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骨科手术安全的最佳实践:检查表实施的全面综述

Best Practices for Surgical Safety in Orthopaedics: A Comprehensive Review of Checklist Implementation.

作者信息

Mohamed Ahmed, Fuad Usman, Hagroo Aasim, Elasad Alaa

机构信息

Trauma and Orthopaedics, Royal Cornwall Hospital, Truro, GBR.

General Practice, Zagazig University, Zagazig, EGY.

出版信息

Cureus. 2025 Aug 6;17(8):e89476. doi: 10.7759/cureus.89476. eCollection 2025 Aug.

Abstract

Despite advances in surgical techniques and technology, surgical complications in orthopaedics remain a significant patient safety concern, with preventable major errors continuing to occur. The implementation of surgical safety checklists and time-out procedures has emerged as a critical intervention to enhance patient safety and reduce complications. This narrative review examines the role of surgical checklists and time-out procedures in reducing complications specific to orthopaedic surgery, analyzing their effectiveness, implementation challenges, and impact on patient outcomes. A comprehensive literature review was conducted examining peer-reviewed articles, systematic reviews, and clinical guidelines related to surgical safety checklists and time-out procedures in orthopaedic practice. Sources included studies on the available surgical safety checklist, never events data, and orthopaedic-specific safety interventions. Evidence demonstrates that structured surgical checklists and time-out procedures significantly reduce wrong-site surgery, retained foreign objects, and communication-related errors in orthopaedic practice. Applying surgical safety checklists in practice has shown effectiveness in reducing overall surgical complications and mortality. However, compliance rates vary significantly across institutions and countries. Surgical checklists and time-out procedures represent essential safety interventions in orthopaedic practice. While evidence supports their effectiveness in reducing complications and improving communication, successful implementation requires organizational commitment, staff education, and ongoing monitoring to ensure sustained compliance and optimal patient outcomes.

摘要

尽管手术技术和科技有所进步,但骨科手术并发症仍是患者安全的重大问题,可预防的重大失误仍时有发生。实施手术安全核对表和暂停程序已成为提高患者安全和减少并发症的关键干预措施。本叙述性综述探讨了手术核对表和暂停程序在减少骨科手术特有并发症方面的作用,分析了它们的有效性、实施挑战以及对患者预后的影响。我们进行了全面的文献综述,查阅了与骨科手术中手术安全核对表和暂停程序相关的同行评议文章、系统评价和临床指南。资料来源包括关于现有手术安全核对表、医疗差错事件数据以及骨科特定安全干预措施的研究。有证据表明,结构化的手术核对表和暂停程序能显著减少骨科手术中的手术部位错误、异物残留以及与沟通相关的错误。在实践中应用手术安全核对表已显示出在降低总体手术并发症和死亡率方面的有效性。然而,不同机构和国家的合规率差异很大。手术核对表和暂停程序是骨科手术中重要的安全干预措施。虽然有证据支持它们在减少并发症和改善沟通方面的有效性,但成功实施需要组织承诺、员工教育以及持续监测,以确保持续合规并实现最佳患者预后。

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