RESUMO
Objectives: The proposed study aims to assess users' perceptions of a surgical safety checklist (SSC) reimplementation toolkit and its impact on SSC attitudes and operating room (OR) culture, meaningful checklist use, measures of surgical safety, and OR efficiency at 3 different hospital sites. Background: The High-Performance Checklist toolkit (toolkit) assists surgical teams in modifying and implementing or reimplementing the World Health Organization's SSC. Through the explore, prepare, implement, and sustain implementation framework, the toolkit provides a process and set of tools to facilitate surgical teams' modification, implementation, training on, and evaluation of the SSC. Methods: A pre-post intervention design will be used to assess the impact of the modified SSC on surgical processes, team culture, patient experience, and safety. This mixed-methods study includes quantitative and qualitative data derived from surveys, semi-structured interviews, patient focus groups, and SSC performance observations. Additionally, patient outcome and OR efficiency data will be collected from the study sites' health surveillance systems. Data analysis: Statistical data will be analyzed using Statistical Product and Service Solutions, while qualitative data will be analyzed thematically using NVivo. Furthermore, interview data will be analyzed using the Consolidated Framework for Implementation Research and reach, effectiveness, adoption, implementation, maintenance implementation frameworks. Setting: The toolkit will be introduced at 3 diverse surgical sites in Alberta, Canada: an urban hospital, university hospital, and small regional hospital. Anticipated impact: We anticipate the results of this study will optimize SSC usage at the participating surgical sites, help shape and refine the toolkit, and improve its usability and application at future sites.
RESUMO
The International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA),a nonprofit organization representing anesthesiologists in 150 countries,and the World Health Organization (WHO).The recommendations have been approved by WHO and the membership of WFSA.These Standards are applicable to all anesthesia providers throughout the world.They are intended to provide guidance and assistance to anesthesia providers,their professional organizations,hospital and facility administrators,and governments for maintaining and improving the quality and safety of anesthesia care.The Standards cover professional aspects;facilities and equipment;medications and intravenous fluids;monitoring;and the conduct of anesthesia.HIGHLY RECOMMENDED standards,the functional equivalent of mandatory standards,include (amongst other things):the continuous presence of a trained and vigilant anesthesia provider;continuous monitoring of tissue oxygenation and perfusion by clinical observation and a pulse oximeter;intermittent monitoring of blood pressure;confirmation of correct placement of an endotracheal tube (if used) by auscultation and carbon dioxide detection;the use of the WHO Safe Surgery Checklist;and a system for transfer of care at the end of an anesthetic.The International Standards represent minimum standards and the goal should always be to practice to the highest possible standards,preferably exceeding the standards outlined in this document.