Evaluation of the Pediatric Regional Anesthesia Time-Out Checklist: A Simulation Study.

Area of Science:

• Anesthesiology
• Patient Safety
• Pediatric Medicine

Background:

• The Society for Pediatric Anesthesia Quality and Safety Committee developed a 14-item checklist for regional anesthesia safety.
• The checklist aims to ensure critical safety items are reviewed by anesthesia teams before procedures.
• The study evaluated the checklist's effectiveness in improving safety practices and clinical decision-making.

Purpose of the Study:

• To determine if using the Pediatric Regional Anesthesia Time-Out Checklist increases the number of safety items performed.
• To assess the checklist's impact on anesthesia teams' clinical judgment regarding procedural safety.
• To evaluate the checklist's usefulness in preventing errors during simulated regional anesthetics.

Main Methods:

• Twenty-two physicians participated in 132 randomized, video-recorded regional anesthesia simulations.
• Checklist training was provided after half of the simulation scenarios were completed.
• Scenarios included programmed errors (e.g., incorrect local anesthetic dosage, coagulation issues); performance and decision-making were scored.

Main Results:

• Checklist training significantly increased safety item completion from 41% to 78% (p < 0.001).
• The rate of appropriate decisions to perform or abort the anesthetic increased from 77% to 92% (p = 0.001).
• Performing procedures with programmed errors decreased from 0.05% before training to 0% after training.

Conclusions:

• Training with the Pediatric Regional Anesthesia Time-Out Checklist enhances the performance of critical safety items.
• The checklist improves clinical judgment, leading to better decisions regarding the safety of simulated pediatric regional anesthetics.
• The tool is effective in increasing adherence to safety protocols in pediatric regional anesthesia.