Safe preoperative regional nerve blocks.

Area of Science:

• Medical safety protocols
• Anesthesiology
• Surgical checklists

Background:

• Procedural time-outs and checklists are established methods for enhancing teamwork and preventing wrong-sided procedures.
• The study addresses the need for consistent application of time-outs in preoperative regional nerve blocks.

Purpose of the Study:

• To ensure all regional nerve blocks in the preoperative area utilized a proper time-out.
• To increase the integration of a safe preoperative block process, including a time-out checklist.
• To verify complete consents, correct patient identification, and proper laterality marking before each procedure.

Main Methods:

• A multidisciplinary approach was used to develop a safe preoperative block process flowchart, a revised time-out checklist, and an action plan within a Plan-Do-Study-Act model.
• Data were collected via direct observation by anonymous medical students before and after implementation.
• Observations focused on the presence of staff, completion of the time-out checklist, and procedure start/sedation times.

Main Results:

• Pre-implementation compliance with a correct time-out was 20% (3/15).
• Post-implementation compliance increased to 85% (12/14), representing a 65% improvement in checklist completion.
• Comparative analysis indicated a decrease in non-compliance and protocol deviations.

Conclusions:

• The creation of a safe nerve block process was achieved through multidisciplinary collaboration and the implementation of a time-out checklist.
• Improved compliance with the time-out checklist, patient verification, and laterality marking enhanced preoperative safety.
• The study successfully integrated a safe preoperative block process, ensuring proper consents and time-outs for all regional nerve blocks.