Valdez, Rhika Mae F.

BSN 3-1

New Review Finds Surgical Safety Checklists Significantly Reduce Post-Op

Complications
November 20, 2014
American Society of Anesthesiologists

Patients experience fewer postoperative complications when a surgical safety

checklist is used by their surgical team, reports the first large-scale review on the
subject published in the June issue of Anesthesiology, the official medical journal of
the American Society of Anesthesiologists (ASA). By following a simple checklist,
healthcare providers can minimize the most common postoperative risks such as
wound infection and blood loss.
Our review represents the first comprehensive analysis of the effect of using
surgical safety checklists on major postoperative complications, says Brigid Gillespie,
PhD, RN, of the National Health & Medical Research Council and Griffith University in
Queensland, Australia. Although checklists are considered a best practice in surgery,
there is still variability in adoption and compliance rates in their use. It is our hope
that this review will provide more extensive evidence on the tremendous patient safety
benefits that checklists offer and will lead to the consistent adoption of their use in
surgery.
Researchers examined seven independent, previously published studies that
tested the effect surgical safety checklists had on postoperative complications. A metaanalysis was performed in which the results of the studies, representing 37,339
patients, were integrated. All patients had either elective or emergency surgery. In all
of the studies, the World Health Organization (WHO)'s Surgical Safety Checklist or a
modified version was used.
Researchers found that using a checklist in surgery significantly reduced overall
postoperative complications wound infections and blood loss. According to the review,
there were 3.7 percent fewer postoperative complications overall (one complication
prevented for every 27 patients when the checklist is used), 2.9 percent fewer wound
infections (one less wound infection prevented for every 34 patients), and a 3.8 percent
reduction in patients who had blood loss greater than 500ml (one less patient had
blood loss greater than 500ml for every 33 patients). However, the use of a checklist

did not significantly reduce mortality rates, pneumonia or unplanned return to the
operating room (OR).
According to researchers, the review represents the best evidence available
regarding the relationship between the use of surgical safety checklists and
postoperative complications to date.
Since its introduction in 2009, the WHO Surgical Safety Checklist has been
mandated in ORs in more than 122 countries. It is a patient safety tool used to ensure
the safe delivery of anesthesia, prevent surgical errors and complications and promote
effective teamwork and communication within surgical teams. The checklist identifies
specific tasks that should be completed during three different phases of surgery
before anesthesia is administered, before skin incision, and before the patient leaves
the OR.

SUMMARY:
It is said that WHO Surgical Safety checklist reduces post-operative complications,
wound infections and blood loss. Using the WHO Surgical checklist, there were 3.7
percent fewer postoperative complications overall. The checklist identifies three phases
of an operation, each corresponding to a specific period in the normal flow of work:
before the induction of anesthesia (sign in), before incision of the skin (time out) and
before the patient leaves the operating room (sign out). In each phase, a checklist
coordinator must confirm that the surgery team has completed the listed tasks before
it proceeds with the operation. Its use has been demonstrably associated with
significant reductions in complications and death rates in diverse hospitals and
settings, and with improvements in compliance to basic standards of care.

REACTION:
Communication is considered vital part of safe health care for our clients and
patients. Checklist has become part of the standard practice in the surgical journey of
patient. The intention of such checklist is to systematically and efficiently ensure that
all conditions are optimum for patient safety, and that all staff are identifiable and
accountable, and errors In patient identity, site and type of procedures are avoided
completely. By following the checklist health care professionals can minimize the most
common and avoidable risks endangering the lives and well-being of surgical patients.

NURSING THEORY:
According to Jean Watsons Assumption theory, the practice of caring is central to
nursing. She compared caring to curing, caring is more healthogenic than is curing.
So it means that first we need to develop a helping trust relationship with the patient,
we need to care for them like what we do for ourselves. The nurse must provide
comfort, privacy, and most of all safety as a part of the carative factor.