Surgical Safety System Research Articles

Effect of Comprehensive Surgical Safety System on Patients' Outcome: A Prospective Clinical Study.

BackgroundPatient safety has become an integral part of hospital management to prevent catastrophic events which adversely affects the patients, care providers and the hospital. Surgical Checklists are an easy and simple way to prevent surgical errors and complications.ObjectiveThis prospective study is to evaluate the effect of SURPASS (Surgical Patient Safety System) checklist on the outcome of the patients who underwent surgery in our hospital.MethodsAll the patients who underwent surgery in the sixth unit of Department of Surgery from April 2014 to May 2015 were included in the study excluding those aged above 13 years and day care surgery cases. For the control group (initial six months) no checklist was implemented whereas for the study group (next six months) SURPASS checklist was implemented. Data collected on age, sex, diagnosis, surgical procedure, type of anaesthesia, number and type of postoperative complications, need of second surgery because of complications, length of hospital stay and outcome (discharge, disability or death). Mann–Whitney U test and Fisher’s exact test were used for analysis.ResultsOf the total 372 patients operated, 200 were before and 172 were after implementation of SURPASS checklist. Before implementation of the checklist, complications were noticed in 66.66% of elective and 77.23% of emergency cases. Whereas after implementation of checklist the complications in elective cases were found to be 51.09% (p-value = 0.008) and 67.50% (p-value = 0.024) in emergency cases.ConclusionImplementation of SURPASS checklist is effective in reducing the rate of postoperative complications in both elective and emergency surgeries.

Cultivation and effect of security thinking among nursing staff based on JCI standard

Objective To explore the cultivation methods and effects of security thinking among nursing staff based on JCI standard .Methods The following measures were taken to nursing staff： developing nursing safety management measures based on the systematic principle of thinking;establishing nursing risk management based on the predictable principle of thinking;improving surgical safety system based on the careful thinking principle;implementing emergency management system based on the requirements of quick mind ; improving identification of patients and disease collection methods based on logic principle of thinking .Results After the implementations lasted for 1 year and 5months,the nursing work was standardized increasingly;the procedure of nursing was optimized;the service quality was improved;the rate of nursing accidents decreased to 0 in 2013;all types of adverse events and nursing disputes gradually reduced .The average rate of hospital patient satisfaction in each nursing unit in creased rapidly , from （60 ±6.3）% in 2012 to （88 ±4.6）%in 2013.In January 2013 our hospital successfully passed JCI international certification and the nursing quality was highly praised by accreditation experts .Conclusions The cultivation of security thinking among nursing staff based on JCI standardcan make security thinking in nursing as a habit , which improves the culture of nursing security in our hospital and the whole nursing quality . Key words: Nursing staff; Nursing security; Thinking; JCI standard; Cultivation

The Image Gently Pediatric Digital Radiography Safety Checklist: Tools for Improving Pediatric Radiography

Transition from film-screen to digital radiography requires changes in radiographic technique and workflow processes to ensure that the minimum radiation exposure is used while maintaining diagnostic image quality. Checklists have been demonstrated to be useful tools for decreasing errors and improving safety in several areas, including commercial aviation and surgical procedures. The Image Gently campaign, through a competitive grant from the FDA, developed a checklist for technologists to use during the performance of digital radiography in pediatric patients. The checklist outlines the critical steps in digital radiography workflow, with an emphasis on steps that affect radiation exposure and image quality. The checklist and its accompanying implementation manual and practice quality improvement project are open source and downloadable at www.imagegently.org. The authors describe the process of developing and testing the checklist and offer suggestions for using the checklist to minimize radiation exposure to children during radiography.

Effect of a Comprehensive Surgical Safety System on Patient Outcomes

Effect of a Comprehensive Surgical Safety System on Patient Outcomes

Effect of a Comprehensive Surgical Safety System on Patient Outcomes

Adverse events in patients who have undergone surgery constitute a large proportion of iatrogenic illnesses. Most surgical safety interventions have focused on the operating room. Since more than half of all surgical errors occur outside the operating room, it is likely that a more substantial improvement in outcomes can be achieved by targeting the entire surgical pathway. We examined the effects on patient outcomes of a comprehensive, multidisciplinary surgical safety checklist, including items such as medication, marking of the operative side, and use of postoperative instructions. The checklist was implemented in six hospitals with high standards of care. All complications occurring during admission were documented prospectively. We compared the rate of complications during a baseline period of 3 months with the rate during a 3-month period after implementation of the checklist, while accounting for potential confounders. Similar data were collected from a control group of five hospitals. In a comparison of 3760 patients observed before implementation of the checklist with 3820 patients observed after implementation, the total number of complications per 100 patients decreased from 27.3 (95% confidence interval [CI], 25.9 to 28.7) to 16.7 (95% CI, 15.6 to 17.9), for an absolute risk reduction of 10.6 (95% CI, 8.7 to 12.4). The proportion of patients with one or more complications decreased from 15.4% to 10.6% (P<0.001). In-hospital mortality decreased from 1.5% (95% CI, 1.2 to 2.0) to 0.8% (95% CI, 0.6 to 1.1), for an absolute risk reduction of 0.7 percentage points (95% CI, 0.2 to 1.2). Outcomes did not change in the control hospitals. Implementation of this comprehensive checklist was associated with a reduction in surgical complications and mortality in hospitals with a high standard of care. (Netherlands Trial Register number, NTR1943.).