Northern Health, 185 Cooper St, Epping, VIC, 3076, Australia.
The University of Melbourne, Parkville, VIC, 3052, Australia.
World J Surg. 2020 Jun;44(6):1755-1761. doi: 10.1007/s00268-020-05397-2.
The World Health Organisation Surgical Safety Checklist (SSC) is a mandated part of surgical practice. Adherence to the SSC has been shown to result in improved patient outcomes. The aim of this study was to determine the current adherence to the timeout section of the SSC and, in particular, the function of individual team members.
A prospective pre- and post-intervention observational audit was conducted on the timeout section. The intervention involved an in-hospital display of interim results and distribution to theatre staff. Data were collected on participants, duration and compliance with checklist items for 400 theatre cases. There were 200 cases before and after the intervention.
There were no cases in which the timeout section was completed correctly in its entirety. Post-intervention, there was a significant improvement in participation of theatre staff (excluding surgeons) as well as a significant improvement in items discussed and documented. Discussion of items such as anticipated critical events, pressure areas and the team introduction remained low. Some items on the checklist were discussed significantly more when a particular staff member participated.
Observed completion rates of the timeout section of the SSC were poor. Individual team members positively influenced checklist items more aligned to their role, highlighting the importance of timeout being performed by the entire theatre team. Improved performance was seen following audit and feedback.
世界卫生组织手术安全检查表（SSC）是手术实践的强制性要求。遵守 SSC 已被证明可以改善患者的预后。本研究旨在确定当前对 SSC 超时部分的遵守情况，特别是个别团队成员的职能。
对超时部分进行了前瞻性的术前和术后干预观察性审核。干预措施包括在医院内展示中期结果并分发给手术室工作人员。在 400 例手术室病例中收集了参与者、持续时间和检查表项目的遵守情况的数据。干预前有 200 例，干预后有 200 例。
没有一个案例完整正确地完成了超时部分。干预后，手术室工作人员（不包括外科医生）的参与率显著提高，讨论和记录的项目也显著增加。讨论预期的关键事件、压力区域和团队介绍等项目的比例仍然较低。检查表上的一些项目在特定工作人员参与时讨论得更多。
观察到 SSC 超时部分的完成率很低。个别团队成员对与其角色更相关的检查表项目产生了积极影响，这突出了超时应由整个手术室团队完成的重要性。审核和反馈后，绩效得到了提高。
