incision, and (3) the period of incision closure and before the patient leaves the operating room. This article reviews the origin of surgical checklists. It examines evidence that indicates that checklists decrease the incidence of human errors, mortality, and morbidity.
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Ventilator-associated pneumonia is a hospital-acquired infection that may develop in patients 48 hours after mechanical ventilation. The project goal was to determine whether a ventilator-associated pneumonia care bundle checklist embedded into an existing electronic health record would increase completeness of nursing documentation in an intensive care unit setting. With the embedded checklist, there were significant improvements in nursing documentation and a decreased incidence of ventilator-associated pneumonia.
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Br J Oral Maxillofac Surg · Jul 2013
Marking the skin for oral surgical procedures: improving the WHO checklist.
We present a system for marking the skin during oral surgical operations. This system identifies teeth to be extracted or exposed under general anaesthesia. Removal of the wrong tooth can cause appreciable morbidity and leaves the surgeon and organisation liable for litigation and scrutiny by regulatory bodies. ⋯ In 2010/2011 the National Reporting and Learning System (NRLS) of the National Patient Safety Agency (NPSA) were notified of 20 incidents when the wrong tooth had been extracted, which accounted for 5% of all incidents reported. We have therefore developed a robust marking system for oral surgical procedures in our hospital, which improves on the World Health Organisation (WHO) checklist. We have audited patients' perceptions and the clinical application of our marking system, and have shown that the system is welcomed by patients, and is simple and effective for clinicians to use.
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The World Health Organisation (WHO) identified patient safety in surgery as an important public health matter and advised the adoption of a universal peri-operative surgical checklist. An adapted version of the WHO checklist has been mandatory in the National Health Service since 2010. Wrong intraocular lens (IOL) implantation is a particular safety concern in ophthalmology. The Royal College of Ophthalmologists launched a bespoke checklist for cataract surgery in 2010 to reduce the likelihood of preventable errors. We sought to ascertain the use of checklists in cataract surgery in 2012. ⋯ Ninety-three per cent of cataract surgeons responding to the questionnaire report using a surgical checklist and 67% use a team brief. However, only 54% use a checklist, which addresses the selection of the correct intraocular implant. We recommend wider adoption of checklists, which address risks relevant to cataract surgery, in particular the possibility of selection of an incorrect IOL.