Modified surgical safety checklist (mSSC)- a must to avoid disaster in neurosurgical procedures!

The World Health Organization (WHO) introduced surgical safety checklist (SSC) as a part of Second Global Patient Safety Challenge: Safe Surgery Saves Lives to address the safety of surgical care. Althoughfound to be benefi cial for general surgical patient, we introduced certain modification to suit neurosurgical patients and hereby present our experience with the modified checklist.We introduced the modified SSC in July 2012 for neurosurgical purpose after we identified minor but common errors in carefully audited 100 patients in our operating theatre. Modification included checklists in pre procedure room, during sign in enquiring for pulse oximeter (for local anesthetic procedures) and lastly during sign out an elaborated list of items to guarantee safe transfer of the patients. Nurses and doctors were trained and SSC was methodically administered.Outcome as number of complications was evaluated and graded according to no harm, low harm, moderated harm, severe harm and death. During last 5 years (July 2012 to June 2017), 1310 patients undergoing surgical procedures in neurosurgical theatre at KMCTH were studied. Modified SSC was used in both routine (50.5%) and emergency cases (49.5%), of which compliance was 80% and 55% respectively. Poor compliance was due to ignorance of its use, emergency nature of procedure, change of staff. Completeness of mSSC was found in 70% cases with most left out part of mSSC was during signing out (i.e during transfer of patients). Use of mSSC identified many common but minor negligent acts on part of doctors, nurses and OR technicians which could be rectified in time and hence avoided any major mishaps. Age of the patients ranged from newborn to 98 year old. There were no major mishaps including death on table events. Despite confirming during mSSC checklist, machine failure occurred in 10 cases (0.8%) which were of low harm category. The total time taken for performing and filling the checklist took roughly 7 minutes.We modified WHO surgical safety checklist to include post operative transfer out to recovery room and used it in both routine and emergency procedures. This has helped us to avoid major mishaps during and after the neurosurgical procedures. We recommend stringent use of SSC in all neurosurgical centre and advise suitable local modifications according to prevailing conditions for special procedures or locations.Nepal Journal of Neuroscience, Volume 14, Number 3, 2017, page: 7-12

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Validation of a Norwegian version of SURgical PAtient Safety System (SURPASS) in combination with the World Health Organizations’ Surgical Safety Checklist (WHO SSC)

BMJ Open Quality ◽

10.1136/bmjoq-2018-000488 ◽

2019 ◽

Vol 8 (1) ◽

pp. e000488 ◽

Cited By ~ 3

Author(s):

Anette Storesund ◽

Arvid Steinar Haugen ◽

Hilde Valen Wæhle ◽

Rupavathana Mahesparan ◽

Marja A Boermeester ◽

...

Keyword(s):

Patient Safety ◽

Focus Groups ◽

Content Validity ◽

Surgical Care ◽

Safety System ◽

World Health ◽

Surgical Patient ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Norwegian Version

IntroductionSurgical safety checklists may contribute to reduction of complications and mortality. The WHO’s Surgical Safety Checklist (WHO SSC) could prevent incidents in operating theatres, but errors also occur before and after surgery. The SURgical PAtient Safety System (SURPASS) is designed to intercept errors with use of checklists throughout the surgical pathway.ObjectiveWe aimed to validate a Norwegian version of the SURPASS’ preoperative and postoperative checklists for use in combination with the already established Sign In, Time Out and Sign Out parts of the WHO SSC.Methods and materialsThe validation of the SURPASS checklists content followed WHOs recommended guidelines. The process consisted of six steps: forward translation; testing the content; focus groups; expert panels; back translation; and approval of the final version. Qualitative content analysis was used to identify codes and categories for adaption of the SURPASS checklist items throughout Norwegian surgical care. Content validity index (CVI) was used by expert panels to score the relevance of each checklist item. The study was carried out in a neurosurgical ward in a large tertiary teaching hospital in Norway.ResultsTesting the preoperative and postoperative SURPASS checklists was performed in 29 neurosurgical procedures. This involved all professional groups in the entire surgical patient care pathway. Eight clinical focus groups revealed two main categories: ‘Adapt the wording to fit clinical practice’ and ‘The checklist items challenge existing workflow’. Interprofessional scoring of the content validity of the checklists reached >80% for all the SURPASS checklists.ConclusionsThe first version of the SURPASS checklists combined with the WHO SSC was validated for use in Norwegian surgical care with face validity confirmed and CVI >0.80%.Trial registration numberNCT01872195.

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PENERAPAN SURGICAL SAFETY CHECKLIST WHO DI RSUD JARAGA SASAMEH KABUPATEN BARITO SELATAN

Berkala Ilmiah Kedokteran Duta Wacana ◽

10.21460/bikdw.v1i3.25 ◽

2016 ◽

Vol 1 (3) ◽

pp. 173

Author(s):

Suryanti Klase ◽

Rizaldy Taslim Pinzon ◽

Andreasta Meliala

Keyword(s):

World Health Organization ◽

World Health ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Health Organization

Latar Belakang: Penerapan pemakaian Surgical Safety Checklist (SSC) dari World Health Organization (WHO) adalah untuk meningkatkan keselamatan pasien dalam proses pembedahan dikamar operasi dan mengurangi terjadinya kesalahan dalam prosedur pembedahan. Tingginya angka komplikasi dan kematian akibat pembedahan menyebabkan tindakan pembedahan seharusnya menjadi perhatian kesehatan global. Penggunaan checklist terstruktur dalam proses pembedahan akan sangat efektif karena standarisasi kinerja manusia dalam memastikan prosedur telah diikuti. Untuk itu diperlukan juga proses penerapan Surgical Safety Checklist WHO di RSUD Jaraga Sasameh Kabupaten Barito Selatan. Metode: Jenis penelitian ini adalah penelitian deskriptif dengan rancangan penelitian kualitatif, studi kasus. Subyek penelitian ini adalah semua personel kamar bedah RSUD Jaraga Sasameh Kabupaten Barito Selatan, Propinsi Kalimantan Tengah selama bulan Maret - Mei 2015. Kuesioner menjelaskan tentang karakteristik umum dari sampel (umur, jenis kelamin, pekerjaan, lama kerja di rumah sakit), pengetahuan tentang Surgical Safety Checklist WHO, penerimaan checklist dan penerapannya, dan kerja sama team kamar bedah. Hasil: Dari 21 personel kamar bedah yang menjawab kuesioner, 100% menyadari keberadaan Surgical Safety Checklist WHO dan mengetahui tujuannya. Kebanyakan personel berpikir bahwa menggunakan checklist keselamatan Bedah WHO bermanfaat dan pelaksanaannya di kamar bedah merupakan keputusan yang tepat. Ada 90,5% personel yang menyatakan bahwa penggunaan Surgical Safety Checklist WHO cukup mudah untuk dilaksanakan. Kesimpulan: Meskipun terdapat penerimaan yang besar terhadap pelaksanaan penerapan checklist ini diantara personel kamar bedah, tetapi terdapat sedikit perbedaan dalam pengetahuan tentang tata cara pengisian ataupun penggunaan checklist.

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Attitudes and compliance with the WHO surgical safety checklist: a survey among surgeons and operating room staff in 138 hospitals in China

Patient Safety in Surgery ◽

10.1186/s13037-020-00276-0 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Jie Tan ◽

James Reeves Mbori Ngwayi ◽

Zhaohan Ding ◽

Yufa Zhou ◽

Ming Li ◽

...

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Operating Room ◽

World Health ◽

Surgical Patient ◽

Local Data ◽

Cross Sectional ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Operating Room Staff

Abstract Background Ten years after the introduction of the Chinese Ministry of Health (MoH) version of Surgical Safety Checklist (SSC) we wished to assess the ongoing influence of the World Health Organisation (WHO) SSC by observing all three checklist components during elective surgical procedures in China, as well as survey operating room staff and surgeons more widely about the WHO SSC. Methods A questionnaire was designed to gain authentic views on the WHO SSC. We also conducted a prospective cross-sectional study at five level 3 hospitals. Local data collectors were trained to document specific item performance. Adverse events which delayed the operation were recorded as well as the individuals leading or participating in the three SSC components. Results A total of 846 operating room staff and surgeons from 138 hospitals representing every mainland province responded to the survey. There was widespread acceptance of the checklist and its value in improving patient safety. 860 operations were observed for SSC compliance. Overall compliance was 79.8%. Compliance in surgeon-dependent items of the ‘time-out’ component reduced when it was nurse-led (p < 0.0001). WHO SSC interventions which are omitted from the MoH SSC continued to be discussed over half the time. Overall adverse events rate was 2.7%. One site had near 100% compliance in association with a circulating inspection team which had power of sanction. Conclusion The WHO SSC remains a powerful tool for surgical patient safety in China. Cultural changes in nursing assertiveness and surgeon-led teamwork and checklist ownership are the key elements for improving compliance. Standardised audits are required to monitor and ensure checklist compliance.

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A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery

AORN Journal ◽

10.1002/aorn.13469 ◽

2021 ◽

Vol 114 (2) ◽

pp. 159-170

Author(s):

Liang Qin Liu ◽

Sinead Mehigan

Keyword(s):

Systematic Review ◽

World Health Organization ◽

World Health ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

The World ◽

Health Organization

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The World Health Organization Surgical Safety Checklist

Anesthesia & Analgesia ◽

10.1213/ane.0000000000003732 ◽

2018 ◽

Vol 127 (6) ◽

pp. 1283-1284

Author(s):

Paulin R. Banguti ◽

Jean Paul Mvukiyehe ◽

Marcel E. Durieux

Keyword(s):

World Health Organization ◽

World Health ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

The World ◽

Health Organization

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Implementation of WHO Surgical Safety Checklist and Pre-operative Anxiety Levels to Study the Effect on Post-operative Recovery among Surgery Patients

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i37a32009 ◽

2021 ◽

pp. 271-283

Author(s):

Rajesh Hadia ◽

Juliet Joy Joseph ◽

Jilce Mathew ◽

Shivani Patel ◽

Trupal Rathod ◽

...

Keyword(s):

Postoperative Recovery ◽

World Health ◽

Routine Practice ◽

Surgical Safety Checklist ◽

Surgical Safety ◽

Quality Of Recovery ◽

Health Organization ◽

Operative Recovery ◽

Or Team

Background: World Health Organization Surgical Safety Checklist demonstrated a significant reduction in both morbidity and mortality. Objectives: This study aimed to find out the feasibility of implementation of WHO Surgical safety checklist in the routine practice, to ensure the teams follow critical safety steps, consistency in patient safety, and to maintain a culture that values achieving it, to assess the pre-operative status and post-operative quality of recovery among the patients undergoing surgery. Methodology: It is a prospective and observational study. A total of 65 patients of age group 18 and above were included in the study. The data was collected by filling the patient medical record sheet. Result: A total of 65 patients were included in the study. 64.62% were male, 35.38% were female. Out of 65 patients 61.54% experienced pre-operative anxiety; of which 20% of patients (n=9) showed very fast to fast recovery, 27.5% of patients (n=11) showed moderate recovery) and 52.5% of patients (n=21) showed slow to very slow recovery. Conclusion: Implementation of the WHO surgical safety checklist may improve miscommunications between the OR team, avoid unexpected errors ((Improving teamwork and communication). Appointing a staff or member of the OR team with the responsibility to check the checklist may improve the feasibility to implement the WHO SSC. The level of pre-operative anxiety greatly influences postoperative recovery. Thus, the Surgical and Anaesthetic team must assess the patient's pre-operative anxiety and take the necessary step before surgery.

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