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Vol. 37. Issue 1.
Pages 52-59 (January - February 2022)
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Vol. 37. Issue 1.
Pages 52-59 (January - February 2022)
Original article
Perceptions from nurses, surgeons, and anesthetists about the use and benefits of the surgical checklist in a teaching hospital
Percepciones del personal de enfermería, cirugía y anestesia sobre el uso y beneficios del listado de verificación quirúrgica en un hospital universitario
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L. Domingoa,b,
Corresponding author
ldomingo@parcdesalutmar.cat

Corresponding author.
, M. Salaa,b, C. Mireta, J.M. Montero-Moragaa, C. Lasso de la Vegac, M. Comasa,b, X. Castellsa,b
a Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003 Barcelona, Spain
b Research Network on Health Services in Chronic Diseases (REDISSEC), Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
c Methodology, Quality and Nursing Research Department, Consorci Parc de Salut MAR de Barcelona, Barcelona, Spain
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Tables (3)
Table 1. Proportion of affirmative answers according to the task in the operating room.
Table 2. Proportion of affirmative answers according to years of experience in the operating room.
Table 3. List of improvement actions proposed by the discussion group.
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Abstract
Objective

To assess attitudes and perceptions from nursing staff, surgeons and anesthetists about compliance, utility, and impact on patient's safety of the surgical checklist in a teaching hospital. We also aimed to identify improvement opportunities for strengthening the usefulness of the checklist in the operating theater.

Methods

We carried out a questionnaire-based an observational cross-sectional study. A questionnaire was distributed to operating room staff, including nursing staff, surgeons, and anesthetists. In addition to the information about surgical checklist, We also collected information regarding years of experience in the operating theater. Fisher's exact was used to compare proportions in each statement. Group discussion meetings with key professionals were held to jointly assess the results, propose improvement actions, and evaluate their feasibility.

Results

The overall response rate was 36.2% (131/362). Nursing staff was perceived as the most supportive group in the use of surgical checklist. A 64.3% of surgeons considered that using the checklist prevented adverse events vs 84.2% and 85.7% among anesthetists and nurses, respectively; p=0.028. Junior staff showed a supportive attitude toward the use of surgical checklist, considering it as a tool that gives them confidence. We ended up with a list of improvement actions aiming at strengthening the surgical checklist reliability and compliance.

Conclusions

The perception of the surgical checklist usefulness as a tool to prevent adverse events was moderate among surgeons, but well appreciated by junior staff. Nursing staff were especially critical regarding compliance and support by other professionals. To reinforce the usefulness perception of the surgical checklist it is needed to increase the involvement of all professionals, especially senior staff and surgical leaders.

Keywords:
Surgical checklist
Patient safety
Healthcare quality improvement
Human factors
Questionnaire-based study
Resumen
Objetivo

Evaluar las actitudes y percepciones del personal de enfermería, cirujanos y anestesistas con relación al cumplimiento, utilidad e impacto en seguridad del checklist quirúrgico en un hospital universitario. Asimismo nos propusimos identificar oportunidades de mejora para reforzar la utilidad del checklist quirúrgico en el quirófano.

Métodos

Estudio observacional de corte transversal basado en la información obtenida mediante un cuestionario distribuido entre el personal de quirófano: incluyendo personal de enfermería, cirujanos y anestesistas. Además de las cuestiones relativas al checklist quirúrgico, se incluyó información sobre años de experiencia en el quirófano. Se utilizó el test exacto de Fisher para comparar las proporciones de las respuestas para cada ítem. Los resultados fueron evaluados conjuntamente por parte de un grupo de discusión con profesionales clave, donde se propusieron acciones de mejora y se estudió su factibilidad.

Resultados

La tasa de respuesta fue del 36,2% (131/362). El personal de enfermería fue percibido como el grupo que daba mayor apoyo en el uso del checklist quirúrgico. Un 64,3% de cirujanos consideró que el uso del checklist quirúrgico previno eventos adversos vs. 84,2% y 85,7% entre anestesistas y personal de enfermería, respectivamente; p=0,028. El personal junior mostró una actitud de apoyo hacia el uso del checklist quirúrgico, considerándolo como una herramienta que les daba confianza. Se elaboró una lista de acciones de mejora con el objetivo de fortalecer la confianza y el cumplimiento del checklist quirúrgico.

Conclusiones

La percepción de la utilidad del checklist quirúrgico como herramienta para evitar eventos adversos fue moderada entre cirujanos, pero bien considerada por el personal con menos experiencia en el quirófano. El personal de enfermería fue especialmente crítico respecto al cumplimiento y el apoyo por parte de otros profesionales. Para reforzar la percepción de la utilidad del checklist quirúrgico, se considera necesario realizar acciones de mejora para aumentar la participación de todos los profesionales, especialmente el personal sénior y los líderes quirúrgicos.

Palabras clave:
Listado de verificación quirúrgica
Seguridad del paciente
Mejora de la calidad asistencial
Factores humanos
Estudio basado en un cuestionario

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