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Surgery checklist implementation to reduce clinical risk in the pediatric operating room
1Maggiore della Carità University Hospital Novara, Italy - aj.spunky@hotmail.it.
Insights
Implementing a surgical safety checklist in a pediatric operating room significantly reduced patient harm. The checklist proved effective in preventing adverse events, with most near-misses and adverse events occurring during the sign-out phase.
Area of Science:
- Pediatric Surgery
- Patient Safety
- Quality Improvement
Background:
- Procedural errors in pediatric operating rooms pose significant clinical risks.
- Surgical safety checklists are recognized tools for mitigating these risks.
Purpose of the Study:
- To proactively analyze procedural errors after implementing a surgical safety checklist in a pediatric operating room.
- To assess the checklist's impact on reducing and preventing clinical risk.
Main Methods:
- A prospective cohort study was conducted.
- A "Checklist for Patient Safety in the Pediatric Operating Room" was implemented in June 2011.
- Data were collected by a single observer over 61 checklist compilations.
Main Results:
- A total of 189 errors were identified, with 59.78% occurring during the sign-out phase.
- Near-miss events (n=168) constituted 88.89% of all events, while adverse events (n=21) accounted for 11.11%.
- Error incidence was lower than reported average rates in the literature.
Conclusions:
- Surgical safety checklist implementation effectively reduced and prevented adverse events, safeguarding patients from injury in 88.89% of cases.
- The study demonstrated a lower error incidence in this pediatric operating room compared to existing literature benchmarks.
Aim:
The aim of this prospective cohort study was to conduct a proactive analysis of procedural errors as revealed after implementation of a surgical safety checklist in the pediatric operating room of the Maggiore della Carità University Hospital, Novara. A further aim was to determine the effect the checklist had on the reduction, prevention, and protection against clinical risk in this setting.
Methods:
A "Checklist for Patient Safety in the Pediatric Operating Room" was derived from documentation in the international literature and implemented in June 2011. All data were collected by a single observer.
Results:
In all, 61 checklists were compiled. Analysis revealed 189 errors (absolute frequency), with the highest error incidence (59.78%) recorded for the sign-out phase (percentage cumulative frequency). Two categories of events were distinguished (surgical and orthopedic) and compared. The absolute frequency of near-miss events (n=168) and adverse events (n=21) was then broken down into the five phases of checklist compilation. The percentage cumulative frequency of near-miss was 88.89% and that of adverse events was 11.11%.
Conclusion:
Safety checklist implementation led to reduction, prevention and protection against adverse events with patient injury in 88.89% of cases. The error incidence in this pediatric operating room was lower than the average rates published in the literature.
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