The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis

Vries, Eefje N. de; Dijkstra, Lucia; Smorenburg, Susanne M.; Meijer, Ronald; Boermeester, Marja A.

doi:10.1186/1754-9493-4-6

Cited by 83 publications

(58 citation statements)

References 29 publications

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“…The use of checklists in health care, however, has been much slower to evolve despite evidence that their use improves patient outcomes and/or improves team behaviours and communication. 5,[18][19][20][21][22][23] Specifically, use of the WHO SSC has shown a decrease in inpatient morbidity and mortality 2,[4][5][6][7]24 as well as improvement in teamwork skills, communication, and adherence to process measures. 1,23,[25][26][27] Nevertheless, Ko et al's recent systematic review of checklist use in medicine has shown limited evidence of their effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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Purpose In 2007, the World Health Organization created a Surgical Safety Checklist (SSC) that encompassed a simple set of surgical safety standards. The threefold purpose of this study was to add ambulatory-specific items to the SSC, to introduce the items into an ambulatory surgical facility, and to determine if patient outcomes regarding postoperative pain and nausea/vomiting improved following implementation. In addition, safety attitudes, antibiotic timing, regional anesthesia/nerve blocks, preemptive pain medications, prophylactic antiemetics, length of stay, and hospital admission were also assessed.Methods After Research Ethics Board approval, staff complete a Safety Attitudes Questionnaire. Seven items were added to the SSC. Data were then collected on 180 surgical cases before SSC implementation and 195 cases following implementation. Compliance with each section of the SSC was assessed. Results On postoperative day one, the median (97.5% confidence interval [CI]) difference between pre-and postimplementation pain scores was 0.5 (97.5% CI, 0 to 1; P = 0.13), and the median difference in the rate of postdischarge nausea/vomiting was -8.4% (97.5% CI, -17.9 to 1.1; P = 0.06). There was no improvement in safety attitudes or any of the secondary outcomes, with the exception of the use of preemptive pain medications. Compliance with the three sections of the checklist, i.e., BRIEFING, TIME OUT, and DEBRIEFING was 99.49%, 97.95%, and 96.92%, respectively. There was low compliance in verbalization of the added ''ambulatory-specific items''. Conclusion Potential reasons for lack of uptake and integration include poor ''user'' buy-in, an overly lengthy checklist, and lack of prioritization of ambulatory-specific items. A shortened SSC was developed based on the results of this study. This trial was registered at ClinicalTrials.gov ID: NCT00934310.Author contributions Pamela J. Morgan was involved in the acquisition of funding for this study. Pamela J. Morgan Lisa Cunningham, Wei Wu, Victoria Noguera, and John Semple were involved in the conception and design of the study. Lisa Cunningham, Sohini Mitra, Natalie Wong, and Mary Li were involved in the acquisition of data for the study. Pamela J. Morgan was involved in the interpretation of the data. Pamela J. Morgan, Wei Wu, and Mary Li analyzed the data. Pamela J. Morgan, Lisa Cunningham, and Mary Li were involved in drafting the article. Sohini Mitra, Natalie Wong, Wei Wu, Victoria Noguera, and John Semple were involved in the critical revision of the article. Résumé Objectif En 2007, l'Organisation mondiale de la Sante´a cre´e´une Liste de contrôle de la se´curite´chirurgicale (LCSC) couvrant un ensemble simple de normes de se´curite´pour la chirurgie. L'objectif triple de cette e´tude e´tait d'ajouter des e´le´ments spe´cifiques au contexte ambulatoire a`la LCSC, d'introduire ces e´le´ments dans un centre de chirurgie ambulatoire, et de de´terminer si les devenirs des patients en matie`re de douleur et de nause´es et vomissements postope´ratoires e´taien...

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Section: Discussionmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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“…As in the fi eld of aviation industry, in surgical practice also, to improve surgical quality and safety, checklists are introduced 2 . WHO has proposed the checklist for surgical procedure to improve team work and to build confi dence by decreasing avoidable errors.…”

Section: Discussionmentioning

confidence: 99%

“…Various checklists such as Surgical Patient Safety System (SURPASS) study showed in hospital morality reduced from 1.5% to 0.8% around the world. However it contains 124 items to be fi lled and its compliance with practitioners was not well assessed 2 . Nepal being a developing country lacks the system of digital medical records, well equipped operation theatre and well trained operation theatre staffs.…”

Section: Introductionmentioning

confidence: 99%

“…With this background the 'Safe Surgery Save Lives' initiative was established by World Alliance for patient safety as a part of the World Health Organization effort to reduce surgical mortality all over the world 2 . Various checklists such as Surgical Patient Safety System (SURPASS) study showed in hospital morality reduced from 1.5% to 0.8% around the world.…”

Section: Introductionmentioning

confidence: 99%

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Compliance and outcome of implementing World Health Organization surgical safety check list in surgical practice in a teaching hospital

Shrestha

Thapa

Lama

et al. 2017

J. Kathmandu Med. Coll.

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Background: Surgical complications represent a signifi cant cause of morbidity and mortality with the rate of major complications after inpatient surgery in industrialized countries. The purpose of this study was to summarize experience with surgical checklist use and effi cacy for improving patient safety. Objective: To evaluate the compliance of implementation and outcome of World Health Organization Surgical checklist use in surgical practice at Kathmandu Medical College. Methods: This is a prospectively designed descriptive study including adult patients undergoing surgical procedure in Kathmandu Medical College Hospital from June 2013 till June 2014. Obtained data on compliance of World Health Organization safety checklist use by practitioner and its outcome in patient's safety were assessed using SPSS version 15. The surgeries that underwent under local anesthesia were excluded from the study. Results: World Health Organization checklist was implemented in all 288 patients undergoing various surgical procedures with acceptable compliance by all 41 practitioners. Although it had no impact on correctable mortality and morbidity, frequent instrument malfunctions were offi cially recorded. Attitudes towards use of checklist was good as 100% of participants wanted use of checklist if they were having operation on themselves. However 22% of the participants complained of extra time needed to fi ll the checklist. Time taken to fi ll up sign in column of checklist was on average from 120 to 150 seconds (mean 135±5secs) and sign out was 80-100 seconds (mean 95±6secs). Only 69% of the participants were available for sign out. Scissor malfunction was detected in 4(1.38%) cases and operation theatre table related problem was found in one case (0.34%). Conclusion: Implementation of World Health Organization Surgical Safety Checklist can be done with acceptable compliance and instrumental malfunction was well documented.

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“…However, we do not assume an impact on the timing or its documentation, as previously described in a retrospective cohort study. 21 Second, the SSI rate was studied in only a subset of patients. The subset of patients with cholecystectomy and colon resection was chosen as a sample for quality control in clean and clean-contaminated wounds.…”

Section: Discussionmentioning

confidence: 99%

Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard

Misteli

Widmer

Weber

et al. 2012

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To evaluate the feasibility of implementation of the refined window for routine antimicrobial prophylaxis (RAP) of 30-74 minutes before skin incision compared to the World Health Organization (WHO) standard of 0-60 minutes.DESIGN. Prospective study on timing of routine antimicrobial prophylaxis in 2 different time periods.SETTING. Tertiary referral university hospital with 30,000 surgical procedures per year.METHODS. In all consecutive vascular, visceral, and trauma procedures, the timing was prospectively recorded during a first time period of 2 years (A; baseline) and a second period of 1 year (B; after intervention). An intensive intervention program was initiated after baseline. The primary outcome parameter was timing; the secondary outcome parameter was surgical site infection (SSI) rate in the subgroup of patients undergoing cholecystectomy/colon resection.RESULTS. During baseline time period A (3,836 procedures), RAP was administered 30-74 minutes before skin incision in 1,750 (41.0%) procedures; during time period B (1,537 procedures), it was administered in 914 (56.0%; P<.001). The subgroup analysis did not reveal a significant difference in SSI rate.CONCLUSIONS. This bundle of interventions resulted in a statistically significant improvement of timing of RAP even at a shortened window compared to the WHO standard. Infect Control Hosp Epidemiol 2012;33(9):912-916Surgical site infections (SSIs) significantly impact morbidity and mortality and represent a leading cause of healthcareattained infection. 1 " 3 Appropriate perioperative antimicrobial prophylaxis can reduce the incidence of SSI. 4 " 6 Today, singleshot administration of a first-or second-generation cephalosporin is the state-of-the-art procedure in routine antimicrobial prophylaxis (RAP), 7 supplemented with metronidazole in colorectal surgery for anaerobic coverage. In addition to the type of antibiotic, the timing of RAP in relation to skin incision is crucial. Based on the findings of the landmark publication in 1992 by Classen et al, 8 guidelines recommend the administration of RAP within 2 hours before skin incision, whereas the 2008 World Health Organization (WHO) guidelines for safe surgery support administration within 1 hour before skin incision. 9 In a prospective cohort study of 6,540 interventions, administration of RAP 30-74 minutes before skin incision achieved the lowest SSI risk. 10

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The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis

Cited by 83 publications

References 29 publications

Surgical safety checklist: implementation in an ambulatory surgical facility

Surgical safety checklist: implementation in an ambulatory surgical facility

Compliance and outcome of implementing World Health Organization surgical safety check list in surgical practice in a teaching hospital

Successful Implementation of a Window for Routine Antimicrobial Prophylaxis Shorter than That of the World Health Organization Standard

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