Articles: checklist.
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J. Thorac. Cardiovasc. Surg. · Apr 2013
Introducing transapical aortic valve implantation (part 2): institutional structured training program.
Introduction of a new procedure has a typical learning curve with the "learning phase" at the beginning, characterized by an increased mortality or complication rate. We developed our institutional structured training program for transcatheter aortic valve implantation (TAVI) with the aim of eliminating these negative effects. ⋯ A structured educational training program enables implementation of a new procedure (TAVI) into clinical practice without increased morbidity and mortality rate during the learning curve. The program may also be used as a basis for any new device introduction into clinical practice.
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Multicenter Study
Diagnostic accuracy of a rapid checklist to identify delirium in older patients transported by EMS.
The presence of delirium in elderly patients is common and has been identified as an independent marker for increased mortality and hospital-acquired complications, yet it is poorly recognized by health care providers. Early recognition of delirium in the prehospital setting has the potential to improve outcomes, but is not feasible without valid assessment tools. ⋯ A rapid delirium checklist can identify 63% of patients with delirium, but performed no better than the GCS. Future research should determine whether a rapid test of cognition improves early identification of elderly patients with delirium.
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Int J Qual Health Care · Apr 2013
Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.
Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. ⋯ The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed.
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We evaluated the impact of the World Health Organization Obstetric Safe Surgery Checklist (WHO Checklist) on perioperative communication between anaesthetists and obstetricians by performing a retrospective audit in a Teaching hospital in London, UK. Caesarean section births from February to March 2009 and April to May 2011 were studied. Caesarean section notes from obstetricians and anaesthetists managing the same woman during the study period were reviewed. ⋯ Grading differences occurred in 24.1% of caesarean sections without checklists compared with 10.3% with checklists (P < 0.001). During emergency caesarean section alone, grading differences between obstetricians and anaesthetists were smaller, although this was not significant (P = 0.222). We conclude that implementation of a WHO Obstetric Safe Surgery checklist improves the communication of caesarean section grade (urgency) between obstetricians and anaesthetists.
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Comparative Study
Effect of a pleural checklist on patient safety in the ultrasound era.
Bedside ultrasound allows direct visualization of pleural collections for thoracentesis and tube thoracostomy. However, there is little information on patient safety improvement methods with this approach. The effect of a checklist on patient safety for bedside ultrasound-guided pleural procedures was evaluated. ⋯ A pleural checklist with systematic scanning and close supervision may further enhance safety of ultrasound-guided procedures. This may also help promote safety while trainees are learning to perform these procedures.