title: A site check prior to regional anaesthesia to prevent wrong-sided blocks.
abstract: This paper describes the implementation of the 'Stop Before You Block' (SB4YB) initiative in an Australian teaching hospital. This process, which began in the UK in 2010, is a pre-procedure pause to confirm the correct side of a regional anaesthetic block. A change in practice was implemented with the formal roll out of a SB4YB educational program. Use of the initiative was then audited over a subsequent three-month period. It was hoped that after implementing the initiative, at least 80% of blocks would have a site check performed. However, despite apparent support for the initiative, uptake was less than expected with only about 57% of blocks having a site check performed. A site check was less frequent if the block was done as an emergency procedure, outside of an operating theatre or by a locum or visiting anaesthetist. Our conclusion from the audit was that education is insufficient to promote a change in this practice. We propose that Stop Before You Block or a block time-out should be performed prior to all unilateral nerve blocks. Success of this initiative requires education, and both cultural and systems changes to occur. We propose that a formal block time-out should become part of the surgical safety checklist and this activity should be endorsed and promoted by anaesthetic professional bodies.
authors.affiliation: Anaesthetic Registrar, Gold Coast University Hospital, Gold Coast, Queensland.
authors.forename: P
authors.initials: P
authors.lastname: Slocombe
authors.affiliation: Senior Staff Specialist, Associate Professor, Gold Coast Hospital & Health Services, Gold Coast, Queensland.
authors.forename: S
authors.initials: S
authors.lastname: Pattullo
mesh_terms: D000765:Anesthesia, Conduction / Q000379:methods*; D000776:Anesthesiology / Q000193:education*; D057189:Checklist; D006801:Humans; D008485:Medical Audit
keywords: anaesthesia; checklist; local; nerve block; patient care; quality improvement