The Surgical Safety Checklist from the resident's perspective. Observational study
Abstract
Introduction: The Surgical Safety Checklist implemented by the World Health Organization has proven to decrease perioperative morbidity and mortality; however, the barriers and limitations to its implementation are consistently reported in the literature.
Objective: To establish the level of appropriation of the surgical safety checklist in the training of human resources in anesthesiology, in addition to identifying the perception and the level of implementation of such checklist at the national scale.
Methods: Descriptive cross-sectional study conducted through a survey administered to the residents of anesthesiology in Colombia. Likert-type questions were included, distributed into three domains: appropriation, perception and implementation.
Results: 215 answers corresponding to 54.5 % of the population were analyzed, comprising participants from all of the anesthesiology programs in the country. 20% of the residents have never been subject to formal academic reviews about checklists, and this trend did not change throughout the residency; 97.2 % considers that the implementation of the lists improves the safety of surgical procedures and 40 % have seen rejection or indifference by surgeons. 80.5 % of the residents have seen the frequent use of the checklist, while only 13.5% have seen the use of the checklist during the three surgical moments – before the induction of anesthesia, before the surgical incision, and before the patient leaves the operating room -; 88 % have observed that the form is completed without actually doing the verification.
Conclusions: There is limited exposure to education about the surgical safety checklist in anesthesiology postgraduate programs in the country. The residents have a favorable perception about the value of the list, however, there are some shortcomings in its administration.
References
World Health Organization. The second global patient safety challenge: safe surgery saves lives [Internet]. 2008 [cited: 2018 Sep 30]. Available at: https://www.who.int/patientsafety/safesurgery/knowledge_base/SSSL_Brochure_finalJun08.pdf
Weiser TG, Haynes AB, Lashoher A, Dziekan G, Boorman DJ, Berry WR, et al. Perspectives in quality: Designing the WHO surgical safety checklist. Int J Qual Heal Care. 2010;22(5):365-70. doi: http://www.doi.org/10.1093/intqhc/mzq039
Collazos C. El compromiso de la SCARE con la calidad de atención: apoyo a la campaña cirugía segura salva vidas en Colombia. Revista Médico Legal [Internet]. 2009 [cited: 2018 Jun 16]. Available at: https://www.academia.edu/3848721/ARTICULO_EL_COMPROMISO_DE_LA_SCARE_CON_LA_CALIDAD_DE_LA_ATENCION.
Koh NJ, Wagner R, Newton RC, Casey BR, Sun H, Weiss KB. Detailed findings from the CLER National Report of Findings 2018. J Grad Med Educ. 2018;10(4):49-68. doi: http://www.doi.org/10.4300/1949-8349.10.4s.49
Bergs J, Hellings J, Cleemput I, Zurel Ö, De Troyer V, Van Hiel M, et al. Systematic review and meta-analysis of the effect of the World Health Organization surgical safety checklist on postoperative complications. British Journal of Surgery. 2014. doi: http://www.doi.org/10.1002/bjs.9381
Treadwell JR, Lucas S, Tsou AY. Surgical checklists: A systematic review of impacts and implementation. BMJ Qual Saf. 2014;23(4):299-318. doi: http://www.doi.org/10.1136/bmjqs-2012-001797
Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491-9. doi: http://www.doi.org/10.1056/NEJMsa0810119
Collazos C, Bermúdez L, Quintero A, Quintero LE, Díaz MM. Checklist verification for surgery safety from the patient’s perspective. Colombian Journal of Anesthesiology. 2013. https://doi.org/10.1016/j.rca.2013.01.001
Ramírez CM, Prada WA, Guayán IC, Patiño M. Utilización de listas de chequeo en cirugías programadas. Bogotá. Rev Colomb Cir. 2017;32:109-23. doi: https://doi.org/10.30944/20117582.14.
Thomassen Ø, Brattebø G, Heltne J-K, Søfteland E, Espeland A. Checklists in the operating room: Help or hurdle? A qualitative study on health workers’ experiences. BMC Health Serv Res. 2010;10(1):342. doi: http://www.doi.org/10.1186/1472-6963-10-342.
Nie Y, Li L, Duan Y, Chen P, Barraclough BH, Zhang M, et al. Patient safety education for undergraduate medical students: A systematic review. BMC Med Educ. 2011;11(1). doi: https://doi.org/10.1186/1472-6920-11-33
Gómez LM, Gómez JC, Sánchez NF, González LM, Naranjo LF, Ríos F, et al. Plan de estudios y competencias para un programa de anestesiología en Colombia [Internet]. 2017 [cited: 2021 Mar 21]. Available: https://scare.org.co/wp-content/uploads/Documento-Marco-del-Plan-de-Estudios-y-Competencias-para-un-programa-de-Anestesiologia-en-Colombia-1.pdf
Kilduff CLS, Leith TO, Drake TM, Fitzgerald JEF. Surgical safety checklist training: A national study of undergraduate medical and nursing student teaching, understanding and influencing factors. Postgrad Med J. 2018;94(1109):143-50. doi: https://doi.org/10.1136/postgradmedj-2016-134559
Suleiman ARM, Amarasinghe D, Kathuria P, Vandel J, Holloway J, Elkin K, et al. Incorporating patient safety into early undergraduate medical education: Teaching medical students to perform surgical time outs during anatomy. BMJ Open Qual. 2021;10(1):1-5. doi: https://doi.org/10.1136/bmjoq-2020-001229
Hurtado JJD, Jiménez X, Pẽalonzo MA, Villatoro C, De Izquierdo S, Cifuentes M. Acceptance of the WHO Surgical Safety Checklist among surgical personnel in hospitals in Guatemala city. BMC Health Serv Res. 2012;12(1):0-4. doi: https://doi.org/10.1186/1472-6963-12-169.
Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AHS, Dellinger EP, et al. Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention. BMJ Qual Saf. 2011;20(1):102-7. doi: https://doi.org/10.1136/bmjqs.2009.040022.
Russ SJ, Sevdalis N, Moorthy K, Mayer EK, Rout S, Caris J, et al. A qualitative evaluation of the barriers and facilitators toward implementation of the who surgical safety checklist across hospitals in England. Ann Surg. 2015;261(1):81-91. doi: https://doi.org/10.1097/SLA.0000000000000793.
Haugen AS, Wæhle HV, Almeland SK, Harthug S, Sevdalis N, Eide GE, et al. Causal analysis of World Health Organization’s surgical safety checklist implementation quality and impact on care processes and patient outcomes: Secondary analysis from a large stepped wedge cluster randomized controlled trial in Norway. Ann Surg. 2019;269(2):283-90. doi: https://doi.org/10.1097/SLA.0000000000002584.
Russ S, Rout S, Caris J, Mansell J, Davies R, Mayer E, et al. Measuring variation in use of the WHO surgical safety checklist in the operating room: A multicenter prospective cross-sectional study. J Am Coll Surg. 2015;220(1):1-11.e4. doi: https://doi.org/10.1016/j.jamcollsurg.2014.09.021.
Solsky I, Berry W, Edmondson L, Lagoo J, Baugh J, Blair A, et al. World Health Organization Surgical Safety Checklist Modification: Do changes emphasize communication and teamwork? J Surg Res. 2020;246:614-22. doi: https://doi.org/10.1016/j.jss.2018.09.035.
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