title: Clinical risk management in eye outpatient surgery: a new surgical safety checklist for cataract surgery and intravitreal anti-VEGF injection.
abstract: BACKGROUND
  A database study to test a new model of surgical safety checklist for eye surgery in the outpatient operating room, especially for cataract surgery and intravitreal anti-VEGF injections.
  
  
  METHODS
  WHO Surgical Safety Checklist analysis, and changes to obtain a customized surgical safety checklist for eye surgery. Testing of the new checklist in the outpatient operating room of the Institute of Ophthalmology, University of Modena during a period of 4 months (January-April 2011). All cataract surgery and intravitreal anti-VEGF operations were included in the study, and controlled by the new surgical safety checklist. The percentage of answers to each safety check was calculated to obtain an estimate of adherence to our new checklist.
  
  
  RESULTS
  Eight hundred and forty nine procedures (390 cataract, 452 anti-VEGF injections, seven combined surgery) were analyzed. The study showed a high level of adherence to the majority of the safety checks in the checklist. Important differences were identified in consent confirmation (correct confirmation in 99.76 %, no confirmation in 0.24 %), surgical site marking (correct marking in 99.29 %, no marking in 0.71 %), patient cooperation during operation (95.17 % of patients were cooperative, 4.83 % of patients were uncooperative), adherence to antibiotic prophylaxis (correct prophylaxis in 93.17 %, no prophylaxis in 6.83 %), critical situation during surgical procedures (no critical situation in 91.76 %, critical situation in 8.24 %)
  
  
  CONCLUSIONS
  The study showed a high level of adherence to the checklist. A surgical safety checklist could improve the management of an eye surgery operating room.
authors.affiliation: Institute of Ophthalmology, University of Modena, Italy, Via del pozzo 71, Modena 41100, Italy. cavallini.gianmaria@unimore.it
authors.forename: Gian Maria
authors.initials: GM
authors.lastname: Cavallini
authors.forename: Luca
authors.initials: L
authors.lastname: Campi
authors.forename: Michele
authors.initials: M
authors.lastname: De Maria
authors.forename: Matteo
authors.initials: M
authors.lastname: Forlini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000556:Ambulatory Surgical Procedures; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D002387:Cataract Extraction; D057189:Checklist; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D009873:Operating Rooms / Q000592:standards*; D011786:Quality Control; D019984:Quality Indicators, Health Care; D012308:Risk Management; D017751:Safety Management / Q000379:methods; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014944:World Health Organization
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A