Articles: checklist.
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Orthop. Clin. North Am. · Oct 2018
ReviewPerioperative Safety: Keeping Our Children Safe in the Operating Room.
The entire operating room team is responsible for the safety of children in the operating room. As a leader in the operating room, the surgeon is impactful in ensuring that all team members are committed to providing this safe environment. This is achieved by the use of perioperative huddles or briefings, the use of appropriate surgical checklists, operating room standardization, surgeons proficient in the care they provide, and team members that embrace Just Culture.
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Oral Maxillofac Surg Clin North Am · May 2018
ReviewOral Surgery Patient Safety Concepts in Anesthesia.
An effective office emergency preparedness plan for the oral and maxillofacial surgery office can be developed through the use of well-designed checklists, cognitive aids, and regularly scheduled in situ simulations with debriefings. In order to achieve this goal, the hierarchal culture of medicine and dentistry must be overcome, and an inclusive team concept embraced by all members of the staff. Technologic advancements in office automation now make it possible to create interactive cognitive aids. These enhance office emergency training and provide a means for more rapid retrieval of essential information and guidance during both simulations and a real crisis.
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Cochrane Db Syst Rev · Jan 2018
ReviewEliciting adverse effects data from participants in clinical trials.
Analysis of drug safety in clinical trials involves assessing adverse events (AEs) individually or by aggregate statistical synthesis to provide evidence of likely adverse drug reactions (ADR). While some AEs may be ascertained from physical examinations or tests, there is great reliance on reports from participants to detect subjective symptoms, where he/she is often the only source of information. There is no consensus on how these reports should be elicited, although it is known that questioning methods influence the extent and nature of data detected. This leaves room for measurement error and undermines comparisons between studies and pooled analyses. This review investigated comparisons of methods used in trials to elicit participant-reported AEs. This should contribute to knowledge about the methodological challenges and possible solutions for achieving better, or more consistent, AE ascertainment in trials. ⋯ This review supports concerns that methods to elicit participant-reported AEs influence the detection of these data. There was a risk for under-detection of AEs in studies using a more general elicitation method compared to those using a comprehensive method. These AEs may be important from a clinical perspective or for patients. This under-detection could compromise ability to pool AE data. However, the impact on the nature of the AE detected by different methods is unclear. The wide variety and low quality of methods to compare elicitation strategies limited this review. Future studies would be improved by using and reporting clear definitions and terminology for AEs (and other important variables), frequency and time period over which they were ascertained, how they were graded, assessed for a relationship to the study drug, coded, and tabulated/reported. While the many potential AE endpoints in a trial may preclude the development of general AE patient-reported outcome measurement instruments, much could also be learnt from how these employ both quantitative and qualitative methods to better understand data elicited. Any chosen questioning method needs to be feasible for use by both staff and participants.
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Anesthesia and analgesia · Jan 2018
ReviewMore Than a Tick Box: Medical Checklist Development, Design, and Use.
Despite improving patient safety in some perioperative settings, some checklists are not living up to their potential and complaints of "checklist fatigue" and outright rejection of checklists are growing. Problems reported often concern human factors: poor design, inadequate introduction and training, duplication with other safety checks, poor integration with existing workflow, and cultural barriers. Each medical setting-such as an operating room or a critical care unit-and different clinical needs-such as a shift handover or critical event response-require a different checklist design. ⋯ We propose such a framework organized around the 5 stages of the checklist life cycle: (1) conception, (2) determination of content and design, (3) testing and validation, (4) induction, training, and implementation, and (5) ongoing evaluation, revision, and possible retirement. We also illustrate one way in which the design of checklists can better match user needs in specific perioperative settings (in this case, the operating room during critical events). Medical checklists will only live up to their potential to improve the quality of patient care if their development is improved and their designs are tailored to the specific needs of the users and the environments in which they are used.
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Observational Study
The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis.
The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. ⋯ Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.