Role and impact of WHO Surgical safety checklist implementation on patient safety, in a tertiary level health care center

Singh, Santosh Kumar; Shukla, Devendra; Singh, Vikram

doi:10.5455/ijsm.who-surgical-safety-checklist-implementation

Cited by 3 publications

(5 citation statements)

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“…Noncompliance, therefore, becomes a primary barrier to checklist application, as well as a major hindrance for its impact measurement. It is also evident that the design of a checklist is paramount in improving patient safety, as implementation of non-validated checklists did not yield an overall significant impact on patient outcomes [81,84,91] . Moreover, there is no significant correlation between number of checklist items and patient related outcomes, indicating number of checklist items does not improve its impact on patient safety [79,89,92] , whereas checklists with less items may also provide significant improvements [85,86] .…”

Section: Discussionmentioning

confidence: 99%

“…Our initial literature search yielded 114 results. Of these 144 articles, we identified 19 articles [78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96] that fit our eligibility criteria. Of these studies, 12 involved checklist use in the surgical setting [78-79, 81-84, 86, 92-96] , 5 involved checklist use in the anaesthesia/critical care setting [78,86,[88][89][90] , 2 involved checklist use in the medical setting [81,91] .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All studies involved comparison of participant groups with checklist usage against participant groups without checklist usage. Two of the 19 studies were randomized controlled trials [80,91] , 10 studies utilized a pre/post intervention study design [78,79,83,85,86,90,92,93,95,96] , while seven studies adopted a retrospective or prospective observational study design [81,82,84,87,88,89,94] .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Furthermore, implementation of SSC resulted in significant reduction intraoperative (3.27% to 0.85%, P=0.06) and postoperative (13.11% to 7.63%, P=0.049) mortality. Spanjersberg et al [84] conducted a prospective multicentre cohort study on introduction of a pre-incision safety checklist (ISC) and its impact on inpatient mortality and adverse outcomes among a cardiac surgery population. They reported significant reductions in 120-day mortality ( both groups on the 72-hour stroke rate (0.7% in both groups, P=0.72).…”

Section: Impact Of Checklist On Inpatient Safetymentioning

confidence: 99%

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Impact of checklists on inpatient safety: A review of recent literature

Wani,

Kaur,

Chew

et al. 2023

Int. J. Appl. Res.

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Background: Increase in public education and demands for patient-centred care prompt further research into transparent, organized and, above all, safe medical care. The checklist appears capable in theory to resolve some of the issues of patient safety, however its relevance and value in current practice has been questioned and adoption remains low among medical communities worldwide. Objective: to conduct a systematic review of articles of the current effect of checklists on patient safety in terms of improving patient outcomes and reducing medical errors in the inpatient setting. Methods: Search was conducted using Google Scholar with no language or study design restrictions and included keywords 'checklist', 'impact' and 'patient safety'. Publications before January 2016 were excluded to more closely reflect its impact in current medical practice. Only studies on quantitative measures of impact were included. Case reports, editorials, letters, commentaries, reviews, overviews and conference abstracts were excluded. Studies with checklists employed as part of a 'bundle', impact assessed in a simulated setting, involved outpatient setting were excluded. Titles that obviously did not match the review's aim were also excluded. Main Results: 114 articles were identified, of which 19 satisfied the eligibility criteria. Articles evaluated checklist impact in terms of patient outcomes (mortality, adverse events, length of hospital stay) and staff adherence to standard guidelines. Studies reported mixed results of checklist impact in patient related outcomes, however uniformly found statistically significant improvements in staff adherence (mean number of items completed 8.7 (SD=1.5) without checklist to 10.9 (SD=1.1) items with checklist out of 12 items, p<0.0001). Several studies also reported significant effects when completed checklists are compared with patient related outcomes (20.0% when checklist not completed vs 11.3% when checklist completed, p=0.026). Conclusion:The studies concluded a possible contribution of the checklist in patient-related outcomes, with much inconsistency in findings among different studies. The few articles reporting on staff adherence however provided significant uniform improvement following checklist implementation. There is a need for more high-quality quantitative studies to effectively conclude its impact in patient safety. As for now, the checklist remains relevant and should be applied at a broader scale, with research priority on checklist design and quality indicators to be included.

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Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Impact Of Checklist On Inpatient Safetymentioning

confidence: 99%

See 2 more Smart Citations

Impact of checklists on inpatient safety: A review of recent literature

Wani,

Kaur,

Chew

et al. 2023

Int. J. Appl. Res.

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“…accounting for 85% was seen in X-Ray Erect abdomen and Chest X-ray PA view. This still remains important diagnostic imaging in 09 (15 %) patients absence of gas might be in cases of distal perforation.Singh SK, et al (2019) [29] study shows that presence of free air under diaphragm in 62.67 % of patients.…”

Section: Free Gas Under Diaphragmmentioning

confidence: 96%

An Observational Study on Assessment of Postoperative Complications Among Perforation Peritonitis Using Clavien-Dindo Classification in Tertiary Care Center of Central India

Deshwali¹,

Prasad²,

Patel³

et al. 2021

IJAR

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Introduction :Surgical team always tries to provide consistently low incidence of major complications for patient undergoing any operation. Clavien-Dindo (CD) classification is the simplest way of reporting all complications. The main aim of this study was to test the usefulness of Clavien-Dindo classification in patients undergoing the abdominal surgery. In this study Clavien-Dindo classification has been used for assessment of postsurgical complications after major abdominal surgery. Material and method: It was an observational study of all perforation peritonitis patients admitted in sri aurobindo medical college and post graduate institute between november 2017 to may 2019 (1 and 1/2 Year) on the basis of Clavien-Dindo classification. Results :This was an observational prospective study was carried out in Department of General Surgery, Sri Aurobindo Medical College and P.G. Institute, Indore, which includes total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. In our study Most common symptoms in patients presenting with perforation is Abdominal pain in 60 (100%) patients. 45(75%) patients had constipation & obstipation, 41 (68.33%) patients had vomiting ,33(55%) of patients had fever 17 (28.33%) patients had abdominal distensions the other common symptoms. Out of 60 patients, all 60(100%) patients had abdominal tenderness and guarding, 47 (78.33%) patients had absent bowel sounds, 42(70%) patients had tachycardia, 26 (43.33%) patients had hypotension, 23 (38.33%) patients had tachypnoea and 21 (35%) patients had low urinary output. In 16 (26.6%) patients comorbid conditions were present. In 10 (16.66%) patients multiple perforations were found out of which only 01 (10%) patient is haemodynamically stable and 09 (90%) patients were unstable. Complication occurred in 09(90%) patients and no complication were only in 01 (10%) patients. In this group 04(40%) patients got discharged and 6(60%) patient expired. P Value was 0.001 which is significant. In our study most common site of perforation was gastric perforation 30(49.18%) Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates. Conclusion :Perforation peritonitis is a life-threatening condition and requires urgent hospital care, resuscitation and surgery. Early resuscitation and surgery are required to decrease morbidity and mortality. On the basis of risk stratification in Peritonitis patients its management requires lots of expensive modalities, skill, monitoring and treatment to provide better care to the patient. For the classification of complications, a new system is proposed by Clavienâ€“Dindo which is very helpful during perforation surgery.Clavien- Dindo classification helps us to distinguish a normal postoperative course and the severity of complications, which allows us to compare postoperative morbidity and evaluate the outcomes. We also recommend a larger study with a bigger sample size for better analysis of clavien-dindo classification of complications and to confirm the findings of our study.

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“Clinical Study of Clavien-Dindo Classification to Assess the Grades of Complication and Factors Responsible in Cases of Gastrointestinal Perforations in a Tertiary Care Centre”

Deshwali¹,

Sharma²

2021

Global Journal for Research Analysis

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INTRODUCTION Perforation peritonitis is one of the most common surgical emergencies across the globe. Gastrointestinal perforations have very high morbidity and mortality rates, irrespective of the type of operative procedure performed. The Clavien-Dindo system is nowadays widely used for complications after surgery for grading adverse events (i.e. complications) which occur as a result of surgical procedures and has become the standard classification system for many surgical specialties for open as well as laparoscopic surgeries . In this study, an attempt is made to find out various preoperative and intra operative factors that may responsible for adverse outcome and to identify the best management that could decrease the complication rate with special reference to CLAVIEN-DINDO classification. MATERIALS AND METHODS We did an observational study of 60 perforation peritonitis patients admitted in Department of Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Indore, M.P. between November 2017 to May 2019(1 and 1/2 Year) on the basis of Clavien-Dindo classification.All were studied with respect to clinical features, time of presentation, comorbid conditions, investigations, intervention done, operative findings and postoperative course and all the data was entered in preformed proforma RESULTS Total 60 patients of perforation peritonitis admitted and treated in the department, During the period of November 2017 to May 2019. End of the study concludes the following points: • In my study, most of the cases were between age group 20-39(50%). more common in males 41 (68.33%). who presented after 3 days from onset of symptoms 20 (33.33%) all of them had complications 20(100%). P Value was<0.001 which is significant. In 16 (26.6%) patient’s comorbid conditions were present, out of them 12 (75%) patients were haemodynamically unstable and 9(56.25%) patient expired.In 29 (48.33%) patient size of perforation was more than 1 cm out of which complication observed in 28(96.55%) patient.. P Value was <0.001 which is significant. In 10 (16.66%) patients multiple perforations were found out of which 09 (90%) patients were unstable. Complication occurred in 09(90%) patients . In this group 6(60%) patient expired. P Value was 0.001 which is significant . In 24(40%) patients more than 500 ml intraperitoneal collection was found, out of which complications developed in all 24(100%) patients,. Chi Square Value was 42.8 and P Value was<0.001 which is significant. Complication according to clavien -dindo classification 14 out of 60 (23.33%) patients had no complications, 4 (6.66%) had grade I complication, 5 (8.33%) had grade II complications, 12 (20%) had grade III complications, 11 (18.33%) had grade IV complications, and 14 (23.33%) had grade V complication rates . CONCLUSION Post-operative complications increase due to comorbid conditions, size and number of perforations and it also affects the outcome of the patient. It is observed that with the increase in contamination (intraperitoneal collection) morbidity increases.For the classification of complications, a new system is proposed by Clavien–Dindo which is very helpful during perforation surgery, it is used in all over the world and facilitates in comparisons or evaluation of various surgical . The new classification mainly focuses on the medical perspective, with a major emphasis on the risk, type of anaesthesia and procedures or therapy used to correct a complication. We therefore recommend the use of clavien-dindo classification of complications.

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Role and impact of WHO Surgical safety checklist implementation on patient safety, in a tertiary level health care center

Cited by 3 publications

References 0 publications

Impact of checklists on inpatient safety: A review of recent literature

Impact of checklists on inpatient safety: A review of recent literature

An Observational Study on Assessment of Postoperative Complications Among Perforation Peritonitis Using Clavien-Dindo Classification in Tertiary Care Center of Central India

“Clinical Study of Clavien-Dindo Classification to Assess the Grades of Complication and Factors Responsible in Cases of Gastrointestinal Perforations in a Tertiary Care Centre”

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