[Patient safety in the operating room. Checklist implementation of general surgery]. / Seguridad del paciente en el quirófano: implantación del checklist en cirugía general.

OBJECTIVES: To plan, implement and evaluate strategies for implementation of Checklist in a general surgery operating rooms and preliminary evaluation of the experience in view of the nurses. METHODOLOGY: Implementation and evaluation of technological application of a checklist format similar to that published by WHO. The process was conducted in three phases using strategies for planning, implementation and evaluation. After training the professionals, design the checklist at each stage, assign the responsibility of screening and determine how registration was applied for 10 months in 68% of planned interventions and 30% urgent. Preliminary evaluation using qualitative methods, discourse analysis of operating room nurses who participated in its implementation and monitoring during implementation. CONCLUSIONS: The qualitative assessment is useful to know the attitudes, opinions and problems of nurses for the implementation of innovations that require interdisciplinary collaboration The application workload increases, but makes visible some activities. The broad participation of nurses reveal their involvement to promote patient safety, but also their training needs. It is essential to the awareness of all professionals to carry out the checklist, which can only be imposed if there is a culture change, innovation and safety and teamwork. For the test does not fall into the routine, it would be wise to do a periodic evaluation. The list should be clear, concise and reliable.

Seguridad del paciente en el quirófano. Implantación del checklist en cirugía general / Patient safety in the operating room. Checklist implementation of general surgery

Objetivos: planificar, implementar y evaluar estrategias de implantación de Checklist en unos quirófanos de cirugía general y evaluación preliminar de la experiencia en opinión de los profesionales de enfermería. Metodología: implementación tecnológica y evaluación de la aplicación de un Checklist de formato similar al publicado por la OMS. El proceso se realizó en tres fases mediante estrategias de planificación, implementación y evaluación. Tras formar a los profesionales, diseñar la lista de comprobaciones en cada una de las fases, asignar a los responsables del chequeo y determinar la forma de registro, se aplicó durante 10 meses en un 68% de las intervenciones programadas y un 30% de las urgentes. Evaluación preliminar mediante técnicas cualitativas: análisis de los discursos de las enfermeras de quirófano que participaron en su aplicación y observación durante la misma. Conclusiones: la evaluación cualitativa es útil para conocer las actitudes, opiniones y dificultades de las enfermeras para la implantación de innovaciones que requieren la colaboración interdisciplinaria. La aplicación incrementa cargas de trabajo pero hace visibles algunas actividades. La amplia participación de las enfermeras revela su implicación para favorecer la seguridad del paciente, pero también las necesidades en su formación. Resulta imprescindible la concienciación de todos los profesionales para llevar a cabo el Checklist, que solo se podrá imponer si existe una cultura del cambio, innovación y seguridad y trabajo en equipo. Para que la comprobación no caiga en la rutina, sería recomendable efectuar una evaluación periódica. La lista debe ser clara, concisa y fiable(AU)

Objectives: To plan, implement and evaluate strategies for implementation of Checklist in a general surgery operating rooms and preliminary evaluation of the experience in view of the nurses. Methodology: Implementation and evaluation of technological application of a checklist format similar to that published by WHO. The process was conducted in three phases using strategies for planning, implementation and evaluation. After training the professionals, design the checklist at each stage, assign the responsibility of screening and determine how registration was applied for 10 months in 68% of planned interventions and 30% urgent. Preliminary evaluation using qualitative methods, discourse analysis of operating room nurses who participated in its implementation and monitoring during implementation. Conclusions: The qualitative assessment is useful to know the attitudes, opinions and problems of nurses for the implementation of innovations that require interdisciplinary collaboration The application workload increases, but makes visible some activities. The broad participation of nurses reveal their involvement to promote patient safety, but also their training needs. It is essential to the awareness of all professionals to carry out the checklist, which can only be imposed if there is a culture change, innovation and safety and teamwork. For the test does not fall into the routine, it would be wise to do a periodic evaluation. The list should be clear, concise and reliable(AU)

Plan de cuidados periquirúrgicos para el paciente trasplantado hepático / Perisurgical Nursing care plan for patients who have undergone liver transplantation

En nuestro hospital, desde el año 2002 se inició el programa de Trasplante Hepático (TH). La complejidad y especificidad de la intervención quirúrgica de TH, nos llevó a plantear la necesidad de elaborar un plan de cuidados periquirúrgico estandarizado que recogiera todas las actuaciones que realizan las/os enfermeras/os. Para ello se llevó a cabo un proceso de mejora de la calidad, que constó de dos etapas: 1ª etapa: se exploraron las actividades perioperatorias que las enfermeras realizan en el paciente trasplantado hepático, se elaboró un protocolo y se pilotó con fines de validación; 2ª etapa: se adecuó el plan de cuidados definitivo según los resultados del pilotaje (AU)

The liver transplantation (LT) programme was started in our hospital in 2002. The complexity and specificity of LT surgery led us to present the need to draw a standardised perisurgical nursing care plan that compiled all the tasks or actions undertaken by professional nursing personnel. To this end, a quality improvement process was undertaken which consisted of two stages: a first stage that explored the perioperative activities undertaken by nurses in patients with a liver transplant and that involved the elaboration of a protocol which as used as a pilot for validation purposes; and a second stage where the final nursing care plan was adapted to meet the results of the pilot phase conducted in the first stage (AU)