title: Effect of surgical safety checklists on postoperative morbidity and mortality rates, Shiraz, Faghihy Hospital, a 1-year study.
abstract: OBJECTIVE
  The study intent was to (1) encourage the use of surgical safety checklists and (2) measure the effect checklists have in reducing surgical complications.
  
  
  METHODS
  An interventional study designed to improve postsurgical outcomes was performed.
  
  
  METHODS
  The study site was a 374-bed referral educational hospital in Shiraz, Iran, with 6 operating rooms. The study lasted 6 months.
  
  
  METHODS
  Patient selection involved a convenient sampling method with all eligible patients entering.
  
  
  METHODS
  Our checklist covered 3 surgical stages--before anesthesia, immediately before an incision, and before moving the patient to a recovery room. Persons included were operating room team members.
  
  
  METHODS
  Rates of postsurgical complication before and after application of the surgical safety checklist underwent comparison.
  
  
  RESULTS
  Incidence of any complication before and after intervention was 22.9% and 10% (P = .03). Five checklist items were in total compliance. The most common complication was surgical site infection. Implementation of the checklist, responsibility in 2 stages, such as time out and sign out, were significant (P < .05). In most cases, these items reflected the performance of surgeons and anesthesia professionals as compared with the World Health Organization Surgical Safety Checklist.
  
  
  CONCLUSIONS
  Complications decreased by 57% after intervention. Both high patient information detection and elevated levels of cooperation by surgical personnel were observed. Compliance likely helped prevent some adverse effects associated with surgery.
authors.affiliation: Department of Community Medicine, Medicinal & Natural Products Chemistry Research Center , Shiraz University of Medical Sciences, Iran. mehrdadaskarian@gmail.com
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Askarian
authors.forename: Farideh
authors.initials: F
authors.lastname: Kouchak
authors.forename: Charles John
authors.initials: CJ
authors.lastname: Palenik
mesh_terms: D000328:Adult; D057189:Checklist / Q000379:methods*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011183:Postoperative Complications / Q000401:mortality* / Q000517:prevention & control*; D011184:Postoperative Period; D013514:Surgical Procedures, Operative / Q000379:methods*