Use of the WHO surgical safety checklist in trauma and orthopaedic patients.
The World Health Organisation (WHO) recommends routine use of a surgical safety checklist prior to all surgical operations. The aim of this study was to prospectively audit checklist use in orthopaedic patients before and after implementation of an educational programme designed to increase use and correlate this with early complications, mortality and staff perceptions. Data was collected on 480 patients before the educational program and 485 patients after. Pre-training checklist use was 7.9%. The rates of early complications and mortality were 8.5% and 1.9%, respectively. Forty-seven percent thought the checklist improved team communication. Following an educational program, checklist use significantly increased to 96.9% (RR12.2; 95% CI 9.0-16.6). The rate of early complications and mortality was 7.6% (RR 0.89; 95% CI 0.58-1.37) and 1.6% (RR 0.88; 95% CI 0.34-2.26), respectively. Seventy-seven percent thought the checklist improved team communication. Checklist use was not associated with a significant reduction in early complications and mortality in patients undergoing orthopaedic surgery. Education programs can significantly increase accurate use and staff perceptions following implementation.
Sewell
Mathew
M
Trauma and Orthopaedics, The Royal National Orthopaedic Hospital, London, UK. matbuzz1@hotmail.com
Adebibe
Miriam
M
Jayakumar
Prakash
P
Jowett
Charlie
C
Kong
Kin
K
Vemulapalli
Krishna
K
Levack
Brian
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000379:methods / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control*; D017064:Process Assessment, Health Care; D013514:Surgical Procedures, Operative / Q000379:methods / Q000592:standards*; D014944:World Health Organization; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult