Abstract
Background
A database study to test a new model of surgical safety checklist for eye surgery in the outpatient operating room, especially for cataract surgery and intravitreal anti-VEGF injections.
Methods
WHO Surgical Safety Checklist analysis, and changes to obtain a customized surgical safety checklist for eye surgery. Testing of the new checklist in the outpatient operating room of the Institute of Ophthalmology, University of Modena during a period of 4 months (January–April 2011). All cataract surgery and intravitreal anti-VEGF operations were included in the study, and controlled by the new surgical safety checklist. The percentage of answers to each safety check was calculated to obtain an estimate of adherence to our new checklist.
Result
Eight hundred and forty nine procedures (390 cataract, 452 anti-VEGF injections, seven combined surgery) were analyzed. The study showed a high level of adherence to the majority of the safety checks in the checklist. Important differences were identified in consent confirmation (correct confirmation in 99.76 %, no confirmation in 0.24 %), surgical site marking (correct marking in 99.29 %, no marking in 0.71 %), patient cooperation during operation (95.17 % of patients were cooperative, 4.83 % of patients were uncooperative), adherence to antibiotic prophylaxis (correct prophylaxis in 93.17 %, no prophylaxis in 6.83 %), critical situation during surgical procedures (no critical situation in 91.76 %, critical situation in 8.24 %)
Conclusion
The study showed a high level of adherence to the checklist. A surgical safety checklist could improve the management of an eye surgery operating room.
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References
Confortini MC, Patrini E (2006) Manuale di risk management in sanità: processi e strumenti di implementazione. 1st edition. Il Sole 24 Ore, Milan
Bates DW, Leape LL, Petrycki S (1993) Incidence and preventability of adverse drug events in hospitalized adults. J Gen Intern Med 8:289–294
Ministero della Salute (2010) Metodi di analisi per la gestione del rischio clinico. Root Cause Analisys — RCA. Analisi delle cause profonde. Volume 1
Ministero della Salute (2006) ‘La sicurezza dei pazienti e la Gestione del Rischio clinico’ — Glossario
The risk management guide. http://www.ruleworks.co.uk/riskguide/index.htm accessed on 2nd of May 2011
World Health Organisation — safe surgery saves lives.http://www.who.int/patientsafety/safesurgery/en/ accessed on 2nd of May 2011
World Alliance for Patient Safety (2009) Implementation Manual WHO Surgical Safety Checklist (First Edition) — safe surgery saves lives. World Health Organization
Samel ME, Resch S, Haynes AB, Funk LM, Bader A, Berry WR, Weiser TG, Gawande AA (2010) Adopting a surgical safety checklist could save money and improve the quality of care in U.S. Hospitals. Health Aff (Millwood) 29(9):1593–1599
Conley DM, Singer SJ, Edmondson L, Berry WR, Gawande AA (2011) Effective surgical safety checklist implementation. J Am Coll Surg 212(5):873–879
Rodrigo-Rincón MI, Tirapu-León B, Zabalza-López P, Martín-Vizcaino MP, de La Fuente-Calixto A, Villalgordo-Ortín P, Domench-Mañero L, Gost-Garde J (2011) The healthcare professional’s perceptions on the implementation and usefulness of the surgical safety checklist. Rev Calid Asist 26(6):380–385
Dany M, Najjar MD, Shady T, Awwad MD (2003) Simple cataract checklist for residents and high-volume surgeons. J Cataract Refract Surg 29(5):1046
Royal College of Surgeons (2002) Good surgical practice. Royal College of Surgeons, London UK
American Academy of Ophthalmology. Minimizing wrong site surgery (2001) Patient Safety Bulletin Number 1. American Academy of Ophthalmology, American Society of Ophthalmic Registered Nurses, and American Association of Eye and Ear Hospitals
De Vries EN, Dijkstra L, Smorenburg SM, Mejer RP, Boermeester MA (2010) The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis. Patient Saf Surg 4(1):6
Royal College of Ophthalmologists (2004) Investigating endophthalmitis outbreaks. Royal Collge of Ophthalmologists, London UK
American Academy of Ophthalmology (2001) Minimizing wrong IOL placement. Patient Safety Bulletin Number 2, Am Acad Ophthalmol
Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183:630–641
Conley DM, Singer SJ, Edmondson L, Berry WR, Gawande AA (2011) Effective surgical safety checklist implementation. J Am Coll Surg 5:873–879
Muhtaseb M, Kalhoro A, Ionides A (2004) A system for preoperative stratification of cataract patients according to risk of intraoperative complications: a prospective analysis of 1441 cases. Br J Ophthalmol 88:1242–1246
Liu C (2004) Risk stratification for the humble cataract. Br J Ophthalmol 88:1231–1232
Najjar DM, Awwad ST (2003) Cataract surgery risk score for residents and beginning surgeons. J Cataract Refract Surg 29:2036–2037
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Cavallini, G.M., Campi, L., De Maria, M. et al. Clinical risk management in eye outpatient surgery: a new surgical safety checklist for cataract surgery and intravitreal anti-VEGF injection. Graefes Arch Clin Exp Ophthalmol 251, 889–894 (2013). https://doi.org/10.1007/s00417-012-2206-2
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DOI: https://doi.org/10.1007/s00417-012-2206-2