Implementation of the safe surgery checklist of the World Health Organization at the University Hospital of Monastir (Tunisia)

Authors

  • S. El Mhamdi
  • M. Letaief
  • Y. Cherif
  • I. Bouanene
  • W. Kallel
  • A. Hamdi

Keywords:

Patient safety - Checklist - Safety management - Quality indicator, Health Care - Tunisia

Abstract

Objective: To evaluate the impact of introduction of the WHO safe surgery checklist in the university hospital of Monastir over a period of five months.

methods: We conducted a longitudinal study (before - after) with evaluation of five result indicators which were: percentage of surgical site infections, not prescribed antibioprophylaxis, unplanned return to the operating room, postoperative length of stay and postoperatively death.

results: We identified 185 patients during the period and 323 patients after the introduction of the WHO checklist. The proportion of surgical site infection decreased significantly from 13.5% in the citationsRaw period to 1.3% after the introduction of the checklist (p < 0.001). The proportion of unplanned return to the operative room was 10.3% before the introduction of the checklist and deceased significantly to 1.3% at the intervention period (p = 0.003). The proportion of not prescribed antibioprophylaxis and median post-operative length of stay deceased also significantly during the study period (p < 0.001).

Conclusion: The surgical checklist control contributes to the development of a safety culture in the operating room. Maintaining its use should be supported by incentives such as certification and accreditation.

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References

Organisation Mondiale de la Santé. Alliance mondiale pour la sécurité des patients. Défi mondial pour la sécurité des patients 2005 - 2006. http://www.who.in/patientsafety /events/05/GPSC_Launch_French%20FINAL_low_res.pdf (Consulté le 20/11/2012).

De Vries EN, Smorenburg SM, Gouma DJ, Boermeester MA. A safer surgical pathway: monitoring in the operation room alone is insufficient. Ned Tijdschr Geneeskd 2008;152:2491-4.

De Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 2008;17:216-23.

Kable AK, Gibberd RW, Spigelman AD. Adverse events in surgical patients in Australia. Int J Qual Health Care 2002;14:269-76.

Organisation Mondiale de la Santé. World alliance for patient safety. « Safe surgery saves lives” initiative. 2008. http://www.who.int/patientsafety /safesurgery/knowledge_base /SSSL_Brochure_finalJun08.pd f (Consulté le 15/11/2012).

Letaief M, El Mhamdi S, El-Asady R, Siddiqi S, Abdullatif A. Adverse events in a Tunisian hospital: results of a retrospective cohort study. Int J Qual Health Care 2010;22:380-5

Rapport de l'hôpital universitaire Fattouma Bourguiba pour l'année 2010.

Haynes AB, Weiser TG, Berry WR et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. N Engl J Med 2009;360:491-9.

De Vries EN, Eikens-Jansen MP, Hamersma AM, Smorenburg SM, Gouma DJ, Boermeester MA. Prevention of surgical malpractice claims by use of a surgical safety checklist. Ann Surg 2011;253:624-8.

William DJ, Oslen S, Crichton W et al. Detection of adverse events in Scottish hospital using a consensus-based methodology. Scott Med J 2008;53:26-30.

Hancorn K, Blair S. Checklist culture. WHO needs changing. Br Med J 2010;340:c909.

Seiden SC, Barach P. Wrong-side/wrong-site, wrong-procedure, and wrong patient adverse events: Are they preventable? Arch Surg 2006;141:931-9.

Neily J, Mills PD, Eldridge N et al. Incorrect surgical procedures within and outside of the operating room: a follow-up report. Arch Surg 2011;146:1235-9. 14- Weiser TG, Haynes AB, Dziekan G, Berry WR, Lipsitz SR, Gawande AA. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010;251:976-80.

Smyth ET, Emmerson AM. Surgical site infection surveillance. J Hosp Infect 2000;45:173-84.

Organisation Mondiale de la Santé. Programme de sécurité des patients. « Safe surgery safe live ». http://www.who.int/patientsafety/safesurgery/en/. (Consulté le 16/11/2012).

Birkmeyer JD, Hamby LS, Birkmeyer CM, Decker MV, Karon NM, Dow RW. Is unplanned return to the operating room a useful quality indicator in general surgery? Arch Surg 2001;136:405-11.

Antonacci AC, Lam S, Lavarias V, Homel P, Eavey RD. Benchmarking surgical incident reports using a database and a triage system to reduce adverse outcomes. Arch Surg 2008;143:1192-7.

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Published

2014-12-25

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Original articles