Surgery checklist implementation to reduce clinical risk in the pediatric operating room.
OBJECTIVE
The aim of this prospective cohort study was to conduct a proactive analysis of procedural errors as revealed after implementation of a surgical safety checklist in the pediatric operating room of the Maggiore della Carità University Hospital, Novara. A further aim was to determine the effect the checklist had on the reduction, prevention, and protection against clinical risk in this setting.


METHODS
A "Checklist for Patient Safety in the Pediatric Operating Room" was derived from documentation in the international literature and implemented in June 2011. All data were collected by a single observer.


RESULTS
In all, 61 checklists were compiled. Analysis revealed 189 errors (absolute frequency), with the highest error incidence (59.78%) recorded for the sign-out phase (percentage cumulative frequency). Two categories of events were distinguished (surgical and orthopedic) and compared. The absolute frequency of near-miss events (n=168) and adverse events (n=21) was then broken down into the five phases of checklist compilation. The percentage cumulative frequency of near-miss was 88.89% and that of adverse events was 11.11%.


CONCLUSIONS
Safety checklist implementation led to reduction, prevention and protection against adverse events with patient injury in 88.89% of cases. The error incidence in this pediatric operating room was lower than the average rates published in the literature.
Maggiore della Carità University Hospital Novara, Italy - aj.spunky@hotmail.it.
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D000293:Adolescent; D057189:Checklist; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009873:Operating Rooms; D011446:Prospective Studies; D012308:Risk Management; D013514:Surgical Procedures, Operative / Q000592:standards*