Articles: checklist.
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Paediatric anaesthesia · Jul 2013
Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.
Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). ⋯ We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.
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Paediatric anaesthesia · Jul 2013
Striving for a zero-error patient surgical journey through adoption of aviation-style challenge and response flow checklists: a quality improvement project.
We describe our aim to create a zero-error system in our pediatric ambulatory surgery center by employing effective teamwork and aviation-style challenge and response 'flow checklists' at key stages of the patient surgical journey. These are used in addition to the existing World Health Organization Surgical Safety Checklists (Ann Surg, 255, 2012 and 44). ⋯ We have created a reproducible model of care involving multiple checklists at high-risk points in the patient surgical journey. The model is reliable and has a high degree of staff engagement. It promotes patient safety by ensuring the patient, team and equipment are correctly configured at every key transition stage in the surgical journey. We have been able to achieve this with no measurable increase in turnover times or reduction in operating room efficiency.
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Br J Oral Maxillofac Surg · Jul 2013
Marking the skin for oral surgical procedures: improving the WHO checklist.
We present a system for marking the skin during oral surgical operations. This system identifies teeth to be extracted or exposed under general anaesthesia. Removal of the wrong tooth can cause appreciable morbidity and leaves the surgeon and organisation liable for litigation and scrutiny by regulatory bodies. ⋯ In 2010/2011 the National Reporting and Learning System (NRLS) of the National Patient Safety Agency (NPSA) were notified of 20 incidents when the wrong tooth had been extracted, which accounted for 5% of all incidents reported. We have therefore developed a robust marking system for oral surgical procedures in our hospital, which improves on the World Health Organisation (WHO) checklist. We have audited patients' perceptions and the clinical application of our marking system, and have shown that the system is welcomed by patients, and is simple and effective for clinicians to use.
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Ambulatory surgery centers (ASCs) are being asked to use a safe surgical checklist in 2012 and to report that it has been used in 2013. Checklists should focus on communication and safe surgery practices in each of 3 perioperative periods: (1) before administration of anesthesia, (2) before skin incision, and (3) the period of incision closure and before the patient leaves the operating room. This article reviews the origin of surgical checklists. It examines evidence that indicates that checklists decrease the incidence of human errors, mortality, and morbidity.