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General Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Rebecca Fish, Aisling Hogan, Aoife Lowery, Frank McDermott, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Yew-Wei Tan, Thomas Tsang
What is the WHO Surgical Safety Checklist?This checklist aims to systemically ensure that all conditions are optimum for patient safety, that all staff are identifiable and accountable, and that errors in patient identity, site and type of surgery are avoided completely.In a large multinational, multi-institutional study, usage of the checklist was associated with a 38% reduction in the odds of 30-day mortality after emergency abdominal surgery.The checklist identifies three distinct phases in the normal theatre workflow – before induction of anaesthesia, before skin incision and before the patient leaves the operating facility. In each phase, the checklist coordinator must ensure that all the listed tasks have been completed by the surgical team before proceeding to the next phase.
Equipment, surgery and practical procedures
Published in T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith, Get Through MRCOG Part 3, 2019
T. Justin Clark, Arri Coomarasamy, Justin Chu, Paul Smith
The WHO surgical safety checklist should be performed prior to any operation and is currently a ‘hot topic’. Any candidate that has spent time in theatre will be expected to be familiar with the components of the checklist. Details of the WHO surgical safety checklist are available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59860.
Applied surgical science
Published in Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury, OSCEs for the MRCS Part B, 2017
Jonathan M. Fishman, Vivian A. Elwell, Rajat Chowdhury
Surgical safety checklist – In 2008, the World Health Organisation (WHO) published guidelines of recommended practices to reduce the rate of preventable surgical complications and deaths worldwide. A set of checks has been incorporated into the WHO surgical safety checklist, which is completed for every patient undergoing a surgical procedure. In the United Kingdom, a five-step process is used to improve theatre communication and to verify and check the surgical procedure (Figure 4.1).
‘Let me take care of you’: what can healthcare learn from a high-end restaurant to improve the patient experience?
Published in Journal of Communication in Healthcare, 2021
Terhi Korkiakangas, Sharon Marie Weldon, Roger Kneebone
The patient experience literature also suggests difficulties in translating knowledge of what needs to be improved into improvements in practice. Quality improvements are often met with resistance when healthcare staff are reluctant to admit that problems exist and feel that new solutions take time and resources from their clinical work [27]. For instance, the frequent comparison of healthcare with the aviation industry has caused new concerns for patient safety initiatives. While the World Health Organisation’s (WHO) Surgical Safety Checklist is a prime example of a quality improvement strategy drawn from aviation, the checklist is used inconsistently in operating rooms around the world [28–30]. In aviation, improvements are never an issue contested when a single problem can lead to a catastrophe on a grand scale, yet there is scope to learn from other industries [31]. When staff’s wellbeing and a cultural focus are prioritized, ‘service excellence training’ with hospitality companies such as Ritz-Carlton, Four Seasons, and Disney have seen healthcare systems improve and achieve their goals [32].
The introduction of a Neurosurgical Postoperative Checklist improved quality of care and patient safety
Published in British Journal of Neurosurgery, 2019
Andrew J. Hall, Niamh S. Toner, Pragnesh M. Bhatt
In 2008 the World Health Organization (WHO) published its Second Global Patient Safety Challenge and introduced the WHO Surgical Safety Checklist.1,2 The Checklist is now ubiquitous, and improvements in perioperative outcomes have been attributed to its use.3 Bespoke versions of the Checklist are commonplace, but the three central components remain constant: (1) a ‘Sign In’ check prior to induction of anaesthesia; (2) a ‘Time Out’ prior to commencing the surgical procedure; and (3) a ‘Sign Out’ prior to leaving the operating room. The immediate postoperative period is potentially hazardous following any surgical procedure, and good quality care requires the safe transfer of the patient from the operating suite (recovery room) to the ward/floor, and the appropriate handover of information to the ward-based nurses and doctors (in the U.K. these are usually junior doctors rotating through Neurosurgical units). The WHO Sign Out is concerned predominantly with documenting intraoperative events and issues that have arisen in the operating theatre, but it does not provide a satisfactory mechanism for communication of complex management plans, nor does it offer a framework for appropriate assessment and intervention in the postoperative period.
Anaesthetists’ knowledge of surgical antibiotic prophylaxis: a prospective descriptive study
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
J. Jocum, W. Lowman, H. Perrie, J. Scribante
Surgical site infection (SSI) is the second most prevalent type of hospital-acquired infection (HAI).1 Short-term consequences of SSI include a longer and more protracted hospital stay with associated increased costs. In certain types of surgery, for example, colonic surgery, SSI may also result in increased mortality.2 Patients with SSI are 60% more likely to be admitted to ICU, five times more likely to be readmitted to hospital and are twice as likely to die.3 The incidence of SSI is thus an important outcome measure of the quality of surgical care.2 The importance of surgical antibiotic prophylaxis (SAP) is exemplified by its inclusion as one of the pre-incision checks in the WHO surgical safety checklist.4