Background: In 1999, the Institute of Medicine reported that, in the United States, 44,000 to 98,000 people die annually as a result of avoidable medical errors. Among the many initiatives undertaken to stem avoidable surgical errors, the World Health Organization (WHO) Surgical Safety Checklist has certainly been one of the most successful. Many surgical units have implemented adapted versions of the WHO Surgical Safety Checklist, audited their performance and discussed issues relating to the implementation process. However, such literature is still lacking in neurosurgery. Methods: A prospective observational study of 171 neurosurgical cases was conducted over an 8-week period. An independent observer assessed compliance with and completeness of the three steps in the perioperative checklist: Sign-in, Time-out and Sign-out. Factors that may reduce compliance were also analyzed. Results: Compliance with the Sign-in, Time-out and Sign-out steps was 82%, 99% and 93% respectively. On average, 92% of the Time-out elements were verified. The emergent nature of a surgery was the only factor that caused a statistically significant reduction in compliance with the checklist. Overall compliance diminished during the observation period. Conclusion: In this internal audit study, compliance with the preoperative checklist reached a satisfactory level. Further work is still needed, however, on some aspects of our surgical strategy, namely, a relatively low compliance rate with the Sign-in process was recorded and emergent cases were associated with decreased performance.RÉSUMÉ: Audit interne de la conformité à la liste de contrôle périopératoire dans une unité de soins tertiaires neurochirurgicaux. Contexte : En 1999, l'Institute of Medicine a rapporté qu'aux États-Unis, entre 44,000 et 98,000 personnes meurent chaque année à cause d'erreurs médicales évitables. Parmi les nombreuses initiatives entreprises dans le but de prévenir les erreurs chirurgicales évitables, la liste de contrôle pour la sécurité chirurgicale de l'Organisation mondiale de la santé (OMS) a certainement été l'une de celles qui a connu le plus de succès. Plusieurs unités chirurgicales ont mis en oeuvre des versions adaptées de la liste de contrôle pour la sécurité chirurgicale de l'OMS, vérifié leur conformité et discuté des problèmes rencontrés au cours de son application. Cependant, la littérature à ce sujet fait toujours défaut en neurochirurgie. Méthode : Nous avons effectué une étude observationnelle prospective de 171 cas neurochirurgicaux au cours d'une période de 8 semaines. Un observateur indépendant a évalué la conformité et l'intégralité des trois étapes de la liste de contrôle périchirurgicale : avant l'induction de l'anesthésie, avant l'incision de la peau, avant que le patient ne quitte la salle d'opération. Nous avons également analysé les facteurs qui peuvent altérer la conformité à la liste. Résultats : La conformité aux étapes avant l'induction de l'anesthésie, avant l'incision de la peau et avant que le patient ne quitte la ...
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