Faculty of Medicine, University of Turku, Turku, Finland.
Scand J Surg. 2014 Mar;103(1):66-72. doi: 10.1177/1457496913482255. Epub 2013 Dec 17.
The World Health Organization's surgical safety checklist is designed to improve adherence to operating room safety standards, and its use has been shown to reduce complications among surgical patients. The objective of our study was to assess the impact of the implementation of the checklist on safety-related issues in the operating room and on postoperative adverse events in neurosurgery.
From structured questionnaires delivered to operating room personnel, answers were analyzed to evaluate communication and safety-related issues during 89 and 73 neurosurgical operations before and after the checklist implementation, respectively. From the analyzed operations, 83 and 67 patients, respectively, were included in a retrospective analysis of electronic patient records to compare the length of hospital stay, reported adverse events, and readmissions. In addition, the consistency of operating room documentation and patient records was assessed.
Communication between the surgeon and the anesthesiologist was enhanced, and safety-related issues were better covered when the checklist was used. Unplanned readmissions fell from 25% to 10% after the checklist implementation (p = 0.02). Wound complications decreased from 19% to 8% (p = 0.04). The consistency of documentation of the diagnosis and the procedure improved. The use of the checklist improved safety-related performance and, contemporarily, reduced numbers of wound complications, and readmissions were observed.
世界卫生组织的手术安全检查表旨在提高手术室安全标准的遵守程度，其使用已被证明可以减少手术患者的并发症。我们的研究目的是评估检查表的实施对手术室安全相关问题以及神经外科术后不良事件的影响。
通过向手术室工作人员发放结构化问卷，分析答案，分别评估检查表实施前后 89 例和 73 例神经外科手术期间的沟通和安全相关问题。从分析的手术中，分别有 83 例和 67 例患者被纳入电子病历的回顾性分析，以比较住院时间、报告的不良事件和再入院率。此外，还评估了手术室文件和患者记录的一致性。
使用检查表时，外科医生和麻醉师之间的沟通得到了加强，安全相关问题得到了更好的覆盖。检查表实施后，计划外再入院率从 25%降至 10%（p=0.02）。伤口并发症从 19%降至 8%（p=0.04）。诊断和手术过程的记录一致性得到了改善。检查表的使用提高了安全相关性能，同时减少了伤口并发症的发生，观察到再入院率降低。
