scholarly journals PROVISION OF SURGICAL SAFETY

2017 ◽  
Vol 176 (2) ◽  
pp. 83-85 ◽  
Author(s):  
V. M. Timerbulatov ◽  
Sh. V. Timerbulatov
Keyword(s):  
Postoperative Complications ◽  
Temperature Control ◽  
Thromboembolic Complications ◽  
Surgical Safety ◽  
Who Checklist ◽  
Operating Unit

OBJECTIVE. The research assessed the efficacy of WHO checklist for prevention of avoidable complications in surgery. MATERIALS AND METHODS. The article presents the results of implementation of WHO recommendations (checklist of measures) for prevention of so-called avoidable complications in surgery during performance of 35300 operations in 3-year period. The authors included two additional issues in the checklist about prevention of thromboembolic complications and temperature control in the operating unit. RESULTS. The number of preventable complications decreased in clinic after the implementation of WHO recommendations. The rate of thromboembolic and different postoperative complications also reduced in comparison with other clinic, where these recommendations haven’t been applied. CONCLUSIONS. The introduction of principles of prevention of complications in surgery according to WHO recommendations allowed significant decrease of the number of avoidable complications.

scholarly journals WHO Surgical Complication Prevention Checklist: a Comparative Analysis of Two Clinics

2021 ◽  
Vol 14 (1) ◽  
pp. 33-41
Author(s):  
Machmud Vilevich Timerbulatov ◽  
Shamil Vilevich Timerbulatov ◽  
Timur Rustemovich Nizamutdinov ◽  
Vil Mamilovich Timerbulatov ◽  
Ekaterina Alexandrovna Grushevskaya
Keyword(s):  
Comparative Analysis ◽  
Postoperative Complications ◽  
Inpatient Treatment ◽  
Surgical Intervention ◽  
Surgical Complication ◽  
Surgical Interventions ◽  
Surgical Safety ◽  
Surgical Department ◽  
Who Checklist ◽  
Surgical Operations

The aim of the study was to examine the effectiveness of the adherence to the WHO surgical safety checklist.Material and methods. A comparative analysis of the performance of the surgical departments in two clinics was carried out: in the first clinic the WHO checklist was applied to control the performance of the surgical department; in the second clinic these recommendations were not used. The results of 3012 (first clinic) and 3527 surgical interventions (second clinic) were analyzed. The authors studied the frequency of postoperative complications, the effectiveness when using all the points of the recommendations.Results. The frequency of antibiotic prophylaxis during general surgical operations in clinic I was 89.3%, in clinic II - 63.7%, the frequency of infection in the area of ​​surgical intervention was by 13.2% and up to two times higher in clinic II, mortality rates after surgery were also significantly higher in clinic II; consequently, the duration of inpatient treatment was 8.7 in clinic I versus 16.4 days in clinic II.Conclusion. The adherence to the surgical safety checklist can effectively reduce the number of postoperative complications, mortality, and reduce the time of inpatient treatment.

scholarly journals Writing’s on the wall: improving the WHO Surgical Safety Checklist

2021 ◽  
Vol 10 (1) ◽  
pp. e001086
Author(s):  
Claire Cushley ◽  
Tom Knight ◽  
Helen Murray ◽  
Lawrence Kidd
Keyword(s):  
Patient Safety ◽  
Online Survey ◽  
Improve Patient Safety ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Time Out ◽  
Mandatory Requirement ◽  
Who Checklist ◽  
Improve Patient ◽  
Theatre Team

Background and problemThe WHO Surgical Safety Checklist has been shown to improve patient safety as well as improving teamwork and communication in theatres. In 2009, it was made a mandatory requirement for all NHS hospitals in England and Wales. The WHO checklist is intended to be adapted to suit local settings and was modified for use in Gloucestershire Hospitals NHS Foundation Trust. In 2018, it was decided to review the use of the adapted WHO checklist and determine whether improvements in compliance and engagement could be achieved.AimThe aim was to achieve 90% compliance and engagement with the WHO Surgical Safety Checklist by April 2019.MethodsIn April 2018, a prospective observational audit and online survey took place. The results showed compliance for the ‘Sign In’ section of the checklist was 55% and for the ‘Time Out’ section was 91%. Engagement by the entire theatre team was measured at 58%. It was proposed to move from a paper checklist to a wall-mounted checklist, to review and refine the items in the checklist and to change the timing of ‘Time Out’ to ensure it was done immediately prior to knife-to-skin.ResultsFollowing its introduction in September 2018, the new wall-mounted checklist was reaudited. Compliance improved to 91% for ‘Sign In’ and to 94% for ‘Time Out’. Engagement by the entire theatre team was achieved 100% of the time. Feedback was collected, adjustments made and the new checklist was rolled out in stages across all theatres. A reaudit in December 2018 showed compliance improved further, to 99% with ‘Sign In’ and to 100% with ‘Time Out’. Engagement was maintained at 100%.ConclusionsThe aim of the project was met and exceeded. Since April 2019, the new checklist is being used across all theatres in the Trust.

Audit of compliance with WHO surgical safety checklist and building a shared mental model in the operating theatre

BMJ Leader ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 132-135
Author(s):  
James Todd
Keyword(s):  
Mental Model ◽  
Patient Death ◽  
Shared Mental Model ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Full Compliance ◽  
Time Out ◽  
Who Checklist ◽  
Grade 3 ◽  
Minor Operations

BackgroundThe use of the checklist has been shown to reduce patient death and postoperative complications and is mandated for use with all National Health Service (NHS) surgery. The aim was to obtain quantitative and qualitative data on compliance with WHO surgical safety checklist during operations in an NHS hospital.MethodData collection was by prospective observational audit of 34 operations using WHO checklist and 5 qualitative criteria to establish efficacy of use: (a) Staff stopped tasks to engage; (b) Staff attentive and listening; (c) Audible to all team; (d) Understanding was checked in briefs and questions/feedback asked; (e) All required staff present.Categorisation: grade 3 (all criteria), grade 2 (three to four of criteria), grade 1 (one to two of criteria). Checklist use was recorded by stage use (eg, Sign In) and component steps.ResultsChecklist stages used were Brief (7/8), Sign In (32/34), Time Out (30/34), Sign Out (18/34) and Debrief (2/8). Checklist component steps were completed more fully in major versus minor operations (17.3/28 vs 8.4/28). Mean qualitative grade was greatest in major surgeries (2.2 vs 1.6) and using general anaesthesia (1.8 vs 1.3). 3/34 of operations achieved Grade 3.ConclusionSign Out and Debrief compliance was low, as was full compliance with component steps of the WHO checklist, especially during minor operations. A focused checklist specific for minor operations could be introduced to remove unnecessary steps and mitigate against excessive omission. Improved qualitative use of the checklist is required to maximise effectiveness and facilitate a shared mental model.

Post-surgery, post-anaesthesia complications

2017 ◽  
Author(s):  
Andrew Toner ◽  
Mark Hamilton ◽  
Maurizio Cecconi
Keyword(s):  
High Risk ◽  
Postoperative Complications ◽  
Inflammatory Responses ◽  
Enhanced Recovery ◽  
Clinical Intervention ◽  
Evidence Base ◽  
Thromboembolism Prophylaxis ◽  
Surgical Safety ◽  
Post Surgery ◽  
Recovery Protocols

Postoperative complications are common in high-risk surgical populations and are associated with poor short-term and long-term outcomes. Morbidity can be identified using prospective assessment of pathological criteria, or deviations from the ideal postoperative course requiring clinical intervention. While infections are the most prevalent complication type, morbidity affecting the heart, lungs, kidneys, or brain carry the worst prognosis. Specific pathophysiological processes drive morbidity in each organ system. In addition, dysfunction of the cardiovascular and immune systems can lead to multiorgan impairment, and have been the focus of many clinical trials. Perioperative strategies backed by the strongest evidence base include smoking cessation, surgical safety checklists, perioperative warming, pre-emptive antibiotics, venous thromboembolism prophylaxis, enhanced recovery protocols, and early critical care rescue when complications arise. Isolated attempts to optimize cardiovascular function or attenuate inflammatory responses have not been consistently successful in improving outcomes. As the proportion of surgical patients meeting high-risk criteria rises, reducing the incidence of postoperative complications has become a priority in many developed healthcare systems. To meet this need, improved implementation of proven strategies should be combined with routine and rigorous surgical outcome reporting. In addition, advances in pathophysiological understanding may lead to novel interventions offering multisystem protection in the surgical period.

Morbidity of Surgery After Neoadjuvant Chemotherapy Including Bevacizumab for Advanced Ovarian Cancer

2013 ◽  
Vol 23 (7) ◽  
pp. 1326-1330 ◽  
Author(s):  
Elisabeth Chéreau ◽  
Eric Lambaudie ◽  
Gilles Houvenaeghel
Keyword(s):  
Ovarian Cancer ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Median Number ◽  
Debulking Surgery ◽  
Surgical Safety ◽  
Computed Tomographic ◽  
Gynecology And Obstetrics ◽  
Grade 3

ObjectiveNeoadjuvant chemotherapy followed by interval debulking surgery is an alternative for the management of advanced ovarian cancer (AOC). Owing to unresectable disease at initial evaluation, some patients received bevacizumab in addition to neoadjuvant chemotherapy. The aim of this study was to evaluate the safety and postoperative course of patients who had received bevacizumab before debulking surgery for AOC.MethodsIn 2012, we identified all patients with AOC who had received neoadjuvant bevacizumab before debulking surgery. We recorded patients’ characteristics, surgical course, and postoperative complications.ResultsFive patients were identified, of whom 80% were International Federation of Gynecology and Obstetrics stage 4 at diagnosis. All patients underwent surgery after 6 courses of neoadjuvant chemotherapy with carboplatin, paclitaxel, and bevacizumab. The median number of bevacizumab injections was 3 (3–4), and the median time between the last injection of bevacizumab and surgery was 54 days (34–110 days). One patient had a grade 3 complication (lymphocyst with puncture under computed tomographic scans).ConclusionIn this preliminary study, debulking surgery after neoadjuvant chemotherapy that included bevacizumab did not increase the rate of postoperative complications when there was a reasonable interval between the last bevacizumab injection and surgery. Larger studies are warranted to assess surgical safety after antiangiogenic treatment in the neoadjuvant setting for advanced ovarian cancer.

scholarly journals Observations of Pre-operative Teamwork and Communication During the Implementation of a City-Wide Surgical Safety Checklist

2012 ◽  
Vol 5 (4) ◽  
pp. 117-133
Author(s):  
Terry Leonid Hansen ◽  
Kyle Goerl ◽  
Reginald Fears ◽  
Tim Nguyen ◽  
Traci Hart ◽  
...  
Keyword(s):  
World Health ◽  
Medical Society ◽  
Convenience Sample ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Wrong Site Surgery ◽  
Time Out ◽  
Who Checklist ◽  
Sedgwick County ◽  
Surgical Teams

BACKGROUND: Use of the World Health Organization's (WHO) perioperative safety checklist has been shown in prior studies to reduce morbidity and mortality. In 2009, the Medical Society of Sedgwick County, Kansas, developed a modified version of the WHO checklist for city-wide implementation. This study evaluated how the checklist was used at a Wichita hospital. METHODS: An observational tool was developed to evaluate time-outs at the beginning of surgical procedures. A convenience sample of cases was evaluated across surgical specialties and procedures. Observations included: 1) when the time-out was done, 2) who led the time-out, 3) which items on the checklist were addressed, 4) how much time was spent, and 5) whether problems were identified or adverse events prevented. RESULTS: Data were collected from 121 observations. Only one of the surgical teams was observed to refer directly to the checklist posted in the OR to conduct their time out. The time-out was done before induction (3%), drape (19%), incision (77%), and after incision (1%). The process was led by the circulating nurse (92%), surgeon (7%), and circulating nurse and surgeon together (1%). The percent of completed checklist items was: patient identity (96%), procedure (96%), antibiotics (87%), site (80%), allergies (75%), position (70%), equipment (60%), DVT prevention (50%), images (40%), surgeon concerns (36%), and anesthesia provider concerns (34%). On average, seven (SD = 2.5) of 11 items on the checklist were addressed. Time spent ranged from less than one minute to five minutes; 78% took one minute or less. Problems were identified in 7% of cases. In one case, a wrong site surgery was prevented. CONCLUSIONS: Despite the intention to implement a city-wide surgical safety checklist, the checklist rarely was used in its entirety to conduct the observed time-outs in the subject hospital. Although the checklist was under-utilized, safety benefits were observed from the time-out process. These would likely be enhanced and extended by consistent use of a checklist.

Attitude and Beliefs About Surgical Safety Checklist in a North Indian Tertiary Care Hospital a Decade Later of WHO Checklist

2020 ◽  
Author(s):  
Lovenish Bains ◽  
Anurag Mishra ◽  
Daljit Kaur ◽  
Pawan Lal ◽  
Lalit Gupta ◽  
...  
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Tertiary Care ◽  
Health Care Facilities ◽  
Leadership Role ◽  
Junior Doctors ◽  
Care Hospital ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Who Checklist

Abstract Avoidable surgical complications account for a large proportion of preventable medical injuries and deaths globally. Surgical Safety Checklist is evidence-based, internationally accepted valid instrument, which has been found to reduce postoperative morbidity and mortality; the benefits of which are most striking in low- and middle-income countries (LMICs) Despite implementation in many hospitals throughout the country, there is still lack of awareness and concern in many LMICS health care facilities towards SSCL and its use, even after a decade of WHO checklist. We conducted a survey to assess the knowledge, attitudes and beliefs about the WHO-surgical checklist in which 65.4% (138) surgeons, 25.1% (53) anaesthetists and 9.5% (20) nurses participated. Majority believed that use of SSCL improves the safety of procedures, improves communication amongst theatre staff and will result in a reduction in errors in theatre yet there was no commitment for use of SSCL. Although all theatre personnel support implementation and use of SSCL however hierarchical issues, lack of administrative support, lack of training, logistics and timing, high patient volume and overburdened residents, lack of co-ordinator or leadership role and shortage of man power can be impediment to effective use. Nurses and junior doctors play a crucial role. Commitment rather than compliance and teamwork will be the key, ably supported by education and training which should be mandatory for all OT stake holders. Therefore, any measure that can potentially improve patient safety should be embraced and benefits of SSCL be told to motivate them and enhance participation for patient safety. Committed leadership, knowledge sharing and periodic trainings, interdisciplinary communication, feedback and regular audits can define and determine effective implementation process.

Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in N orth A merica

2018 ◽  
Vol 47 (8) ◽  
pp. 1052-1065 ◽  
Author(s):  
Megan T. Cray ◽  
Laura E. Selmic ◽  
Briana M. McConnell ◽  
Lorissa M. Lamoureux ◽  
Daniel J. Duffy ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Academic Institution ◽  
Surgical Safety Checklist ◽  
Surgical Safety
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