Röhsig Vania, Maestri Rubia Natasha, Parrini Mutlaq Mohamed Fayeq, Brenner de Souza Aline, Seabra Artur, Farias Eliane Reus, Lorenzini Elisiane
CNO Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.
Nurse Director Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil.
Ann Med Surg (Lond). 2020 May 11;55:19-23. doi: 10.1016/j.amsu.2020.04.027. eCollection 2020 Jul.
The World Health Organization Surgical Safety Checklist is an effective tool to reduce morbidity, mortality, perioperative complications, and hospital length of stay. However, its implementation that involves complex social interaction is still challenging.
The aim was to increase use of the Surgical Safety Checklist to 100% of performed surgeries compared to current practice at Hospital Moinhos de Vento, in Porto Alegre, Brazil.
A quality improvement strategy was implemented based on the Plan, Do, Study, Act cycle. During the intervention, Surgical Safety Checklist structure and content were adjusted to the local context and surgeons were engaged in discussions of the medical and scientific basis of the Surgical Safety Checklist. Also, the surgery center nursing team was trained as well as empowered to use the Surgical Safety Checklist.
As compared to baseline data, there was an increase in the use of the tool and data was monitored to evaluate sustainability of the strategy over 26 months. Mean compliance with the Surgical Safety Checklist after the intervention reached 89%. Compliance with the most critical phase - time out - began at 26%. After the intervention, an increase in time out compliance was noted, varying from 60% to 90%.
The proposed quality improvement strategy, implemented at no additional cost to the institution, was effective to increase Surgical Safety Checklist compliance and produced sustainable results.
世界卫生组织手术安全核对表是降低发病率、死亡率、围手术期并发症及缩短住院时间的有效工具。然而，其实施涉及复杂的社会互动，仍具有挑战性。
与巴西阿雷格里港莫因霍斯·德·文托医院的当前做法相比，目标是将手术安全核对表的使用率提高到所实施手术的100%。
基于计划、执行、研究、行动循环实施了一项质量改进策略。在干预期间，手术安全核对表的结构和内容根据当地情况进行了调整，外科医生参与了关于手术安全核对表医学和科学依据的讨论。此外，手术中心护理团队接受了培训并被授权使用手术安全核对表。
与基线数据相比，该工具的使用有所增加，并对数据进行了监测，以评估该策略在26个月内的可持续性。干预后手术安全核对表的平均依从率达到89%。最关键阶段——暂停——的依从率开始时为26%。干预后，暂停依从率有所提高，从60%到90%不等。
所提出的质量改进策略在未给机构增加额外成本的情况下实施，有效提高了手术安全核对表的依从性，并产生了可持续的结果。
