Tang Reuben, Ranmuthugala Geetha, Cunningham Frances
University of New South Wales, Sydney, New South Wales, Australia.
ANZ J Surg. 2014 Mar;84(3):148-54. doi: 10.1111/ans.12168. Epub 2013 Apr 18.
Surgical checklists are designed to improve patient outcomes following surgery. While such checklists have been widely implemented worldwide, few studies examine surgical checklists within an Australian context. For this purpose, we have performed a literature review using data from OECD member nations to determine the effectiveness of surgical checklists in improving patient outcomes and factors that contribute to their successful implementation.
The databases, Pubmed, Medline, EMBASE, Cochrane and CINAHL were searched using the keywords ('surgical' AND 'checklist') and ( (surgical) AND checklist) AND ( (implementation) OR (utilization) OR (usage) ). Studies were limited to those written in the English language, peer-reviewed, published between January 2000 and December 2012, and including an abstract.
Our search yielded 2242 papers, of which 72 papers were identified for their potential relevance and selected for full text review. Of these, nine papers met the inclusion criteria and were reviewed in detail. Evidence that supports the use of surgical checklists in countries with a large number of protocols already in place is limited. Adequate checklist implementation plays a central role in checklist effectiveness, which in turn is dependent on multiple factors.
Although evidence from OECD member countries is non-conclusive, it does suggest that surgical checklists, when effectively implemented, have the potential to be effective at reducing complication and mortality rates following surgery. Within an Australian context, more studies are needed to fully establish the potential effectiveness of surgical checklists and to monitor checklist use compliance in order to ensure greater patient safety.
手术清单旨在改善术后患者的治疗效果。尽管此类清单已在全球广泛实施，但很少有研究在澳大利亚背景下对手术清单进行考察。为此，我们利用经合组织成员国的数据进行了一项文献综述，以确定手术清单在改善患者治疗效果方面的有效性以及有助于其成功实施的因素。
使用关键词（“手术”和“清单”）以及（（手术）和清单）以及（（实施）或（使用）或（应用））在数据库PubMed、Medline、EMBASE、Cochrane和CINAHL中进行检索。研究限于用英语撰写、经过同行评审、2000年1月至2012年12月期间发表且包含摘要的文献。
我们的检索共得到2242篇论文，其中72篇因其潜在相关性被确定并入选全文评审。其中，9篇论文符合纳入标准并进行了详细评审。在已经有大量规程的国家，支持使用手术清单的证据有限。清单的充分实施在清单有效性中起着核心作用，而有效性又取决于多个因素。
尽管经合组织成员国的证据尚无定论，但确实表明手术清单若有效实施，有可能有效降低术后并发症和死亡率。在澳大利亚背景下，需要更多研究来全面确定手术清单的潜在有效性，并监测清单使用的依从性，以确保更高的患者安全性。
