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[Evaluation of a checklist for anesthetic equipment before use]
1Département d'anesthésie-réanimation, hôpital Antoine-Béclère, Clamart, France.
Objective:
To describe and to assess the use of a checklist for anaesthetic equipment, the effects on the quality of care, as well as the difficulty to obtain a complete and permanent compliance of anaesthesia staff to the use of the checklist, in comparison with the practice patterns in other countries and of the recommendations by the French society of anaesthesia and intensive care for the anaesthetic machine checking.
Study Design:
Prospective quality assurance study with two subsequent phases.
Methods:
Both a detailed and a simplified checklist were initially tested over a 57-day-period to evaluate the incidence and severity of recognized abnormalities and to assess the compliance of the staff with this new procedure. Four months later, the same evaluation was performed again. The detailed checklist was used before the first anaesthetic in the morning and called "Theater opening form". The simplified list was used before the subsequent anaesthetics and called "Checking before induction form".
Results:
During phase I, the detailed and simplified forms of the checklist were only used in 54% and 32% of cases respectively. They were more often completed in scheduled (93%) than in emergency cases (31%). The detailed checklist detected 5/165 potentially severe abnormalities in the breathing system that could be amended before use. After formal discussion with all members of the department, the simplified checklist was abandoned, as it did not detect any significant abnormality and was considered too time-consuming. During the phase II of the study, as the staff checked the anaesthetic machine more often in emergency cases (52%), the overall compliance increased (73%) but remained insufficient. However, no critical incident could be detected during the second evaluation period.
Discussion:
This study demonstrated the safety benefits associated with the procedure of checking anaesthetic equipment, but also pointed out the difficulty to obtain a full participation of the staff in quality-assurance programmes.