Articles: checklist.
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Review Meta Analysis
The effect of the WHO Surgical Safety Checklist on complication rate and communication.
In 2009, the World Health Organisation issued a worldwide recommendation for the use of its Surgical Safety Checklist in all operative procedures. In this review, we present the available data on the implementation of this checklist and its effect on perioperative morbidity and mortality and on operating-room safety culture. We also survey the experience with the checklist to date and give some recommendations for its practical implementation. ⋯ These results support the WHO's recommendation to use the Surgical Safety Checklist in all operative procedures. The checklist should be understood not merely as a list of items to be checked off, but as an instrument for the improvement of communication, teamwork, and safety culture in the operating room, and it should be implemented accordingly.
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Critical care medicine · Oct 2012
The impact of meeting donor management goals on the number of organs transplanted per donor: results from the United Network for Organ Sharing Region 5 prospective donor management goals study.
Many organ procurement organizations have implemented critical care end points as donor management goals in efforts to increase organs transplanted per donor after neurologic determination of death. Although retrospective studies have demonstrated an association between meeting donor management goals and organ yield, prospective studies are lacking. ⋯ Meeting donor management goals prior to consent and prior to organ recovery were both associated with achieving ≥4 organs transplanted per donor. However, only 15% of donors have donor management goals met at the time of consent. The donor hospital management of patients with catastrophic brain injuries, before the intent to donate organs is known, affects outcomes and should remain a priority in the intensive care unit.
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Surgery like civil aviation is a risk-prone occupation. Civil Aviation has reported a death rate of less than 1 in a million exposures. On the other hand, surgery has a reported mortality rate of 100 per million surgeries. ⋯ In 2009, the checklist was modified with an intention to reduce major surgical complications and was proved to be effective. Wrong level spinal surgery needs special emphasis. There may be an increasing role for checklists in Trauma and Orthopaedic surgical practice to improve its safety profile by being procedure-specific.
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This study examined the reliability of the scores of an assessment instrument, the Debriefing Assessment for Simulation in Healthcare (DASH), in evaluating the quality of health care simulation debriefings. The secondary objective was to evaluate whether the instrument's scores demonstrate evidence of validity. ⋯ The DASH scores showed evidence of good reliability and preliminary evidence of validity. Additional work will be needed to assess the generalizability of the DASH based on the psychometrics of DASH data from other settings.