The use of a checklist reduces errors in equipment set-up by veterinary student anesthetists

To investigate the relative frequency of set-up errors documented before and after the introduction of an anesthesia equipment checklist in two successive veterinary classes.

Pre- and post-intervention observational study.

In study year 1, our typical educational practices for training third year veterinary students in anesthesia equipment set-up and testing were followed (participant rate 96/96). In study year 2, a new third year class of students was introduced to and trained on the use of an anesthesia equipment checklist (participant rate 94/98). Data on errors in equipment set-up were recorded prospectively on a standardized collection sheet in a de-identified manner. Negative binomial regression models compared the overall count of errors per laboratory session and per possible error. Binary logistic regression models investigated the probability of each specific error occurring before and after introduction of the equipment checklist, as each specific error type could occur only once per equipment set-up.

Checklist availability was the only variable with a significant effect on error. The relative number of errors per laboratory session was 88% less in the year after introduction of the checklist than the year prior, decreasing from an average of 0.066 errors per possible error (111 errors with 1691 opportunities for error) to 0.008 per possible error (15 errors with 1947 opportunities for error). The odds of making an airway supplies error from study year 1 to year 2 was reduced by 97.2%, decreasing from an occurrence in 16.2% of equipment set-ups to 0.8% of equipment set-ups. The odds of failure to open the adjustable pressure limiting valve decreased by 75.7%, from an occurrence in 5.9% of equipment set-ups to 1.5% of equipment set-ups.

Exposure to an anesthesia equipment checklist decreased but did not eliminate equipment set-up errors by student anesthetists.