Reality check of using the surgical safety checklist: A qualitative study to observe application errors during snapshot audits.
PLoS One
; 13(9): e0203544, 2018.
Article
em En
| MEDLINE
| ID: mdl-30188955
ABSTRACT
BACKGROUND:
The WHO Surgical Safety Checklist (SSC) was established to address important safety issues and to reduce the number of surgical deaths. So far, numerous reports have demonstrated sub-optimal implementation of the SSC in practice and limited improvements in patient outcomes. Therefore, the aim of this study was to audit the SSC-practice in a real-world setting in a university hospital setting.METHODS:
From 2015 to 2016, independent observers performed snapshot audits in operating theatres and shadowed the three phases of the SSC. Using a 4-point Likert-scale to rate the compliance on each audit day, we generated a report highlighting possible improvements and provided feedback to the operating team members.RESULTS:
Audits were performed on 36 operating days (2015 n = 19; 2016 n = 17), in which a total of 136 surgical interventions were observed. Overall, the percentage of "very good compliance" improved from 2015 to 2016 for the sign-in from 52.9% to 81.2% (p = 0.141), for the team-time-out from 33.3% to 58.8% (p = 0.181), and for the sign-out from 21.4% to 41.7% (p = 0.401). The qualitative review revealed inconsistencies when applying the SSC, of which the missing documentation of an actually performed item or the wrong timing for an item was most common.CONCLUSION:
Snapshot audits revealed that SSC compliance has improved over the observed period, while its application revealed inconsistencies during the three phases of the SSC. Snapshot audits proved to be a valuable tool in the qualitative analysis of SSC compliance and gave more insight than a mere completeness check of ticks in SSC documents.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Lista de Checagem
Tipo de estudo:
Qualitative_research
Limite:
Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article