Roybal Jessica, Tsao KuoJen, Rangel Shawn, Ottosen Madelene, Skarda David, Berman Loren
Department of Pediatric Surgery, Ochsner Hospital for Children, New Orleans, LA.
Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, TX.
Pediatr Qual Saf. 2018 Oct 16;3(5):e108. doi: 10.1097/pq9.0000000000000108. eCollection 2018 Sep-Oct.
Surgical safety checklists (SSCs) aim to create a safe operating room environment for surgical patients. Provider attitudes toward checklists affect their ability to prevent harm. Pediatric surgeons' perceptions surrounding SSCs, and their role in improving patient safety, are unknown.
American Pediatric Surgical Association members conducted an online survey to evaluate the use of and attitudes toward SSCs. The survey measured surgeons' perceptions of checklists, including the components that make them effective and barriers to participation. To better evaluate the available data on SSCs, the authors performed a systematic literature review on the use of SSCs with a focus on pediatric studies.
Of the 353 survey respondents, 93.6% use SSCs and 62.6% would want one used in their own child's operation, but only 54.7% felt that checklists improve patient safety. Reasons for checklist skepticism included the length of the checklist process, a distraction from thoughtful patient care, and lack of data supporting use. Literature review shows that checklists improve communication, promote teamwork, and identify errors, but do not necessarily decrease morbidity. Staff perception is a major barrier to implementation.
Almost all pediatric surgeons participate in SSCs at their institutions, but many question their benefit. Better pediatric surgeon engagement in checklist use is needed to change the safety culture, improve operating room communication, and prevent harm.
手术安全核对表（SSCs）旨在为手术患者营造安全的手术室环境。医护人员对核对表的态度会影响其预防伤害的能力。小儿外科医生对SSCs的看法及其在提高患者安全方面的作用尚不清楚。
美国小儿外科协会成员开展了一项在线调查，以评估SSCs的使用情况和态度。该调查衡量了外科医生对核对表的看法，包括使其有效的组成部分和参与的障碍。为了更好地评估关于SSCs的现有数据，作者对SSCs的使用进行了系统的文献综述，重点是儿科研究。
在353名调查受访者中，93.6%使用SSCs，62.6%希望在自己孩子的手术中使用SSCs，但只有54.7%的人认为核对表能提高患者安全。对核对表持怀疑态度的原因包括核对表流程的长度、分散对周到患者护理的注意力以及缺乏支持使用的数据。文献综述表明，核对表能改善沟通、促进团队合作并识别错误，但不一定能降低发病率。工作人员的看法是实施的主要障碍。
几乎所有小儿外科医生都在其所在机构参与SSCs，但许多人质疑其益处。需要小儿外科医生更好地参与核对表的使用，以改变安全文化、改善手术室沟通并预防伤害。
