Surgical safety checklist: an element of work organization in the operating theater / Lista de verificação de segurança cirúrgica: um elemento de organização do trabalho no bloco cirúrgico

Objectives: the surgical safety checklist (SSC) is a document that is intended to increase patient safety in the operating theater by eliminating avoidable errors. The original document has been published in English by the WHO which recommends its obligatory use. The document's name is often distorted when translated into European languages, for instance into the "surgical control list". This article aims to assess the consequences of the distortion of the originally intended meaning for the completion of SSC in the operating theater. Methods: we compared the exactness of the meaning of translation in 29 European languages based on Google translator. Particular attention was paid to the presence of essential words such as "checklist" and "safety" in the translation. Results: we found that in 15 out of the 29 languages, the translation of these two words was incorrect, particularly in Slavic languages. The most often mistranslation was the "control card" or "control list", which was a misnomer. Conclusions: the translation of the SSC name into native languages is inadequate in about one-half of the cases, which may jeopardize its proper use by team members of the operating theater, and thus the patient perioperative safety.

Objetivo: a lista de verificação de segurança cirúrgica (SSC) é um documento que visa aumentar a segurança do paciente no centro cirúrgico, eliminando possíveis erros. O documento original foi publicado em inglês pela OMS que recomenda seu uso obrigatório. O nome do documento é frequentemente distorcido quando traduzido para idiomas europeus, por exemplo, na "lista de controle cirúrgico". Este artigo visa avaliar as consequências da distorção do significado originalmente pretendido para a realização do SSC na sala de cirurgia. Métodos: para isso, comparamos a exatidão do significado da tradução em 29 idiomas europeus com base no tradutor do Google. Atenção especial foi dada para a presença de palavras essenciais como "lista de verificação" e "segurança" na tradução. Resultados: descobrimos que em 15 dos 29 idiomas, a tradução dessas duas palavras estava incorreta, principalmente em idiomas eslavos. A tradução incorreta mais frequente era o "cartão de controle" ou "lista de controle", o que era um equívoco. Conclusão: a tradução do nome do SSC para as línguas nativas é inadequada em cerca de metade dos casos, o que pode comprometer seu uso adequado pelos membros da equipe de centro cirúrgico e, portanto, a segurança perioperatória do paciente.

Surgical Safety Checklist: Polychromatic or Achromatic Design.

The Surgical Safety Checklist (SSC) has been created based on the recommendations of the WHO and obligatorily introduced worldwide. SSC is used to increase the patient's safety and reduce complications while in the hospital, especially in the perioperative period. The original SSC template was of a multicolor polychromatic design. However, an achromatic black-and-white or gray-gray design on plain printer paper appears often used in clinical practice. This review aims to assess the level of SSC use in the polychromatic versus achromatic versions and the pros and cons of using either in practice. We used the Google browser for the identification and collection of SSC graphic images available as of June 2021 using the following search commands: "surgical safety checklist WHO" or "surgical safety checklist" or "SSC WHO." The commands were repeated in 103 languages representing the five continents with the back answers provided in 41 languages. The successive top 10 thematically relevant images or fewer if not available in the cases of some foreign languages were considered for analysis, providing a mean of 5 ±2 images per language. The numbers of achromatic and polychromatic two-color or multicolor images were calculated. The number of images corresponding to the respective color designs ranged as follows: 0-6 (27.6%), 0-9 (41.6%), and 0-6 (27.6%) We conclude that polychromatic imaging of SSC documents predominates in practical use. The polychromatic SSC design catches the doctor's eye, which likely increases the effectiveness of completing the document.

Compliance with the Surgery Safety Checklist: An Update on the Status.

WHO has recommended the implementation of the Surgery Safety Checklist (SSC) to reign in often simple logistic errors that lead to numerous complications, some of them being fatal, in the perioperative period. This study aims to discuss doubts presented in the medical literature concerning the effectiveness of SSC in the currently existing form. The article is based on the literature search performed in PubMed using the command phrase "Surgery Safety Checklist". The search yielded 1,476 articles up to March 2021. Out of this group, we selected 811 articles for further detailed analysis. The selection was based on the meritorious SSC-related topicality and scrutinized content of the articles. Out of these articles, we identified 59 studies that specifically raised the issue of the effectiveness of SSC use in its current form, which we discussed herein in detail. The review distinctly indicates that the SSC reduces perioperative complications including fatalities. However, there are issues reported with the itemized content of the checklist that hardly correspond to the diverseness of patients' conditions and operating room settings. Further, it is unclear if a reduction in the complications stems from the use of SSC or the algorithms for performing procedures it contains. The consensus arises that SSC should be periodically updated so that it would catch up with the advances in medical knowledge and the emerging technologies, which would safeguard the SSC from becoming just another paperwork nuisance for the operating room staff.

Causes and Effects of Introducing Surgery Safety Checklist: A Review.

The medical treatment process, particularly surgery, is inescapably bound to potential complications or undesirable adverse events. This narrative review aims to present the causes and effects of the introduction of the WHO Surgery Safety Checklist (SSC), the use of which is expected to reduce the number of perioperative errors, complications, and mortality. To achieve this objective, we performed a bibliometric analysis of medical citations indexed in the PubMed database using the SSC subject heading. Findings revealed a total of 1441 articles meeting inclusion status, with 1171 published during the last decade. After the screening of titles and abstracts, the members of the research team selected 75 articles, deemed most relevant for inclusion in the review, which were then thoroughly analyzed. All in all, the findings were that the use of SSC appreciably reduced the number of simple logistic errors in the perioperative period decreasing the frequency of resulting complications and mortality.

Overload of Medical Documentation: A Disincentive for Healthcare Professionals.

This review addresses the theories concerning the development and functioning of medical bureaucracy creating an excess of the patient records. An ever-growing number of medical files comply with the typical development of the bureaucratic management of an entrepreneurial organization, an essential feature of which is the life cycle of documentation. When the life cycle ends, an update is created with a multiplication of forms and items to be filled out, resembling that of what happens with the outdated computer program. Yet medical records should have a logical and well-functioning structure using the language of computer science in the form of a cascade or evolutionary model. Further, we believe that mass computerization, in contradistinction to the primary predestination purpose, increases the number of time-consuming medical records, with the evidence that it enhances the occupational burnout among physicians. Clear and concise medical documentation is necessary to handle economic and legal issues in medicine. However, the creation of medical records sits at the crux between a health-conscious provision of the best evidence-driven treatment and the continuum of care and a potential health detriment caused by taking away the time and care devoted to the patient by healthcare professionals. We submit that the hitherto pattern of creating medical records requires a turnabout to attain the intended reasons and user-friendliness for practical ends.