Surgery, International Centre for Surgical Safety, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
Surgery, International Centre for Surgical Safety, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
BMJ Qual Saf. 2022 Jun;31(6):463-478. doi: 10.1136/bmjqs-2021-014361. Epub 2022 Apr 7.
Despite being implemented for over a decade, literature describing the surgical safety checklist (SSC) is completed by operating room (OR) teams and how this relates to its effectiveness is scarce. This systematic review aimed to: (1) quantify how many studies reported SSC completion versus described the SSC was completed; (2) evaluate the impact of the SSC on provider outcomes (ommunication, case nderstanding, afety ulture, CUSC), patient outcomes (complications, mortality rates) and moderators of these relationships.
A systematic literature search was conducted using Medline, CINAHL, Embase, PsycINFO, PubMed, Scopus and Web of Science on 10 January 2020. We included providers who treat human patients and completed any type of SSC in any OR or simulation centre. Statistical directional findings were extracted for provider and patient outcomes and key factors (eg, attentiveness) were used to determine moderating effects.
300 studies were included in the analysis comprising over 7 302 674 operations and 2 480 748 providers and patients. Thirty-eight per cent of studies provided at least some description of how the SSC was completed. Of the studies that described SSC completion, a clearer positive relationship was observed concerning the SSC's influence on provider outcomes (CUSC) compared with patient outcomes (complications and mortality), as well as related moderators.
There is a scarcity of research that examines how the SSC is completed and how this influences safety outcomes. Examining how a checklist is completed is critical for understanding why the checklist is successful in some instances and not others.
尽管手术安全检查表（SSC）已经实施了十余年，但描述手术室（OR）团队完成 SSC 的文献却很少，其与有效性的关系也鲜为人知。本系统评价旨在：（1）量化有多少研究报告了 SSC 的完成情况，以及描述了 SSC 的完成情况；（2）评估 SSC 对提供者结果（沟通、案例理解、安全文化、CUSC）、患者结果（并发症、死亡率）的影响，以及这些关系的调节因素。
我们于 2020 年 1 月 10 日使用 Medline、CINAHL、Embase、PsycINFO、PubMed、Scopus 和 Web of Science 对文献进行了系统检索。我们纳入了治疗人类患者并在任何 OR 或模拟中心完成任何类型 SSC 的提供者。提取了提供者和患者结果的统计方向发现，并使用关键因素（如注意力）来确定调节作用。
共纳入 300 项研究，涉及超过 7302674 例手术和 2480748 名提供者和患者。38%的研究至少对 SSC 的完成情况进行了描述。在描述 SSC 完成情况的研究中，与患者结果（并发症和死亡率）相比，SSC 对提供者结果（CUSC）的影响观察到更清晰的积极关系，以及相关的调节因素。
目前研究中缺乏对 SSC 完成情况以及这如何影响安全结果的研究。检查检查表的完成情况对于理解为什么检查表在某些情况下成功而在其他情况下不成功至关重要。
