Articles: checklist.
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Acta Neurochir. Suppl. · Jan 2011
Improving patient safety in the intra-operative MRI suite using an on-duty safety nurse, safety manual and checklist.
This paper describes the use of an on-duty safety nurse, a surgical safety manual and a checklist as an essential precursor to evaluating how these approaches affect surgical quality, communication in surgery crews and contribute to the safety of surgical care in the intra-operative magnetic resonance imaging (MRI) suite.
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Observational Study
Compliance with a time-out procedure intended to prevent wrong surgery in hospitals: results of a national patient safety programme in the Netherlands.
To prevent wrong surgery, the WHO 'Safe Surgery Checklist' was introduced in 2008. The checklist comprises a time-out procedure (TOP): the final step before the start of the surgical procedure where the patient, surgical procedure and side/site are reviewed by the surgical team. The aim of this study is to evaluate the extent to which hospitals carry out the TOP before anaesthesia in the operating room, whether compliance has changed over time, and to determine factors that are associated with compliance. ⋯ Large differences in compliance with the TOP were observed between participating hospitals which can be attributed at least in part to the type of hospital, surgical specialty and patient characteristics. Hospitals do not comply consistently with national guidelines to prevent wrong surgery and further implementation as well as further research into non-compliance is needed.
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As part of our plan to decrease infection rates, we instituted a rounding sticker used during daily rounds. This sticker is a checklist that serves as a reminder of interventions known to improve quality of care in the PICU. ⋯ Date was collected on central venous catheter days, foley catheter days, arterial line days, infection rates, GI prophylaxis use, neuromuscular blocker use, and changes in medications before and after institution of the rounding sticker. Following rounding sticker use, there was a 56% reduction in urinary tract infections [4.13/1000 device days vs 1.8/1000 device days; p = 0.027], as well as an increase in GI prophylaxis (1846 vs 2399) and enoxaparin (119 vs 151) use.
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New Zealand appears to have a relatively high rate of perioperative adverse events. The Health Quality & Safety Commission's Safe Surgery NZ programme was introduced to address the rates of perioperative harm in New Zealand by promoting proper and effective use of the World Health Organization (WHO) Surgical Safety Checklist, and by encouraging use of operating room (OR) team briefings and debriefings. Venous thromboembolism prophylaxis is a key part of the checklist as deployed in New Zealand ORs, but it remains underused or variably used as well. Communication and teamwork are critical to improving patient safety and efficiency in the OR, and these interventions have demonstrated effectiveness in building and melding effective teams.