On The Quick
Use of Surgical Checklists Leads to Four Percent Drop in Complications
Making a list, checking it twice
Ever since the collision of two 747s on the runway in Tenerife, Canary Islands, writers have drawn parallels between cockpit dynamics and the surgical suite. There are similarities: an authoritarian environment with one person in charge of events, and a complex system that must work in harmony to achieve good results. Both locations lend themselves to Jim Reason’s classic Swiss cheese model: the convergence of multiple tiny errors can cascade into disaster.
Study after study proves just that point, including the latest in the New England Journal of Medicine. A one-year study of eight hospitals worldwide, co-sponsored by Harvard University and the World Health Organization, showed that the routine use of a basic surgical checklist led to a four percent drop in complications, from 11 percent to seven percent. And inpatient deaths decreased by more than 40 percent.
The checklist is simple; it involves such unsophisticated features as calling the patient by name, confirming allergies and monitoring blood sugars at set intervals. Additional checks take place before the patient leaves the room, and making the entire team participate and countercheck is critical; no one is exempt.
Communication in the surgical suite is crucial. When doctors and nurses work as a team and all members are coordinating, including the anesthesiologist and the scrub tech, errors are less likely. When mishaps are anticipated, prevention works wonders.
Surprisingly, most hospitals do not use such a list; it is a low-cost, low-tech innovation whose time has clearly come. But would you really want to fly in an airplane where the pilot could skip checking the gas gauge?
This article is from workingnurse.com.