Articles: checklist.
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Research suggests that surgical safety checklists can reduce mortality and other postoperative complications. The real world impact of surgical safety checklists on patient outcomes, however, depends on the effectiveness of hospitals' implementation processes. ⋯ The impact of surgical safety checklists on patient outcomes is likely to vary with the effectiveness of each hospital's implementation process. Further research is needed to confirm these findings and reveal additional factors supportive of checklist implementation.
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Given the current operating climate, organizations are coming under pressure to develop and implement sustainability programs and projects, yet few managers truly understand what is meant by sustainability and its implications for managing organizations. This article examines the concept of sustainability and provides a broader definition of the term than going "green." Using a puzzle metaphor, the authors outline and explain the different components of sustainability and provide a checklist for achieving sustainability goals. In addition, resources such as guides and tools are reviewed and offered to assist managers in gaining more insight into the challenges and complexity of sustainability.
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Catheter-associated urinary tract infections account for 40% of all health care-associated infections. An evidence-based, nurse-driven daily checklist for initiation and continuance of urinary catheters was implemented in 5 adult intensive care units. Measures of compliance, provider satisfaction, and clinical outcomes were recorded. Compliance with the checklist was 50 to 100%: catheter-associated urinary tract infections decreased from 2.88 to 1.46 per 1000 catheter days and catheter days decreased in 2 intensive care units.
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Hospital checklists are gaining momentum, particularly since the World Health Organization's Safe Surgery Saves Lives Program published results of its study in 2009, indicating that a safety checklist significantly improved surgical outcomes in hospitals across the world. The South Carolina Hospital Association, in partnership with Dr Atul Gawande, has launched a program to implement the World Health Organization Surgical Safety Checklist in every operating room in the state over the next few years. ⋯ Drawing on research, recent initiatives, and the company's experience in high-acuity units, this article explores the implications and challenges of implementing checklists in today's hospitals. If a checklist is to succeed as a mechanism for transforming evidence-based care and safety protocols into best and actual practice, it needs to be used consistently and durably; to achieve this, hospitals need to foster a supportive environment as well as acquire a system to monitor, measure, and manage a culture that effectively embraces checklists.
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Multicenter Study Comparative Study
Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists.
In 2008, all 18 regional referral NICUs in New York state adopted central-line insertion and maintenance bundles and agreed to use checklists to monitor maintenance-bundle adherence and report checklist use. We sought to confirm whether adopting standardized bundles and using central-line maintenance checklists reduced central-line-associated bloodstream infections (CLABSI). ⋯ Although standardizing central-line care elements led to a significant statewide decline in NICU CLABSIs, site of care remains an independent risk factor. Using maintenance checklists reduced CLABSIs.