Veterinary surgery : VS · 2018
Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America.
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Cray Megan T, Selmic Laura E, McConnell Briana M, Lamoureux Lorissa M, Duffy Daniel J, Harper Tisha A, Philips Heidi, Hague Devon W, Foss Kari D
Аннотация
OBJECTIVE: To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications.
STUDY DESIGN: Before-and-after intervention study.
ANIMALS: Client-owned dogs (n = 633) and cats (n = 44).
METHODS: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC- ) followed by 75 SSC- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC+ ) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication.
RESULTS: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications.
CONCLUSION: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications.
CLINICAL SIGNIFICANCE: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.
STUDY DESIGN: Before-and-after intervention study.
ANIMALS: Client-owned dogs (n = 633) and cats (n = 44).
METHODS: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC- ) followed by 75 SSC- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC+ ) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication.
RESULTS: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications.
CONCLUSION: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications.
CLINICAL SIGNIFICANCE: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.