Effect of Checklist on the Occurrence of Postoperative Complication on Surgical Patient

Abstract

Background: Surgical safety checklists (SSCs) are designed to improve interprofessional communications and ultimately avoiding catastrophic errors that often characterizes the culture of surgical teams. However, data on the effect of surgical checklists implementation are scarce in the study area. The purpose of this research project was to directly examine the effect of utilization surgical safety checklist on patient outcomes at the University of Gondar Hospital, in Northwest Ethiopia. Material and methods: Institution based cross-sectional study was conducted at University of Gondar Hospital from January to May 2013. We reviewed medical records of all consecutive patients admitted to the surgery department (N=403). For those who have clinical symptoms of surgical site infection, a laboratory diagnosis was performed to compare occurrences of all postoperative complication among patients with and without utilization of surgical safety checklist. Results: During the study period from 403 patients operated, SSCs were attached for only 158 (39.2%) of the surgical patients. The postoperative complication was observed in 238 (59 %) of the patients, and postoperative fever was the primary complication accounting for 70 (17.3%) of all the complication. Surgical wound infection and pneumonia accounted for 47(16.6%) and 33(11.7%) respectively. S. aureus was the predominantly isolated bacteria accounted for 7(30%). Also, a statistically non-significant 11.2% decline the rate of surgical wound infection in the checklist group. In a logistic regression model of postoperative fever, the SSCs emerged as a significant independent predictor of this outcome: (OR = 0.49, 95% CI 0.31-0.75, and P-value = 0.001). Conclusions and recommendations: Patients with checklist have observed significant reductions of postoperative complication particularly bacterial infection. It is possible to some extent that the improved usage of the checklist and preoperative prophylactic antibiotics may be implicated in the reduction of postoperative fever and bacterial infection.

Perioperative Nurses’ Awareness and Attitude about Use of WHO Surgical Safety Checklist in India: An Institution Based Cross-Sectional Study

“…9 The utilization of the checklist increased safety related performance in the operation theatre and reduction in post-operative fever, surgical wound infections (11.2%), pneumonia and unplanned readmission which was reported by a cross-sectional study. 10 In another cohort study, it was seen that checklist was associated with 36.6% relative reduction in mortality; 0.069% during and 0.019% after implementation of the checklist. 11 In a systematic review, checklist exposure was related with reduced post-operative mortality [OR 0.75 (0.62-0.92); P<0.01; I 2 =87%], reduced complication rates [OR 0.73 (0.61-0.88); p<0.01; I 2 =89%) and also results in better postoperative outcomes.…”