Periprocedural checklist in the catheterisation laboratory is associated with decreased rate of treatment complications.
BACKGROUND
Interventional cardiology and electrophysiology are disciplines with a growing number of complex procedures, which are exposed to the occurrence of many complications.


OBJECTIVE
To assess efficacy and legitimacy of the periprocedural checklist in prevention of cardiovascular adverse events, in elective patients undergoing invasive diagnostic and treatment.


METHODS
A total of 2064 patients directed to treatment in the catheterisation laboratory between May 2011 to August 2012 were analysed. Patients who were hospitalised without invasive diagnostics and treatment were not included in the study. Patients were divided into two groups: a control group - 1011 patients with invasive diagnostics and treatment before introduction of periprocedural checklist; and an intervention group - 1053 patients with invasive diagnostics and treatment after introduction of periprocedural checklist. We analysed the studied groups, assessing adverse events associated with hospitalisation and performed procedures. We also conducted subjective evaluation of checklists by medical staff on the basis of a questionnaire.


RESULTS
Baseline characteristics between the studied groups were comparable except for a higher rate of stable coronary artery disease (50.7% vs. 39.6%, p £ 0.001) and electrophysiology procedures in the control group. Implementation of a checklist was favourable in cases of decreased adverse events (6.8% vs. 3.9%, p = 0.004) especially bleedings (2.3% vs. 0.3%, p < 0.001). Multivariate analysis confirmed that lack of a periprocedural checklist during hospitalisation was an independent factor associated with a higher rate of adverse events (OR = 2.97, 95% CI 1.60-5.53, p = 0.001). Subjective evaluation of medical staff opinions showed that implementation of a checklist seems to be associated with improved communication skills, work organisation, prevention of the occurrence of medical errors, and reduced rate of complications associated with procedures.


CONCLUSIONS
Introduction of a periprocedural checklist was associated with significant reduction of adverse events among patients undergoing invasive procedures. It also showed a positive influence on team communication, and organisation and quality of treatment, according to the opinions of medical staff.
Michał
M
Hawranek
Silesian Center for Heart Diseases, Third Department of Cardiology. p.m.gasior@gmail.com.
Paweł M
PM
Gąsior
Piotr
P
Buchta
Marek
M
Gierlotka
Krystyna
K
Czapla
Mateusz
M
Tajstra
Łukasz
Ł
Pyka
Andrzej
A
Lekston
Lech
L
Poloński
Mariusz
M
Gąsior
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods* / Q000592:standards*; D057189:Checklist; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D011183:Postoperative Complications / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods* / Q000592:standards*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires