Articles: checklist.
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Anesthesia and analgesia · Jul 2011
Randomized Controlled Trial Comparative StudyMissed steps in the preanesthetic set-up.
Anesthesiologists accomplish many tasks rapidly during induction of an anesthetic. Key preparation for induction is needed to maximize patient safety. Given the intense environment of the operating room, preparatory steps may be missed either unintentionally or possibly even intentionally to save time. We conducted this study to determine the incidence of missed steps in the operating room immediately before induction. ⋯ Missed steps do occur at a significant and measurable rate. Measures need to be taken to decrease the number of missed steps to improve patient safety.
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A checklist is a cognitive tool specifying the actions necessary to complete a given task. It serves to improve the quality of care, support the memory of the user and it may serve to indicate the necessary communicative steps within a team. ⋯ Preliminary results indicate a potential for patient safety. However, no evidence indicates that a checklist in itself is sufficient to obtain clinical results: training and motivating staff, supporting implementation, and conducting follow-up and evaluation are as important as the checklist itself to achieve results.
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Following the overwhelming evidence of adverse events in hospital practice, the World Health Organization (WHO)'s World Alliance for Patient Safety has launched the 'Safe Surgery Saves Lives' campaign, which has developed a surgical safety checklist aimed to improve patient safety. The implementation of this checklist has met with mixed reactions in different institutions. Many countries have still not adopted its use. In this article, a brief review is presented regarding the role of the WHO checklist, barriers to its implementation and strategies for successful adoption.
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BMJ quality & safety · Jun 2011
Multicenter StudyEvaluation of a preoperative team briefing: a new communication routine results in improved clinical practice.
BACKGROUND Suboptimal communication within healthcare teams can lead to adverse patient outcomes. Team briefings were previously associated with improved communication patterns, and we assessed the impact of briefings on clinical practice. To quantify the impact of the preoperative team briefing on direct patient care, we studied the timing of preoperative antibiotic administration as compared to accepted treatment guidelines. ⋯ In cases where the timing of antibiotics administration was documented unambiguously in the chart (n=259 pre-intervention and n=283 post-intervention), antibiotic prophylaxis was on time for 77.6% of cases in the pre-intervention phase of the study, and for 87.6% of cases in the post-intervention phase (p<0.01). CONCLUSIONS Use of a preoperative team checklist briefing was associated with improved physician compliance with antibiotic administration guidelines. Based on the results, recommendations to enhance timely antibiotic therapy are provided.
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Ann Fr Anesth Reanim · Jun 2011
Multicenter Study[Assessment of the French surgical checklist: the experience of 17 French cancer centres].
The use of WHO checklist has been associated to a decrease of complication incidence and mortality. This control is mandatory since January the 1st 2010. Evaluation of the quality of documentation is important and includes filling rate, which is a reflexion of participant adhesion and analysis of the circumstances where the team answers "no" during the control. ⋯ There is a large discrepancy between centres and for a given centre in reporting quality. Significant progress should be expected using target improvement. This approach implies multiple critical analysis of checklist content in each hospital and in multicentre enquiries.