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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Surgical procedures are now very common, with estimates ranging from 4% of the general population having an operation per annum in economically-developing countries; this rising to 8% in economically-developed countries. Whilst these surgical procedures typically result in considerable improvements to health outcomes, it is increasingly appreciated that surgery is a high risk industry. Tools developed in the aviation industry are beginning to be used to minimise the risk of errors in surgery. One such tool is the World Health Organization's (WHO) surgery checklist. The National Patient Safety Agency (NPSA) manages the largest database of patient safety incidents (PSIs) in the world, already having received over three million reports of episodes of care that could or did result in iatrogenic harm. The aim of this study was to estimate how many incidents of wrong site surgery in orthopaedics that have been reported to the NPSA could have been prevented by the WHO surgical checklist. ⋯ Orthopaedic surgery is a high volume specialty with major technical complexity in terms of equipment demands and staff training and familiarity. There is therefore an increased propensity for errors to occur. Wrong-site surgery still occurs in this specialty and is a potentially devastating situation for both the patient and surgeon. Despite the limitations of inclusion and reporting bias, our study highlights the need to match technical precision with patient safety. Tools such as the WHO surgical checklist can help us to achieve this.
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Acta Anaesthesiol Belg · Jan 2011
Case ReportsUnintentional side error for continuous sciatic nerve block at the popliteal fossa.
Among all fields of healthcare about 45% of medical errors occur in the operating theatre. Wrong site procedures remain one of the most preventable medical errors. ⋯ The surgical safety checklist was established in 2008 by the world Health organization (WHO) as a part of the "Safe surgery save Lives" initiative. We report in this article a case of wrong sided continuous popliteal sciatic nerve block and discuss the role of the WHO's checklist in preventing wrong side peripheral nerve block and surgery.
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Obstetrics and gynecology · Dec 2010
EditorialA simple checklist for preventing major complications associated with cesarean delivery.
I propose a simple, evidence-based, eight-item checklist that, if followed, should reduce the frequency of many of the most serious complications associated with cesarean delivery: endometritis, wound infection, wound disruption, thrombophlebitis, and uterine scar dehiscence in a subsequent pregnancy. The frequency of abdominal wound infections can be reduced significantly by using electric clippers, rather than a razor, to remove the hair at the site of the surgical incision, washing the skin with a chlorhexidine solution, and administering broad-spectrum antibiotic prophylaxis before the start of surgery rather than after the neonate's umbilical cord has been clamped. ⋯ Closure of the deep subcutaneous layer in patients whose subcutaneous tissue is greater than 2 cm in thickness will significantly reduce the risk of seroma, hematoma, and subsequent wound disruption. Institution of appropriate prophylaxis for deep vein thrombosis in intermediate and high-risk patients will reduce the risk of subsequent thromboembolic events.