Application Of Checklist Research Articles

The current state of anesthesia safety in a third world country: a cross-sectional survey among anesthesia providers in Ethiopia

BackgroundImproving patient safety during anesthesia and surgery becomes a major global public health issue due to the increasing in surgical burden. Anesthesia is delivered safely in developed countries, but its safety is hampered by complex problems in third world countries. This survey assesses the unmet anesthesia needs of one of a third world country, Ethiopia.MethodsA cross-sectional survey was conducted in Amhara region of Ethiopia from 15/12/2019 to 30/1/2020. All 81 hospitals of the region were stratified by their level as district, general, and referral hospital. The study was conducted in 66 hospitals. The number of hospitals from each strata were calculated by proportional sampling technique resulting; five referral, three general, and fifty eight primary hospitals. Each hospital from each strata was selected by convenience. Each anesthesia provider for the survey was selected randomly from each hospital and questionnaires were distributed. The minimum expected safe anesthesia requirements were taken from World Health Organization-World Federation of Societies of Anesthesiologists International Standard and Ethiopian Hospitals Standard. Anesthesia practice was expected safe if the minimum requirements were practiced always (100%) in each hospital. P < 0.05 with 95% confidence interval were used to compare the safety of anesthesia between higher and lower level hospitals.ResultsSeventy eight (88.6%) anesthesia providers working in 62 hospitals responded to the survey. On aggregate, 36 (58%) hospitals from the total 62 hospitals have met the minimum expected safe anesthesia requirements. Among the different variables assessed; professional aspects 32 (52.45%), medication and intravenous fluid 33 (53.36%), equipment and facilities 33 (52.56%), patient monitoring 43(68.88%), and anesthesia conduct 38 (62.1%) of surveyed hospitals have met the minimum requirements. Anesthesia safety is relatively higher in higher level hospitals (general and referral) 6 (75%) when compared to district hospitals 30 (55.5%), P < 0.001.ConclusionAnesthesia safety in Ethiopia appears challenged by substandard continuous medical education and continuous professional development practice, and limited availability of some essential equipment and medications. Patient monitoring and anesthesia conduct are relatively good, but World Health Organization surgical safety checklist application and postoperative pain management are very low, affecting the delivery of safe anesthesia conduct.

Design and application of Checklist for quality control in intensive care unit

To design a Checklist for quality control in intensive care unit and observe the effect of clinical application. By consulting guidelines and literature, such as Critical care medicine professional medical quality control index (2015 edition), the quality control Checklist of intensive care unit was designed. It included four parts: quality control data collection, medical record quality verification, special diagnosis and treatment, and hospital infection prevention and control supervision. Every month, a doctor with a senior professional title served as the quality control director, and was responsible for the quality control of the department's medical care, including collecting data of the past 24 hours during the morning handover, discussing and registering special diagnosis and treatment behaviors that would be performed on the day, and coordinating with the nursing team leader, controlling the quality of the whole department throughout the day, such as supervising each medical staff if they had unreasonable behaviors, checking the running and discharge medical records, and inspecting the status of the staff on duty. The data in 2018, 2019 (Checklist implemented) and 2017 (Checklist not implemented) were retrospectively analyzed, including the status of admitted patients, department management information, length of intensive care unit (ICU) stay, and the incidence of three-tube infection [ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI), catheter-associated urinary tract infection (CAUTI)], and standardized mortality, etc. From 2017 to 2019, the number of patients admitted was 373, 446, and 480, with annual growth of 19.57% and 7.62% in 2018 and 2019, respectively, and an increase of 28.69% in 2019 compared with 2017. There was no statistically significant difference in the average age and acute physiology and chronic health evaluation II (APACHE II) of patients in the three years. Compared with 2017, the length of ICU stay of patients in 2018 and 2019 were significantly shortened (days: 8.99±6.12, 9.14±7.02 vs. 10.20±7.21), and the incidence of VAP, CRBSI and CAUTI were significantly reduced [VAP (cases/1 000 ventilation days): 12.97±3.60, 9.62±3.14 vs. 17.48±4.89, CRBSI (cases/1 000 catheter days): 3.75±2.19, 3.87±1.87 vs. 6.19±3.13, CAUTI (cases/1 000 catheter days): 3.29±2.18, 3.28±1.87 vs. 5.61±3.18]. The standardized mortality were also significantly reduced [(77.27±7.24)%, (70.61±7.49)% vs. (84.41±9.05)%], the number of non-compliance with hospital infection prevention per month decreased significantly (person times: 54.00±6.30, 41.08±10.76 vs. 72.08±19.68), and the number of special diagnosis and treatment per month increased significantly (person times: 1 056.67±235.27, 1 361.75±278.48 vs. 722.25±145.96), the rate of etiology submission before antimicrobial treatment [(93.21±3.68)%, (96.59±2.49)% vs. (87.86±5.28)%] and deep vein thrombosis (DVT) prevention rate [(91.13±6.36)%, (96.23±2.99)% vs. (85.58±7.68)%] were significantly improved, and all the differences were statistically significant (all P < 0.05). All medical records in the three years were Grade A, but the average scores in 2018 and 2019 were higher than those in 2017 (96.82±2.84, 96.73±2.94 vs. 93.70±3.33, both P < 0.01). Compared with 2018, the incidence of VAP, the rate of etiology submission before antimicrobial treatment, the DVT prevention rate, and the standardized mortality rate in 2019 were further improved, and the number of non-compliance with hospital infection prevention per month decreased and the number of special diagnosis and treatment per month increased, and the differences were statistically significant (all P < 0.05). The application of quality control Checklist in intensive care unit can build an effective quality control system, reduce the incidence of three-tube infection, standardized mortality and length of ICU stay, improve the quality control awareness and execution of medical staff, and promote the improvement of medical quality.

Development and application of quality checklist for the prevention and control of COVID-19 in fever clinic and isolation ward of the general hospital.

To develop a quality control checklist for the prevention and control of coronavirus disease 2019 （COVID-19） in fever clinic and isolation ward of the general hospital and to assess its application. Based on the relevant prevention and control plans and technical guidelines for COVID-19，Delphi method was used to identity items for evaluation，and a quality control checklist for the prevention and control of COVID-19 in the fever clinic and isolation ward was developed in Sir Run Run Shaw Hospital. The checklists included 8 dimensions and 32 items for fever clinic，7 dimensions and 27 items for the isolation ward. The appointed inspectors conducted daily quality control for each shift with this checklist. The expert authority coefficient was 0.88，the mean of the importance of each index in the quality control table was not less than 4.8，and the coefficient of variation was not more than 0.07. During the entire February 2020，8 problems were found and rectified on-the-spot with the application of the checklist. Quality inspection rate was 100% in both isolation wards and fever clinic. The compliance rate and accuracy rate of hand hygiene were 100%; the correct rate of wearing and removing protective equipment increased from 96% to 100%. During the same period，a total of 1915 patients were admitted to the fever clinic，including 191 suspected patients （all were isolated in the hospital，3 were confirmed）. There were no medical staff infected with COVID-19，no cross infection of patients and their families in the hospital. A quality control checklist for the prevention and control of COVID-19 has been developed and applied in the isolation wards and fever clinic，which plays an important role in preventing nosocomial infection.

Checklist application to evaluate good management practices in aquaculture

The objective of the study was to evaluate good management practices through a Checklist for aquaculture enterprises in the Marajó archipelago (Pará, Brazil). The research was carried out in the municipality of Curralinho, as part of the actions of the project “Transfer of technology through training and technical assistance for creators of tambaqui, Colossoma macropomum, in the archipelago of Marajó/PA” of the Federal Institute of the Pará (IFPA), Campus Breves, between September 2019 and January 2020. A total of 13 fish farms participated in the survey. The instrument for data collection was a checklist, which includes items related to the management of fish farming. After applying the checklist, it was possible to identify that the implementation of fish farming, identification of infrastructure, soil management and application of limestone, occurrence of diseases and storage of fry, presented levels of non-conformities between 75% to 79%. The items filters and anti-leak prevention, handling during the process of draining the tanks, stocking density and handling of fishing, presented levels of non-conformities between 80 - 89%. For the item soil disinfection the level of non-conformities was 94% and for the items: fertilization, protection of tanks with anti-bird nets, water quality, biometrics management, transfer management, cleaning procedures and equipment asepsis and the condition and safety of fish farming workers, presented levels of non-conformities varying between 95 - 100%. It was concluded that all sites are not suitable for good practices and therefore put the species' fish farming in the region at risk.

Safety plugins for risks prevention through design resourcing BIM

Purpose The use of building information modelling (BIM) methodology has been increasing in the architecture, engineering, construction and operation sector, driven to a new paradigm of work with the use of three-dimensional (3D) parametric models. However, building information modelling (BIM) has been mostly used for as-built models of a building, not yet been widely used by designers during project and construction phases for occupational risks prevention and safety planning. This paper aims to show the capacity of developing tools that allow adding functionalities to Revit software to improve safety procedures and reduce the time spent on modelling them during the design phase. Design/methodology/approach To reach this objective, a structural 3D model of a building is used to validate the developed tools. A plugin prototype based on legal regulations was developed, allowing qualitative safety assessment through the application of job hazard analysis (JHA), SafeObject and checklists. These tools allow the automated detection of falls from height situations and the automated placement of the correspondent safety systems. Findings Revit application programming interface allowed the conception and addition of several functionalities that can be used in BIM methodology, and more specifically in the prevention of occupational risks in construction, contributing this paper to the application of a new approach to the prevention through design. Originality/value This paper is innovative and important because the developed plugins allowed: automated detection of potential falls from heights in the design stage; automated introduction of safety objects from a BIM Safety Objects Library; and the intercommunication between a BIM model and a safety database, bringing JHA integration directly on the project. The prototype of this work was validated for fall from height hazards but can be extended to other potentials hazards since the initial design stage.

Testing the effects of checklists on team behaviour during emergencies on general wards: An observational study using high-fidelity simulation

IntroductionClinical teams struggle on general wards with acute management of deteriorating patients. We hypothesized that the Crisis Checklist App, a mobile application containing checklists tailored to crisis-management, can improve teamwork and acute care management. MethodsA before-and-after study was undertaken in high-fidelity simulation centres in the Netherlands, Denmark and United Kingdom. Clinical teams completed three scenarios with a deteriorating patient without checklists followed by three scenarios using the Crisis Checklist App. Teamwork performance as the primary outcome was assessed by the Mayo High Performance Teamwork scale. The secondary outcomes were the time required to complete all predefined safety-critical steps, percentage of omitted safety-critical steps, effects on other non-technical skills, and users’ self-assessments. Linear mixed models and a non-parametric survival test were conducted to assess these outcomes. Results32 teams completed 188 scenarios. The Mayo High Performance Teamwork scale mean scores improved to 23.4 out of 32 (95% CI: 22.4–24.3) with the Crisis Checklist App compared to 21.4 (20.4–22.3) with local standard of care. The mean difference was 1.97 (1.34–2.6; p < 0.001). Teams that used the checklists were able to complete all safety-critical steps of a scenario in more simulations (40/95 vs 21/93 scenarios) and these steps were completed faster (stratified log-rank test χ2 = 8.0; p = 0.005). The self-assessments of the observers and users showed favourable effects after checklist usage for other non-technical skills including situational awareness, decision making, task management and communication. ConclusionsImplementation of a novel mobile crisis checklist application among clinical teams was associated in a simulated general ward setting with improved teamwork performance, and a higher and faster completion rate of predetermined safety-critical steps.

LEAN MANUFACTURING APPLIED TO COLLECTIVE FOOD KITCHENS LEAN KITCHEN

The Lean Kitchen is based on the Japanese TPS (Toyota Production System) system that increases productivity, efficiency and effectiveness within the kitchens. One of the principles of this philosophy is to identify the problem, optimizing resources to reduce waste, that is, lean manufacturing, in terms of eliminating bottlenecks and gaps. This article brings the theme of Lean Kitchen, to increase productivity, efficiency and effectiveness within the kitchens, as well as the concept of value, in terms of how much the customer is willing to pay. Therefore, the objective is to apply the lean concept within its outsourced industrial restaurants. Restaurants respond to variations in demands and varieties of service, however, as in any process, there are several problems that need to be meticulously detected in order to heal them. Literature based on Lean philosophy and the case study and metrics were used, such as: Visit to the Gemba reports; information collections; check-list application; problem identification; Brainstorming (team and leadership); Dynamics of engagement with team and leadership; visual communication application, feedback schedule with customers; Tools (5s; Pareto, Ishikawa, 5W2H; PDCA).

Application of JSA and Checklist in Asbestos Sealing

Application of JSA and Checklist in Asbestos Sealing

ESTUDO ERGONÔMICO PARA IMPLANTAÇÃO DE SERRARIA PARA USO COMUNITÁRIO NA FLONA DO TAPAJÓS – PA

Este trabalho teve por objetivo realizar um estudo ergonômico para implantação de serraria para uso comunitário na Floresta Nacional do Tapajós, por meio do levantamento antropométrico dos comunitários, avaliação ergonômica dos trabalhadores em serviço, aplicação de Check-list para a averiguação da qualidade ergonômica e aplicação do questionário nórdico para a verificação da saúde dos trabalhadores. Foi desenvolvido em novembro de 2016. A população estudada foi composta por 100% dos trabalhadores envolvidos nas atividades da serraria, dos quais foram capturadas imagens e vídeos, durante a jornada de trabalho, em seguida foram selecionadas posturas representativas das atividades. Os dados obtidos foram analisados no software 3D SSPP, que indica a simulação dos esforços sofridos em cada grupo de articulações. Como resultado observou-se que a postura do auxiliar de montagem foi a mais prejudicial ao trabalhador. As articulações que sofreram maiores forças atuantes e maior desequilíbrio entre os lados esquerdo e direito, foram: frente do pé, tornozelo, joelho e quadril. A compressão do disco L4/L5 ultrapassou o recomendado apenas na postura de auxiliar de montagem, com maior comprometimento no percentil 95%. Somente as posturas referentes as atividades limpeza pré desdobro, manuseio da serraria móvel- trás e auxiliar de desdobro, foram consideradas aceitáveis no balanço corporal. As articulações que apresentaram menores percentuais de capazes foram a do joelho, quadril e tornozelo, com maior comprometimento para o percentil 95%. Observou-se ainda que 75% dos trabalhadores avaliaram as condições de trabalho como ruins e as maiores queixas relatadas pelos mesmos foram decorrente a dores na coluna lombar (42,9%). PALAVRAS-CHAVE: Ergonomia florestal, Serraria ergonômica, Saúde no trabalho.

Técnicas Psicométricas Versus Técnicas Projetivas na Avaliação da Dinâmica Intrapsíquica de Doentes Psiquiátricos em Consulta Externa: Um Estudo Comparativo

Enquadramento: para se proceder a toda e qualquer intervenção no âmbito da psiquiatria ou da psicóloga clínica é necessário proceder inicialmente às avaliações psiquiátricas e psicológicas a fim de se estabelecer um diagnóstico inicial de referência. Objetivo: atestar as potencialidades psicométricas e clinimétricas da utilização de métodos projetivos na avaliação psicológica, em termos de aprofundamento da dinâmica intrapsíquica, prognóstico, previsibilidade de adesão ao tratamento e evolução terapêutica, comparativamente com os instrumentos de autorrelato. Metodologia: foi utilizada uma amostra clínica de 10 doentes psiquiátricos atendidos na Consulta Externa do Hospital de Magalhães Lemos. Os dados foram recolhidos com recurso a um questionário de dados sociodemográficos; aplicação do Symptom Checklist 90 - Revised (SCL 90 - R - Derogatis, 2002); e administração da prova projetiva de Rorschach (Chabert, 1998; Marques, 2001). Resultados: os resultados obtidos apontam o Rorschach como um instrumento que viabiliza a identificação de indicadores psicopatológicos discretos, que podem passar despercebidos em questionários de autorrelato. Conclusão: constatou-se que as técnicas projetivas são indicadas para completar o processo de psicodiagnóstico, fornecendo indicadores mais profundos do funcionamento da personalidade e dos seus recursos.

La fiscalidad ambiental: auditoría a la gestión de las oficinas tributarias de los municipios de El Doncello y El Paujil en el Caquetá

Los municipios tienen una gran responsabilidad frente a la gestión ambiental en virtud de su política tributaria, en especial por la administración de tributos con alguna incidencia ambiental, entre ellos los impuestos de publicidad exterior visual, sobretasa ambiental, delineación urbana, uso del espacio público y el de circulación y tránsito. Cada uno de ellos tiene una justificación en el ingreso, pero puede convertirse en una herramienta poderosa para desincentivar el consumo o corregir acciones del ciudadano, que sin pretenderlo terminan por fomentar el daño ambiental. La investigación realizada se centró en evaluar, en primer lugar, la estructura organizacional de las oficinas tributarias de los municipios de El Paujil y El Doncello, del departamento del Caquetá (Colombia) y, en segundo lugar, la legalidad y conveniencia de aplicar o crear impuestos relacionados con el derecho que tienen los ciudadanos a un ambiente sano. Se realizó una investigación mixta a través de técnicas cualitativas y cuantitativas, utilizando como instrumentos la aplicación de listas de chequeo y encuestas a funcionarios, así como revisión de fuentes normativas reguladoras de los tributos en cada municipio. Los resultados dan cuenta de la existencia de falencias relacionadas con los procesos de determinación, fiscalización, liquidación y cobro coactivo de los tributos municipales, a partir de su estructura organizacional.

The application of checklist in ward rounds on the prognosis of critically ill patients

The study was to investigate whether the application of checklist during ward rounds could improve the prognosis of critical ill patients.The results suggested that the checklist used during ward rounds could not improve the inhospital mortality of critically ill patients, but it increased the proportion of deep vein thrombosis prophylaxis, and shortened prophylaxis treatment of gastric stress ulcer.

Factores que inciden en la aceptabilidad de la vasectomía

La vasectomía es un procedimiento que genera mínimas complicaciones y ostenta una tasa de éxito del 99 %; además tiene menor costo que la esterilización femenina, por lo cual se debe tener en cuenta el rol que desempeña el hombre en el número de hijos que se proyecta tener. En esta revisión de tema se identificaron los factores que inciden en la aceptabilidad de la vasectomía. Se realizó la búsqueda de la literatura en las bases de datos de PubMed, ProQuest, BioMed Central, ScienceDirect y Clinical Key para el periodo 2008-2017. Se seleccionaron 39 artículos por haber cumplido los criterios de inclusión: (a) publicado entre el 2008 y el 2017, en inglés, español o portugués y b) reportar resultados afines al tema de interés con evidencia de calidad científica durante la aplicación de las listas de chequeo. La sistematización y análisis de la información permitió la construcción de tres categorías temáticas: Entorno cultural, Condiciones sociales y Educación e información. Sobre la temática se evidenció que los factores como las creencias, el entorno sociocultural y la educación e información que tienen los hombres y sus parejas sobre la vasectomía influyen en la decisión de realizarse o no este procedimiento. Un hallazgo novedoso fue que el sexo de la descendencia también incide en esta decisión. Se recomienda una educación masiva para aumentar el acceso y conocimiento de la vasectomía.

AVALIAÇÃO DA DISPONIBILIDADE DE FRUTAS E HORTALIÇAS NOS ESTABELECIMENTOS QUE COMERCIALIZAM REFEIÇÕES NA UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO

Objetivos: Descrever a oferta de frutas e hortaliças no ambiente alimentar universitário, além de identificar a presença de propagandas e a disposição das frutas e hortaliças no balcão de distribuição de refeições, e avaliar a qualidade e acessibilidade física e financeira. Métodos: Trata-se de um estudo seccional, conduzido em todos os estabelecimentos que comercializavam refeições na universidade, com aplicação de checklist. Resultados: Foram estudados oito estabelecimentos, dos quais, 50% ofereciam frutas e 100% pelo menos um tipo de verdura. 100% ofereciam as frutas in natura, inteiras e/ou em pedaços, e dentre esses, apenas 12,5% a fruta frita. As hortaliças eram oferecidas in natura, cozida e refogada. 100% das frutas apresentaram boa qualidade e 25% dos estabelecimentos apresentaram três variedades com qualidade ruim. Com relação ao preço das refeições ofertadas pelos estabelecimentos destaca-se o Restaurante Universitário por possuir o menor valor da refeição e subsidiado pela universidade. Somente um estabelecimento apresentou propaganda para suco de fruta. Conclusão: O universo de estabelecimentos aqui avaliados, no tocante a oferta de frutas e hortaliças pode facilitar escolhas alimentares saudáveis, porém, considerando todos os estabelecimentos que contemplam o campus analisado, infere-se a predominância de um ambiente não promotor da alimentação saudável.DOI: 10.12957/demetra.2019.37913

Creation of a Systems-Level Checklist to Address Stress and Violence in Fire-Based Emergency Medical Services Responders

Between 57 and 93% of Emergency Medical Services (EMS) responders reported having experienced verbal or physical violence at least once in their career. Therefore, the primary goal of this study was to develop a systems-level checklist for violence against fire-based EMS responders using findings from a systematic literature review and outcomes from a national stakeholder meeting. First, a literature review of violence against EMS responders resulted in an extensive list of 162 academic and industrial publications. Second, from these sources, 318 potential candidate items were developed. Third, Q-methodology was employed to categorize, refine, and de-duplicate the items. Fourth, ThinkLet systems facilitated consensus-building, collaboration, and evaluation of the checklist with diverse subject matter experts representing 27 different EMS organizations, government, academia, labor unions, and fire departments during a two-day consensus conference. The final SAVER checklist contains 174 items organized by six phases of EMS response: pre-event, traveling to the scene, scene arrival, patient care, assessing readiness to return to service, and post-event. So called pause points for the individual EMS responder were incorporated at the end of each of phase. Overall, 47.5% of votes across all phases rated items as most feasible, 33.7% as less feasible, and 11.6% as extremely difficult. The SAVER systems-level Checklist is an innovative application of traditional checklists, designed to shift the onus of safety and health from that of the individual first responder to the organization by focusing on actions that leadership can institute through training, policy, and environmental modifications.

Application of checklist in patient safety management: a review

Patient safety management is one of the key of nursing management, and checklist plays an active role in patient safety management. In this paper, the definition and origin of the checklist, creating methods and principles, as well as the research status at home and abroad were summarized to provide references for clinical nursing staff to compile and apply the checklist. Key words: Checklist; Patient safety; Safety management

The application of checklist for nursing handover in emergency department

Objective To explore the effects of checklist for nursing handover in emergency department. Methods A total of 48 emergency department nurses were recruited by convenient sampling method. We implemented nursing bedside handover checklist four months, the quality of the nursing handover and nurses′ mastery of the patients′ condition and the patients′ satisfaction were compared before and after the implementation. Results After four-month intervention, the score of the nursing handover quality increased from 60.39±3.22 to 67.73±3.09, the difference was statistically significant (t=-14.377, P<0.01). The score of the nurses′ mastery of the patients′ condition increased from 23.89±2.34 to 27.08±1.82, and there was significant difference (t=-7.287, P<0.01). Patients′ satisfaction improved from 91.163% (111/121) to 96.67% (116/120), the difference was statistically significant (χ2=10.66, P<0.05). Conclusions Implementation of nursing bedside-handover checklist in emergency department can reduce individual cognitive defects, decrease the information missing of the nursing handover,improve the quality of nursing work and ensure the safety of patients. Key words: Checklist; Emergency department; Nursing handover

Adherence to the WHO surgical safety checklist: an observational study in a Swiss academic center

BackgroundThe World Health Organization (WHO) Surgical Safety Checklist is used globally to ensure patient safety during surgery. Two years after its implementation in the University Hospital Basel’s operating rooms, adherence to the protocol was evaluated.MethodsThis mixed method observational study took place in the surgical department of the University Hospital of Basel, Switzerland from April to August 2017. Data collection was via individual structured interviews with selected OR team members regarding checklist adherence and on-site non-participant observations of Team Time Out and Team Sign Out sequences in the OR. Data were subjected to thematic analysis and descriptive statistics compiled.ResultsComprehensive local expert interviews indicated that individual, procedural and contextual variables influenced the application of the checklist. Facilitating factors included well-informed specialists who advocated the use of the Checklist, as well as teams focused on the checklist’s intended process and on its content. In contrast, factors such as staff insecurity, a generally negative attitude towards the checklist, a lack of teamwork, and hesitance to complete the checklist, hindered its implementation.The checklist’s application was evaluated in 104 on-site observations comprising of 72 Team Time Out (TTO) and 32 Team Sign Out (TSO) sections. Adherence to the protocol ranged between 96 and 100% in TTO and 22% in TSO respectively. Lack of implementation of the TSO was mainly due to the absence of one of the key OR team members, who were busy with other tasks or no longer present in the operating room.ConclusionThe study illustrates factors, which foster and hinder consistent application of the WHO surgical safety checklist namely individual, procedural and contextual. It also demonstrates that the TTO was consistently and correctly applied, while the unavailability of key OR team members at sign-out time was the most common reason for omission or incomplete use of the TSO.

Impact of Education on Trauma Patients' Handover Quality; a Before-After Trial.

Poor handover and inadequate transmission of clinical information between shifts cause a lot of problems in patient care and result in significant risks for physicians and patients. This study was designed to evaluate the impact of education and application of handover checklist on trauma patients' handover quality. In this before-after trial, handover process of trauma patients in an educational hospital was evaluated before and after education and application of a handover checklist, abbreviated as "WHO MISSED IP?", using a questionnaire that consisted of 10 necessary items, which should be delivered during handover of trauma patients. A total score of 10 was considered for each patient handover, the score 10 out of 10 indicating that all 10 important pieces of patient information were correctly delivered. 52 pre and post-intervention handover sessions were evaluated (438 patients). Prior to intervention, 18% of patients were not delivered to the next shift, most of which were in the night shift handover (p < 0.001). From the pre-intervention to the post-intervention period, significant improvements were detected in all items except for diagnosis and consulting items. The mean duration of handover changed from 1.22 ± 0.24 minutes to 1.58 ± 0.23 minutes after intervention (p < 0.01). In the pre-intervention period, the score equal or greater than 9 was observed in 7.5% of patients, while after intervention, 63.6% of patients had score ≥ 9 regarding complete handover (p < 0.01). Based on the findings of the present study, teaching handover standards and application of handover checklist could be helpful in improving the quality of information delivery between emergency medicine residents and improve trauma patients' handover indices.

Analysis of the Russian experience in reforming control and supervisory activities (part 2)

The modern period of reform of control and Supervisory activities is full of events, novelties of norm-setting, social experiments. In recent years, the main vector of reforms is aimed at respecting the interests of controlled objects in the preparation and conduct of control and Supervisory activities, the introduction of risk-based control, allowing to concentrate resources for control and supervision in those areas where there is a high probability of violation of the values protected by law. The article considers the dynamics and the main results of the reform of control and Supervisory activities. Among the positive results of the reform are the pilot implementation of a risk-based approach in control and supervisory activities, a system for evaluating the effectiveness and efficiency of control and supervisory activities. Some positive dynamics emerged in the application of checklists. From the point of view of the author, insufficient attention is paid to questions of a critical analysis of the need and sufficiency of control and supervisory activities in terms of the protection of legally protected values; the possibility of replacing state control and supervision by other, including non-state institutions. The author substantiates the conclusion about the analysis of the need for control (supervision), systematization of control and Supervisory functions and audit of mandatory requirements before making and implementing decisions related to the technological aspects of control (supervision). Also, proposals are made to adjust the provisions contained in the draft law “on state and municipal control (supervision) in the Russian Federation”.