Articles: checklist.
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BMJ quality & safety · Jul 2011
Student-observed surgical safety practices across an urban regional health authority.
Recognising the global push for patient safety in healthcare, students in medicine and nursing participated in a project to compare surgical safety practices in the Winnipeg Regional Health Authority (WRHA) with the WHO surgical safety checklist. ⋯ Surgical safety practices in ORs across the WRHA are consistent with the guidelines established by the WHO in 2007, but most are not monitored or enforced. The use of a checklist in the preoperative briefing period may improve adherence to these guidelines and facilitate surgical team interaction, resulting in standardisation of practice and improvements in team communication. Student interprofessional team observers are an effective tool for monitoring safety and teamwork.
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Anesthesia and analgesia · Jul 2011
Randomized Controlled Trial Comparative StudyMissed steps in the preanesthetic set-up.
Anesthesiologists accomplish many tasks rapidly during induction of an anesthetic. Key preparation for induction is needed to maximize patient safety. Given the intense environment of the operating room, preparatory steps may be missed either unintentionally or possibly even intentionally to save time. We conducted this study to determine the incidence of missed steps in the operating room immediately before induction. ⋯ Missed steps do occur at a significant and measurable rate. Measures need to be taken to decrease the number of missed steps to improve patient safety.
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A checklist is a cognitive tool specifying the actions necessary to complete a given task. It serves to improve the quality of care, support the memory of the user and it may serve to indicate the necessary communicative steps within a team. ⋯ Preliminary results indicate a potential for patient safety. However, no evidence indicates that a checklist in itself is sufficient to obtain clinical results: training and motivating staff, supporting implementation, and conducting follow-up and evaluation are as important as the checklist itself to achieve results.
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BMJ quality & safety · Jun 2011
Multicenter StudyEvaluation of a preoperative team briefing: a new communication routine results in improved clinical practice.
BACKGROUND Suboptimal communication within healthcare teams can lead to adverse patient outcomes. Team briefings were previously associated with improved communication patterns, and we assessed the impact of briefings on clinical practice. To quantify the impact of the preoperative team briefing on direct patient care, we studied the timing of preoperative antibiotic administration as compared to accepted treatment guidelines. ⋯ In cases where the timing of antibiotics administration was documented unambiguously in the chart (n=259 pre-intervention and n=283 post-intervention), antibiotic prophylaxis was on time for 77.6% of cases in the pre-intervention phase of the study, and for 87.6% of cases in the post-intervention phase (p<0.01). CONCLUSIONS Use of a preoperative team checklist briefing was associated with improved physician compliance with antibiotic administration guidelines. Based on the results, recommendations to enhance timely antibiotic therapy are provided.