Askarian Mehrdad, Kouchak Farideh, Palenik Charles John
Department of Community Medicine, Medicinal & Natural Products Chemistry Research Center , Shiraz University of Medical Sciences, Iran.
Qual Manag Health Care. 2011 Oct-Dec;20(4):293-7. doi: 10.1097/QMH.0b013e318231357c.
The study intent was to (1) encourage the use of surgical safety checklists and (2) measure the effect checklists have in reducing surgical complications.
An interventional study designed to improve postsurgical outcomes was performed.
The study site was a 374-bed referral educational hospital in Shiraz, Iran, with 6 operating rooms. The study lasted 6 months.
Patient selection involved a convenient sampling method with all eligible patients entering.
Our checklist covered 3 surgical stages--before anesthesia, immediately before an incision, and before moving the patient to a recovery room. Persons included were operating room team members.
Rates of postsurgical complication before and after application of the surgical safety checklist underwent comparison.
Incidence of any complication before and after intervention was 22.9% and 10% (P = .03). Five checklist items were in total compliance. The most common complication was surgical site infection. Implementation of the checklist, responsibility in 2 stages, such as time out and sign out, were significant (P < .05). In most cases, these items reflected the performance of surgeons and anesthesia professionals as compared with the World Health Organization Surgical Safety Checklist.
Complications decreased by 57% after intervention. Both high patient information detection and elevated levels of cooperation by surgical personnel were observed. Compliance likely helped prevent some adverse effects associated with surgery.
本研究旨在（1）鼓励使用手术安全检查表，（2）评估检查表在降低手术并发症方面的效果。
进行了一项旨在改善术后结果的干预性研究。
研究地点是伊朗设拉子一家拥有374张床位的转诊教学医院，有6间手术室。研究持续了6个月。
患者选择采用方便抽样法，所有符合条件的患者均可纳入。
我们的检查表涵盖3个手术阶段——麻醉前、即将切开前以及将患者转移至恢复室前。涉及人员为手术室团队成员。
比较手术安全检查表应用前后的术后并发症发生率。
干预前后任何并发症的发生率分别为22.9%和10%（P = 0.03）。5项检查表项目完全符合要求。最常见的并发症是手术部位感染。检查表的实施，如“暂停”和“签字确认”这两个阶段的职责，具有显著意义（P < 0.05）。与世界卫生组织手术安全检查表相比，在大多数情况下，这些项目反映了外科医生和麻醉专业人员的表现。
干预后并发症减少了57%。观察到患者信息检测水平提高以及手术人员的合作程度提升。符合要求可能有助于预防一些与手术相关的不良影响。
